Receptor revision and atypical mutational characteristics in clonally expanded B cells from the cerebrospinal fluid of recently diagnosed multiple sclerosis patients.

To determine whether cerebrospinal fluid (CSF) B cells exhibit clonal expansion in patients recently diagnosed with multiple sclerosis (MS). CSF B cell clonal expansion was detected early in the disease process. Evidence of receptor revision was present in at least one MS patient who had been recently diagnosed with MS. Targeting of mutations to RGYW/WRCY motifs within CDRs was nominally observed in the CSF B cell clones despite the high mutational frequencies (MF). These observations are consistent with the presence of intense specific B cell stimulation and expansion in the CNS of MS patients early in the disease process.