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- Title
Increased cortical lesion load and intrathecal inflammation is associated with oligoclonal bands in multiple sclerosis patients: a combined CSF and MRI study.
- Authors
Farina, Gabriele; Magliozzi, Roberta; Pitteri, Marco; Reynolds, Richard; Rossi, Stefania; Gajofatto, Alberto; Benedetti, Maria Donata; Facchiano, Francesco; Monaco, Salvatore; Calabrese, Massimiliano
- Abstract
<bold>Background: </bold>Although IgG oligoclonal bands (OCBs) in the cerebrospinal fluid (CSF) are a frequent phenomenon in multiple sclerosis (MS) patients, their relationship with grey matter lesions, intrathecal/meningeal inflammation and clinical evolution has not been clarified yet. The aim of our study was to assess the relationship between the OCBs, the inflammatory/neurodegenerative CSF profile at diagnosis, the cortical lesion load and the clinical evolution after 10 years.<bold>Methods: </bold>This is a 10-year observational, cross-sectional study based on a combined MRI, cognitive and CSF profiling of the examined patients. Forty consecutive OCB-negative (OCB-) and 50 OCB-positive (OCB+) MS patients were included in this study. Both groups had mean disease duration of 10 years and were age and gender matched. Each patient underwent neurological and neuropsychological evaluation and 3-T MRI. Analysis of the presence and levels of 28 inflammatory mediators was performed in the CSF obtained from 10 OCB- MS, 11 OCB+ MS and 10 patients with other neurological conditions.<bold>Results: </bold>Increased number of CLs was found in OCB+ compared to OCB- patients (p < 0.0001), whereas no difference was found in white matter lesion (WML) load (p = 0.36). The occurrence of OCB was also associated with increased levels of neurofilament light chains and of several inflammatory mediators linked to B lymphocyte activity and lymphoid-neogenesis (CXCL13, CXCL12, CXCL10, TNFSF13, TNFSF13B, IL6, IL10) and other pro-inflammatory molecules, such as IFN-γ, TNF, MMP2, GM-CSF, osteopontin and sCD163. Finally, the occurrence of OCB was found associated with poor prognosis, from both physical and cognitive points of view.<bold>Conclusions: </bold>OCB at MS onset are associated with more severe GM pathology and with a more severe physical disability and cognitive impairment after 10 years. Increased levels of cytokines linked to B cell activation, lymphoid-neogenesis, and pro-inflammatory immune response in the CSF of OCB+ patients support the hypothesis of crucial role played by compartmentalized, intrathecal B cell response in the pathogenesis of CLs and OCB production.
- Subjects
SPINAL canal diseases; OLIGOCLONAL bands; BIOMARKERS; CEREBROSPINAL fluid; MULTIPLE sclerosis; GRAY matter (Nerve tissue); PATIENTS; B cells; CEREBRAL cortex; COGNITION disorders; CYTOKINES; GRANULOCYTE-macrophage colony-stimulating factor; INFLAMMATION; LONGITUDINAL method; PROTEINS; PROTEOLYTIC enzymes; CROSS-sectional method; DISEASE complications
- Publication
Journal of Neuroinflammation, 2017, Vol 14, p1
- ISSN
1742-2094
- Publication type
journal article
- DOI
10.1186/s12974-017-0812-y