脑脊液体液免疫在多发性硬化症鉴别诊断中的作用
Cerebrospinal fluid humoral immunity in the differential diagnosis of multiple sclerosis.
作者信息
Bernitsas Evanthia, Khan Omar, Razmjou Sara, Tselis Alexandros, Bao Fen, Caon Christina, Millis Scott, Seraji-Bozorgzad Navid
机构信息
Department of Neurology, Wayne State School of Medicine, Detroit, MI, United States of America.
Department of Physical Medicine and Rehabilitation; Wayne State University School of Medicine, Detroit, MI, United States of America.
出版信息
PLoS One. 2017 Jul 20;12(7):e0181431. doi: 10.1371/journal.pone.0181431. eCollection 2017.
BACKGROUND
The diagnostic accuracy of cerebrospinal fluid oligoclonal bands (CSF-OCB) detected by isoelectric focusing (IEF) in patients with multiple sclerosis (MS) was evaluated in our study.
METHODS
Three hundred and twenty-one patients with MS and other central nervous system (CNS) immune mediated disorders were assessed (CIMD). Cerebrospinal fluid and matched serum samples were examined for the presence of OCB by IEF-IB (isoelectric focusing with immunoblotting).
RESULTS
Isolated oligoclonal bands (ISO-OCB) were the only predictor of MS diagnosis independent of age, gender and CSF-OCB. ISO-OCB ≥ 3.5 detected by IEF yielded a sensitivity of 98% and specificity of 87% in distinguishing MS from MS mimickers.
CONCLUSIONS
For the neurologist, a score of ≥ 4 ISO-OCB supports the diagnosis of MS. On the other hand, ISO-OCB ≤3 favors CIMD. Further studies with larger population samples are warranted to confirm these findings.
背景
在我们的研究中，评估了通过等电聚焦（IEF）检测脑脊液寡克隆区带（CSF-OCB）对多发性硬化症（MS）患者的诊断准确性。
方法
对321例患有MS和其他中枢神经系统（CNS）免疫介导性疾病（CIMD）的患者进行了评估。通过IEF-IB（等电聚焦免疫印迹法）检测脑脊液和匹配的血清样本中OCB的存在情况。
结果
孤立寡克隆区带（ISO-OCB）是独立于年龄、性别和CSF-OCB的MS诊断唯一预测指标。通过IEF检测ISO-OCB≥3.5在区分MS与MS模仿者时，灵敏度为98%，特异性为87%。
结论
对于神经科医生来说，ISO-OCB评分≥4支持MS的诊断。另一方面，ISO-OCB≤3则倾向于CIMD。需要更大样本量的进一步研究来证实这些发现。
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