Oligoclonal band
Oligoclonal bands are bands of immunoglobulins that are seen when a patient's blood serum, gained from blood plasma, or cerebrospinal fluid (CSF) is analyzed.
Two methods of analysis are possible: (a) protein electrophoresis, a method of analyzing the composition of fluids, also known as "agarose gel electrophoresis/Coomassie Blue staining", and (b) the combination of isoelectric focusing/silver staining. The latter is more sensitive.[1]
For the analysis of cerebrospinal fluid, a patient has a lumbar puncture performed, which collects some of his or her cerebrospinal fluid.
Each of the two to five oligoclonal bands seen by protein electrophoresis represent proteins (or protein fragments) secreted by plasma cells, although why exactly these bands are present, and which proteins these bands represent, has not yet been fully elucidated. HHV-6 and EBV specific antibodies have been found in approximately 40% of MS patients with oligoclonal bands.[2] HHV-6 specific OCBs have also been found in other demyelinating diseases.[3][4] A lytic protein of HHV-6A virus was identified as the target of HHV-6 specific oligoclonal bands.[5][6]
Diagnostic value
The presence of oligoclonal bands in cerebrospinal fluid combined with their absence in blood serum often indicates that immunoglobulins are produced in central nervous system. Therefore it is normal to subtract bands in serum from bands in CSF when investigating CNS diseases.
Oligoclonal bands are an important indicator in the diagnosis of multiple sclerosis. Approximately 79%-90% of all patients with multiple sclerosis have permanently observable oligoclonal bands.
The presence of one band (a monoclonal band) may be considered serious, such as lymphoproliferative disease, or may simply be normal—it must be interpreted in the context of each specific patient. More bands may reflect the presence of a disease. The bands tend to disappear from the cerebrospinal fluid as a person recovers from the neurological disease.
Diseases associated
Oligoclonal bands are found in:
- Multiple sclerosis
- Lyme Disease
- Neuromyelitis optica (Devic's disease)
- Systemic lupus erythematosus
- Neurosarcoidosis
- Subacute sclerosing panencephalitis
- Subarachnoid hemorrhage
- Syphilis
- Primary central nervous system lymphoma
- Sjögren's Syndrome
- Guillain-Barre Syndrome
- Meningeal carcinomatosis
- Multiple Myeloma
- Parry–Romberg syndrome
External links
- Oligoclonal bands in multiple sclerosis - The Medical School, Birmingham University
- Oligoclonal Bands in CSF - ClinLab Navigator
References
- ↑ Oligoclonal bands in cerebrospinal fluids: significance of corresponding bands in serum for diagnosis of multiple sclerosis,
- ↑ http://www.ncbi.nlm.nih.gov/pubmed/23722324
- ↑ http://www.ncbi.nlm.nih.gov/pubmed/21767883
- ↑ http://www.ncbi.nlm.nih.gov/pubmed/25088617
- ↑ http://www.ncbi.nlm.nih.gov/pubmed/24724742
- ↑ http://hhv-6foundation.org/news/hhv-6a-protein-identified-in-spinal-fluid-of-patients-with-ms-a-case-of-molecular-mimicry