Contributions
Abstract: P481
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - 15 Immunology
Background: The presence of oligoclonal IgM bands (OCMB) was found associated with poor MS prognosis in adult MS patients. These data were validated in independent cohorts. Oligoclonal IgG bands (OCGB) also associate with an earlier disability progression in MS. The intrathecal immunoglobulin synthesis (ITMS) has recently shown to associate with the genetic background in MS. The aim of our study was to evaluate the prognostic value of ITMS in a big cohort of Sardinian patients.
Materials: We enrolled MS patients diagnosed in accordance with McDonald 2010 criteria. All of them were randomly recruited from the MS Centre of the University of Cagliari from 2007 until to 2013 and underwent lumbar puncture (LP) for diagnostic purpose.
Methods: For each patient were recorded demographic data, clinical course at LP, time to reach EDSS 3, 6, 8, 10, EDSS at last follow-up (2016), MS treatments until the last follow-up. The analysis of ITMS was performed by isoelettrofocusing and immunoblotting, using specific anti-human IgM antibodies, as described by Villar in 2011, but using different migration conditions. The influence of gender, clinical course, age at onset, disease modifying drugs and ITMS on reaching EDSS 3 was analysed with Cox regression, while Kaplan-Meier curves were used to study the time to reach EDSS 3 considering ITMS and therapies.
Results: The enrolled subjects were 503: 479 relapsing-remitting (RR) and 24 primary progressive (PP); 416 patients started a MS treatment. Cox regression showed that the variables influencing the achievement of EDSS 3 were male gender (p=0,005), clinical course PP (p=0,001), age at onset (p< 0,001), and treatment with disease modifying drugs (p< 0,001). The influence of OCGB and OCMB was not significant. The Kaplan-Meier analysis showed that the time to reach EDSS 3 is not different in patients with and without OCGB or OCMB both in treated and not treated groups.
Discussion and conclusion: Our study did not confirm in a large sample size of patients the prognostic value of IgG and IgM in terms of clinical course and time to reach the EDSS 3. To explain our results, we could hypothesize a role of genetic factors, having MS Sardinian patients peculiar predisposing and protective genotype. We will study in the next future this aspect.
References:
Villar LM, et al. Neurology 2002
Villar LM, et al. Ann Neurol 2003
Thangarajh M et al. Multiple Sclerosis 2008
Tintoré M, et al. Brain 2015
Disclosure: The authors have nothing to disclose about this work
Abstract: P481
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - 15 Immunology
Background: The presence of oligoclonal IgM bands (OCMB) was found associated with poor MS prognosis in adult MS patients. These data were validated in independent cohorts. Oligoclonal IgG bands (OCGB) also associate with an earlier disability progression in MS. The intrathecal immunoglobulin synthesis (ITMS) has recently shown to associate with the genetic background in MS. The aim of our study was to evaluate the prognostic value of ITMS in a big cohort of Sardinian patients.
Materials: We enrolled MS patients diagnosed in accordance with McDonald 2010 criteria. All of them were randomly recruited from the MS Centre of the University of Cagliari from 2007 until to 2013 and underwent lumbar puncture (LP) for diagnostic purpose.
Methods: For each patient were recorded demographic data, clinical course at LP, time to reach EDSS 3, 6, 8, 10, EDSS at last follow-up (2016), MS treatments until the last follow-up. The analysis of ITMS was performed by isoelettrofocusing and immunoblotting, using specific anti-human IgM antibodies, as described by Villar in 2011, but using different migration conditions. The influence of gender, clinical course, age at onset, disease modifying drugs and ITMS on reaching EDSS 3 was analysed with Cox regression, while Kaplan-Meier curves were used to study the time to reach EDSS 3 considering ITMS and therapies.
Results: The enrolled subjects were 503: 479 relapsing-remitting (RR) and 24 primary progressive (PP); 416 patients started a MS treatment. Cox regression showed that the variables influencing the achievement of EDSS 3 were male gender (p=0,005), clinical course PP (p=0,001), age at onset (p< 0,001), and treatment with disease modifying drugs (p< 0,001). The influence of OCGB and OCMB was not significant. The Kaplan-Meier analysis showed that the time to reach EDSS 3 is not different in patients with and without OCGB or OCMB both in treated and not treated groups.
Discussion and conclusion: Our study did not confirm in a large sample size of patients the prognostic value of IgG and IgM in terms of clinical course and time to reach the EDSS 3. To explain our results, we could hypothesize a role of genetic factors, having MS Sardinian patients peculiar predisposing and protective genotype. We will study in the next future this aspect.
References:
Villar LM, et al. Neurology 2002
Villar LM, et al. Ann Neurol 2003
Thangarajh M et al. Multiple Sclerosis 2008
Tintoré M, et al. Brain 2015
Disclosure: The authors have nothing to disclose about this work