Cerebrospinal fluid oligoclonal bands in Chinese patients with multiple sclerosis: the prevalence and its association with clinical features

Author:

Zhang Xiang,Hao Hongjun,Jin Tao,Qiu Wei,Yang Huan,Xue Qun,Yin Jian,Shi Ziyan,Yu Hai,Ji Xiaopei,Sun Xiaobo,Zeng Qiuming,Liu Xiaoni,Wang Jingguo,Li Huining,He Xiaoyan,Yang Jing,Li Yarong,Liu Shuangshuang,Lau Alexander Y.,Gao Feng,Hu Shimin,Chu Shuguang,Ding Ding,Zhou Hongyu,Li Haifeng,Chen Xiangjun

Abstract

BackgroundCerebrospinal fluid oligoclonal band (CSF-OCB) is an established biomarker in diagnosing multiple sclerosis (MS), however, there are no nationwide data on CSF-OCB prevalence and its diagnostic performance in Chinese MS patients, especially in the virtue of common standard operation procedure (SOP).MethodsWith a consensus SOP and the same isoelectric focusing system, we conducted a nationwide multi-center study on OCB status in consecutively, and recruited 483 MS patients and 880 non-MS patients, including neuro-inflammatory diseases (NID, n = 595) and non-inflammatory neurological diseases (NIND, n=285). Using a standardized case report form (CRF) to collect the clinical, radiological, immunological, and CSF data, we explored the association of CSF-OCB positivity with patient characters and the diagnostic performance of CSF-OCB in Chinese MS patients. Prospective source data collection, and retrospective data acquisition and statistical data analysis were used.Findings369 (76.4%) MS patients were OCB-positive, while 109 NID patients (18.3%) and 6 NIND patients (2.1%) were OCB-positive, respectively. Time from symptom onset to diagnosis was significantly shorter in OCB-positive than that in OCB-negative MS patients (13.2 vs 23.7 months, P=0.020). The prevalence of CSF-OCB in Chinese MS patients was significantly higher in high-latitude regions (41°-50°N)(P=0.016), and at high altitudes (>1000m)(P=0.025). The diagnostic performance of CSF-OCB differentiating MS from non-MS patients yielded a sensitivity of 76%, a specificity of 87%.InterpretationThe nationwide prevalence of CSF-OCB was 76.4% in Chinese MS patients, and demonstrated a good diagnostic performance in differentiating MS from other CNS diseases. The CSF-OCB prevalence showed a correlation with high latitude and altitude in Chinese MS patients.

Funder

Shanghai Municipal Hospital Development Center

Publisher

Frontiers Media SA

Subject

Immunology,Immunology and Allergy

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