Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Medicina (Kaunas). 2011;47(7):368-73.
The aim of the present study was to determine the value of immunogenetic risk factors and to estimate their relationship with the clinical features and disability status of patients with multiple sclerosis in a Lithuanian population.
This was a prospective study of 80 patients with multiple sclerosis. The diagnosis of multiple sclerosis was based on the revised McDonald criteria. Oligoclonal bands (OCBs) of immunoglobulin G (IgG) were tested using isoelectric focusing and IgG specific immunofixation. HLA DRB1 alleles were genotyped using polymerase chain reaction.
Of all patients, 55% were positive for OCBs and 56% for HLA DRB11501. OCB-positive patients with multiple sclerosis had higher EDSS scores than their OCB-negative counterparts at onset of the disease (3.93±1.21 and 3.36±0.96 points, respectively; P=0.02) and during the last visit (4.31±2.06 and 3.09±1.98 points, respectively; P=0.009). The mean relapse rate was higher in the OCB-positive group compared with OCB-negative group (1.45±0.69 and 0.58±0.64, respectively; P=0.001). OCB-positive patients had higher IgG index compared with OCB-negative patients (P=0.0001). No relationship was found between HLA DRB11501 antigen status and the clinical features or EDSS score, and presence or absence of OCB in the present subset of patients with multiple sclerosis.
The presence of oligoclonal bands in the cerebrospinal fluid of the patients with multiple sclerosis was associated with the greater number of exacerbations, higher degree of disability, and higher IgG index. There were no significant associations between the presence of HLA DRB1*1501 allele and the clinical symptoms, course of disease, or disability score.
本研究旨在确定免疫遗传风险因素的价值，并评估其与立陶宛人群中多发性硬化症患者的临床特征和残疾状况的关系。
这是一项对 80 例多发性硬化症患者的前瞻性研究。多发性硬化症的诊断基于修订后的 McDonald 标准。使用等电聚焦和 IgG 特异性免疫固定电泳检测免疫球蛋白 G（IgG）的寡克隆带（OCB）。使用聚合酶链反应对 HLA DRB1 等位基因进行基因分型。
所有患者中，55%的 OCB 阳性，56%的 HLA DRB11501 阳性。多发性硬化症的 OCB 阳性患者在疾病发作时（分别为 3.93±1.21 和 3.36±0.96 分；P=0.02）和最后一次就诊时（分别为 4.31±2.06 和 3.09±1.98 分；P=0.009）的 EDSS 评分高于 OCB 阴性患者。OCB 阳性组的平均复发率高于 OCB 阴性组（分别为 1.45±0.69 和 0.58±0.64；P=0.001）。OCB 阳性患者的 IgG 指数高于 OCB 阴性患者（P=0.0001）。在本多发性硬化症患者亚组中，未发现 HLA DRB11501 抗原状态与临床特征或 EDSS 评分之间以及 OCB 的存在或缺失之间存在相关性。
多发性硬化症患者脑脊液中存在寡克隆带与更多的恶化、更高的残疾程度和更高的 IgG 指数相关。HLA DRB1*1501 等位基因的存在与临床症状、疾病过程或残疾评分之间没有显著关联。
