Cerebrospinal fluid oligoclonal bands in Chinese patients with multiple sclerosis: the prevalence and its association with clinical features

• Published in: Frontiers in immunology 2023-11, Vol.14, p.1280020-1280020
• Main Authors: Zhang, Xiang, Hao, Hongjun, Jin, Tao, Qiu, Wei, Yang, Huan, Xue, Qun, Yin, Jian, Shi, Ziyan, Yu, Hai, Ji, Xiaopei, Sun, Xiaobo, Zeng, Qiuming, Liu, Xiaoni, Wang, Jingguo, Li, Huining, He, Xiaoyan, Yang, Jing, Li, Yarong, Liu, Shuangshuang, Lau, Alexander Y, Gao, Feng, Hu, Shimin, Chu, Shuguang, Ding, Ding, Zhou, Hongyu, Li, Haifeng, Chen, Xiangjun
• Format: Article
• Language: English
• Subjects: cerebrospinal fluid; China; diagnostic performance; East Asian People; Humans; Immunology; multiple sclerosis; Multiple Sclerosis - diagnosis; Multiple Sclerosis - epidemiology; oligoclonal bands; Oligoclonal Bands - cerebrospinal fluid; Prevalence; Prospective Studies; Retrospective Studies
• ISSN: 1664-3224; 1664-3224
• DOI: 10.3389/fimmu.2023.1280020

Cerebrospinal fluid oligoclonal band (CSF-OCB) is an established biomarker in diagnosing multiple sclerosis (MS), however, there are no nationwide data on CSF-OCB prevalence and its diagnostic performance in Chinese MS patients, especially in the virtue of common standard operation procedure (SOP). With a consensus SOP and the same isoelectric focusing system, we conducted a nationwide multi-center study on OCB status in consecutively, and recruited 483 MS patients and 880 non-MS patients, including neuro-inflammatory diseases (NID, n = 595) and non-inflammatory neurological diseases (NIND, n=285). Using a standardized case report form (CRF) to collect the clinical, radiological, immunological, and CSF data, we explored the association of CSF-OCB positivity with patient characters and the diagnostic performance of CSF-OCB in Chinese MS patients. Prospective source data collection, and retrospective data acquisition and statistical data analysis were used. 369 (76.4%) MS patients were OCB-positive, while 109 NID patients (18.3%) and 6 NIND patients (2.1%) were OCB-positive, respectively. Time from symptom onset to diagnosis was significantly shorter in OCB-positive than that in OCB-negative MS patients (13.2 vs 23.7 months, P=0.020). The prevalence of CSF-OCB in Chinese MS patients was significantly higher in high-latitude regions (41°-50°N)(P=0.016), and at high altitudes (>1000m)(P=0.025). The diagnostic performance of CSF-OCB differentiating MS from non-MS patients yielded a sensitivity of 76%, a specificity of 87%. The nationwide prevalence of CSF-OCB was 76.4% in Chinese MS patients, and demonstrated a good diagnostic performance in differentiating MS from other CNS diseases. The CSF-OCB prevalence showed a correlation with high latitude and altitude in Chinese MS patients.