Oligoclonal band positive and negative multiple sclerosis: do they represent clinically distinct subgroups of multiple sclerosis?

SMK Gamage, F.N. Nasim, A.A.D. Wickramarathna, W.M.W.C. Wijenayake, I Wijeweera, S.B Adikari, H.M.A. Sominanda

Research output: Contribution to conferenceAbstractResearchpeer-review

Abstract

The oligoclonal band test is an important investigation which aids diagnosis of
Multiple Sclerosis (MS). Isoelectric Focusing (IEF) and immunoblotting is the gold standard method for OCB detection according to current consensus. In a typical western MS population, 95-98% of patients are positive for OCB, reflecting an intrathecal antibody response parallel to the central nervous system inflammatory pathology. A genetic basis for this discrepancy has been reported in a number of studies. OCB positive patients are associated with HLA-DRB1*15 and negative with HLA-DRB1*04, suggesting the possibility of immunogenetically different subgroups that may have a different disease course, and outcome status with varied drug response and possibly prognosis. Therefore, the relationship of OCB status has been studied in relation to clinical presentation and outcome in patients with MS, but still the relationship remains unclear.

Thus, the objective of this study was to compare between OCB positive and negative MS populations in terms of clinical, demographic and investigation findings.

Thirty one definite MS patients diagnosed using McDonalds criteria were included in the study. Clinical and MRI features were documented and analyzed to compare between OCB positive and negative groups. All were tested for OCB in both serum and CSF samples.

Of the 31 MS patients, 14 (45.2%) were positive for OCB whereas 17 (54.8%) were
negative. Comparison of demographic features (i.e. gender, nationality), clinical subtype frequency (i.e. relapsing- remitting, secondary progressive or primary progressive MS), disease course and disability (EDSS) revealed no significant difference between OCB positive and negative groups. Similarly, comparison of clinical features (i.e. cerebral sensory, cerebral motor, cerebellar, etc.) revealed no significant difference. However, on comparison of MRI features, the presence of cervical cord lesions were significantly higher among the OCB positive group (p<0.01). The rest of the imaging features were not different between groups.

In conclusion, there are no major differences in presentation and clinical course of OCB positive and negative subgroups of MS. Yet, there are some differences seen in MRI findings reflecting an association between MS immunopathology and radiological manifestations of Sri Lankan MS. This might facilitate defining MS subtypes on OCB status with further studies on larger samples.
Original languageEnglish
Pages145-145
Number of pages1
Publication statusPublished - 4 Nov 2016
Externally publishedYes
EventPERADENIYA UNIVERSITY INTERNATIONAL RESEARCH SESSIONS: iPURSE 2016 - University of Peradeniya, Sri Lanka
Duration: 4 Nov 20165 Nov 2016
https://site.pdn.ac.lk/ipurse/2016/ (2016 conference website)

Conference

ConferencePERADENIYA UNIVERSITY INTERNATIONAL RESEARCH SESSIONS: iPURSE 2016
Abbreviated titleiPURSE 2016
Country/TerritorySri Lanka
Period4/11/165/11/16
OtheriPURSE-2016,the Annual International Research Sessions of the University of Peradeniya, hosted by the Faculty of Dental Sciences will be held on 4th and 5th November 2016.

The University of Peradeniya, nestled in the foothills of the misty Hantana mountain range is a premier academic institution in Sri Lanka renowned for excellence in teaching and research. Located on the banks of the river Mahaweli, it is in close proximity to the Royal Botanical Gardens and the historic city of Kandy.

iPURSE-2016 aims to provide an open forum for researchers from different disciplines to deliberate on their research findings, exchange ideas, build partnerships and collaborations for the advancement of knowledge..
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