Spinal fluid oligoclonal bands: are they the secret to uncovering the cause of MS?

Epub ahead of printKorn & Tumani. Patterns of intrathecal autoreactive antibodies in MS using antigen microarrays. Neurology. 2012 Jan 18.  

The role of autoreactive antibodies in MS has received intense attention since the discovery of oligoclonal immunoglobulin (Ig) bands in the spinal fluid of the majority (>95%) of MS'ers. However, many questions remain. We still do not know whether the production of Ig in the brain of MS'ers is an epiphenomenon of CNS autoimmunity, resulting from growth factor-driven expansion of long-lived B cells (the cells that make antibodies) in the meningeal* compartment or whether Ig production from antigen-driven proliferation of B-cell clones contributes to CNS pathology. CSF Ig from oligoclonal bands is produced by CSF B lineage cells and primarily recognizes epitopes of multiple neurotropic viruses and Epstein-Barr virus antigens.  However, antimyelin antibodies also occur in the serum and CSF of patients with MS.

*meningeal or meninges = the layer of membranes to covers the brain and spinal cord

"In my opinion the secret to the cause of MS lies in uncovering the antigen or proteins against which the antibodies are directed. In disease with known causes (e.g. viral encephalitis) that have oligoclonal IgG bands, the bands react to proteins from the causative agent."

"Cosimo Maggiore in our group is completing a PhD to try and delineate the antigens against which OCBs in MS'ers react. The project has a long way to run. Let's hope he gets there."