Band typ o positive3/16/2023 ![]() ![]() Some reports point that the underlying condition that causes the MS lesions in these patients is different. It is known since long ago that OCB negative MS patients have a slower evolution. Other application for OCBs is as a tool to classify patients. The last available reports in 2017 were pointing to a sensitivity of 98% and specificity of 87% for differential diagnosis versus MS mimickers (specificity respect unselected population should be equal or higher). Up to 95% of all patients with multiple sclerosis have permanently observable oligoclonal bands at least for those with European ancestry. Oligoclonal bands are an important indicator in the diagnosis of multiple sclerosis. Nevertheless, OCBs remain useful as a biomarker. Though early theories assumed that the OCBs were somehow pathogenic autoantigens, recent research has shown that the IgG present in the OCBs are antibodies against debris, and therefore, OCBs seem to be just a secondary effect of MS. A lytic protein of HHV-6A virus was identified as the target of HHV-6 specific oligoclonal bands. HHV-6 specific OCBs have also been found in other demyelinating diseases. In 40% of MS patients with OCBs, antibodies specific to the viruses HHV-6 and EBV have been found. The target antigens for these antibodies are not easy to find because it requires to isolate a single kind of protein in each band, though new techniques are able to do so. Each one of them represent antibody 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. ![]() New techniques like "capillary isoelectric focusing immunoassay" are able to detect IgG OCBs in more than 95% of multiple sclerosis patients. After all these bands are localized, OCBs should be assessed in the γ region which normally hosts small group of polyclonal immunoglobulins. As expected large molecular proteins are absent in CSF column. CSF has a relatively higher concentration of prealbumin than does serum. Transferrin is another prominent protein on CSF column because its small molecular size easily increases its filtration in to CSF. Albumin is typically the dominant band on both fluids. After this dilution/concentration prealbumin appears as higher on CSF. Typically for an OCB analysis, the CSF is concentrated and the serum is diluted. The presence of these IgM OCBs is associated with a more severe course. In MS, normally only OCBs made of immunoglobulin G antibodies are considered, though sometimes other proteins can be taken into account, like lipid-specific immunoglobulin M. OCBs are especially important for multiple sclerosis (MS). ![]() 1 Oligoclonal bands in multiple sclerosis.Therefore, it is normal to subtract bands in serum from bands in CSF when investigating CNS diseases. Normally it is assumed that all the proteins that appear in the CSF, but are not present in the serum, are produced intrathecally (inside the central nervous system). The blood serum can be gained from a clotted blood sample. įor the analysis of cerebrospinal fluid, a patient has a lumbar puncture performed, which collects some of his or her cerebrospinal fluid. Two methods of analysis are possible: (a) protein electrophoresis, a method of analyzing the composition of fluids, also known as "SDS-PAGE (sodium dodecyl sulphate polyacrylamide gel electrophoresis)/ Coomassie blue staining", and (b) the combination of isoelectric focusing/silver staining. They are used in the diagnosis of various neurological and blood diseases, especially in multiple sclerosis. Oligoclonal bands (OCBs) are bands of immunoglobulins that are seen when a patient's blood serum, or cerebrospinal fluid (CSF) is analyzed. Proteins separated by SDS-PAGE, Coomassie brilliant blue staining ![]()
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