Cerebrospinal Fluid IgM and Oligoclonal IgG Bands in Multiple Sclerosis: A Meta-Analysis of Prevalence and Prognosis

The presence of intrathecal IgM synthesis (ITMS) has been associated with an aggressive multiple sclerosis (MS) clinical course. In the present systematic review, we aimed at assessing the prevalence of ITMS among different MS phenotypes. Moreover, we aimed at quantifying the risk of a second relaps...

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Autores principales:	Mattia Fonderico, Emilio Portaccio, Lorenzo Razzolini, Luisa Pastò, Angelo Bellinvia, Ilaria Addazio, Matteo Betti, Maria Grazia Aprea, Clara Ballerini, Tiziana Biagioli, Maria Pia Amato
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	multiple sclerosis biomarker intrathecal IgM synthesis oligoclonal bands Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
Acceso en línea:	https://doaj.org/article/2c725d62e9db4816ba5f02c4bc7e90ac
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spelling	oai:doaj.org-article:2c725d62e9db4816ba5f02c4bc7e90ac2021-11-25T16:57:33ZCerebrospinal Fluid IgM and Oligoclonal IgG Bands in Multiple Sclerosis: A Meta-Analysis of Prevalence and Prognosis10.3390/brainsci111114442076-3425https://doaj.org/article/2c725d62e9db4816ba5f02c4bc7e90ac2021-10-01T00:00:00Zhttps://www.mdpi.com/2076-3425/11/11/1444https://doaj.org/toc/2076-3425The presence of intrathecal IgM synthesis (ITMS) has been associated with an aggressive multiple sclerosis (MS) clinical course. In the present systematic review, we aimed at assessing the prevalence of ITMS among different MS phenotypes. Moreover, we aimed at quantifying the risk of a second relapse in ITMS positive and oligoclonal IgG bands (OCGBs)-positive patients. We selected clinical studies reporting the ITMS prevalence assessed as oligoclonal IgM Bands (OCMBs), lipid-specific OCMBs (LS-OCMBs), and/or as an intrathecal IgM production > 0% (IgMLoc, Reiber formula). The overall prevalence of ITMS was higher in relapsing-remitting (RR) than clinically isolated syndrome (CIS) patients (40.1% versus 23.8%, <i>p</i> < 0.00001), while was in line with that detected in primary progressive MS (PPMS, 26.7%). Almost all patients (98%) with ITMS had also OCGBs. The risk of having a second relapse was higher in OCGBs positive patients (HR = 2.18, <i>p</i> = 0.007) but much higher in ITMS positive patients (HR = 3.62, <i>p</i> = 0.0005). This study revealed that the prevalence of ITMS is higher in RRMS patients. It suggests that the risk of having a second relapse, previously ascribed to OCGBs, may, to a certain extent, be related to the presence of intrathecal IgM.Mattia FondericoEmilio PortaccioLorenzo RazzoliniLuisa PastòAngelo BellinviaIlaria AddazioMatteo BettiMaria Grazia ApreaClara BalleriniTiziana BiagioliMaria Pia AmatoMDPI AGarticlemultiple sclerosisbiomarkerintrathecal IgM synthesisoligoclonal bandsNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENBrain Sciences, Vol 11, Iss 1444, p 1444 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	multiple sclerosis biomarker intrathecal IgM synthesis oligoclonal bands Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
spellingShingle	multiple sclerosis biomarker intrathecal IgM synthesis oligoclonal bands Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Mattia Fonderico Emilio Portaccio Lorenzo Razzolini Luisa Pastò Angelo Bellinvia Ilaria Addazio Matteo Betti Maria Grazia Aprea Clara Ballerini Tiziana Biagioli Maria Pia Amato Cerebrospinal Fluid IgM and Oligoclonal IgG Bands in Multiple Sclerosis: A Meta-Analysis of Prevalence and Prognosis
description	The presence of intrathecal IgM synthesis (ITMS) has been associated with an aggressive multiple sclerosis (MS) clinical course. In the present systematic review, we aimed at assessing the prevalence of ITMS among different MS phenotypes. Moreover, we aimed at quantifying the risk of a second relapse in ITMS positive and oligoclonal IgG bands (OCGBs)-positive patients. We selected clinical studies reporting the ITMS prevalence assessed as oligoclonal IgM Bands (OCMBs), lipid-specific OCMBs (LS-OCMBs), and/or as an intrathecal IgM production > 0% (IgMLoc, Reiber formula). The overall prevalence of ITMS was higher in relapsing-remitting (RR) than clinically isolated syndrome (CIS) patients (40.1% versus 23.8%, <i>p</i> < 0.00001), while was in line with that detected in primary progressive MS (PPMS, 26.7%). Almost all patients (98%) with ITMS had also OCGBs. The risk of having a second relapse was higher in OCGBs positive patients (HR = 2.18, <i>p</i> = 0.007) but much higher in ITMS positive patients (HR = 3.62, <i>p</i> = 0.0005). This study revealed that the prevalence of ITMS is higher in RRMS patients. It suggests that the risk of having a second relapse, previously ascribed to OCGBs, may, to a certain extent, be related to the presence of intrathecal IgM.
format	article
author	Mattia Fonderico Emilio Portaccio Lorenzo Razzolini Luisa Pastò Angelo Bellinvia Ilaria Addazio Matteo Betti Maria Grazia Aprea Clara Ballerini Tiziana Biagioli Maria Pia Amato
author_facet	Mattia Fonderico Emilio Portaccio Lorenzo Razzolini Luisa Pastò Angelo Bellinvia Ilaria Addazio Matteo Betti Maria Grazia Aprea Clara Ballerini Tiziana Biagioli Maria Pia Amato
author_sort	Mattia Fonderico
title	Cerebrospinal Fluid IgM and Oligoclonal IgG Bands in Multiple Sclerosis: A Meta-Analysis of Prevalence and Prognosis
title_short	Cerebrospinal Fluid IgM and Oligoclonal IgG Bands in Multiple Sclerosis: A Meta-Analysis of Prevalence and Prognosis
title_full	Cerebrospinal Fluid IgM and Oligoclonal IgG Bands in Multiple Sclerosis: A Meta-Analysis of Prevalence and Prognosis
title_fullStr	Cerebrospinal Fluid IgM and Oligoclonal IgG Bands in Multiple Sclerosis: A Meta-Analysis of Prevalence and Prognosis
title_full_unstemmed	Cerebrospinal Fluid IgM and Oligoclonal IgG Bands in Multiple Sclerosis: A Meta-Analysis of Prevalence and Prognosis
title_sort	cerebrospinal fluid igm and oligoclonal igg bands in multiple sclerosis: a meta-analysis of prevalence and prognosis
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/2c725d62e9db4816ba5f02c4bc7e90ac
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Cerebrospinal Fluid IgM and Oligoclonal IgG Bands in Multiple Sclerosis: A Meta-Analysis of Prevalence and Prognosis

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