Contributions
Abstract: EP1558
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - Biomarkers
Background/aim: Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system. Intrathecal synthesis of immunoglobulin G (IgG), which is a major diagnostic hallmark of MS, can be demonstrated in about 95% of patients by the detection of oligoclonal IgG bands (OCB) in the cerebrospinal fluid (CSF). It has been suggested, that OCB can be found not only in the CSF, but also in the tear fluid of MS patients. However, data on pre-analytical standardization of tear fluid collection and analysis are not well established. Therefore, we aimed to develop a standardized collection method to subsequently allow the investigation of tear fluid samples from MS patients.
Methods: Tear fluid was collected using Schirmer test strips and plastic capillary tubes. The collection methods were established with the help of healthy controls (n=12) and compared regarding feasibility, safety and convenience. In a second step, samples were collected from patients (n=37), whose experiences were recorded on a questionnaire. OCB were analysed in tear fluid, CSF and serum samples from 22 MS patients by isoelectric focusing (IEF) followed by immunoblot.
Results: Both methods were tolerated well and allowed the collection of small volumes of tear fluid without any report of adverse events. The detection method was adjusted to account for the small volume as well as the high protein and low IgG concentration of tear fluid. In first IEF experiments one or more IgG bands with differing pattern when compared to CSF and serum OCB were detected in the tear fluid of 14 out of 20 analysable MS patient samples.
Discussion: The tested sampling methods allowed the collection and subsequent investigation of tear fluid. Despite particular properties of tear fluid, which required adjustments in the analysis method, first results indicate that IgG bands can indeed be detected in the tear fluid of MS patients. The detection of inflammatory signs in tear fluid of MS patients implies interesting possibilities for research and diagnostics. Next steps include the refinement of analytical methods and further sample collection from patients with MS as well as other inflammatory and non-inflammatory neurological diseases.
Disclosure: F.B. has no conflict of interest to declare.
M.S. has received honoraria for speaking and/or travel grants from Bayer, Teva and Biogen and research funding from the Hertha-Nathorff-Program, none related to this study.
A.H.: nothing to disclose.
H.T. received funding for research projects, lectures and travel from Bayer, Biogen, Genzyme, Fresenius, Merck, Novartis, Roche, Siemens Health Diagnostics, Teva, and received research support from DMSG, Hertie-Stiftung, BMBF, University of Ulm and Landesstiftung BW.
The investigator initiated study was supported by Merck KGaA Darmstadt, Germany and the University Hospital Ulm.
Abstract: EP1558
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - Biomarkers
Background/aim: Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system. Intrathecal synthesis of immunoglobulin G (IgG), which is a major diagnostic hallmark of MS, can be demonstrated in about 95% of patients by the detection of oligoclonal IgG bands (OCB) in the cerebrospinal fluid (CSF). It has been suggested, that OCB can be found not only in the CSF, but also in the tear fluid of MS patients. However, data on pre-analytical standardization of tear fluid collection and analysis are not well established. Therefore, we aimed to develop a standardized collection method to subsequently allow the investigation of tear fluid samples from MS patients.
Methods: Tear fluid was collected using Schirmer test strips and plastic capillary tubes. The collection methods were established with the help of healthy controls (n=12) and compared regarding feasibility, safety and convenience. In a second step, samples were collected from patients (n=37), whose experiences were recorded on a questionnaire. OCB were analysed in tear fluid, CSF and serum samples from 22 MS patients by isoelectric focusing (IEF) followed by immunoblot.
Results: Both methods were tolerated well and allowed the collection of small volumes of tear fluid without any report of adverse events. The detection method was adjusted to account for the small volume as well as the high protein and low IgG concentration of tear fluid. In first IEF experiments one or more IgG bands with differing pattern when compared to CSF and serum OCB were detected in the tear fluid of 14 out of 20 analysable MS patient samples.
Discussion: The tested sampling methods allowed the collection and subsequent investigation of tear fluid. Despite particular properties of tear fluid, which required adjustments in the analysis method, first results indicate that IgG bands can indeed be detected in the tear fluid of MS patients. The detection of inflammatory signs in tear fluid of MS patients implies interesting possibilities for research and diagnostics. Next steps include the refinement of analytical methods and further sample collection from patients with MS as well as other inflammatory and non-inflammatory neurological diseases.
Disclosure: F.B. has no conflict of interest to declare.
M.S. has received honoraria for speaking and/or travel grants from Bayer, Teva and Biogen and research funding from the Hertha-Nathorff-Program, none related to this study.
A.H.: nothing to disclose.
H.T. received funding for research projects, lectures and travel from Bayer, Biogen, Genzyme, Fresenius, Merck, Novartis, Roche, Siemens Health Diagnostics, Teva, and received research support from DMSG, Hertie-Stiftung, BMBF, University of Ulm and Landesstiftung BW.
The investigator initiated study was supported by Merck KGaA Darmstadt, Germany and the University Hospital Ulm.