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

Xiang Zhang; Hongjun Hao; Tao Jin; Wei Qiu; Huan Yang; Qun Xue; Jian Yin; Ziyan Shi; Hai Yu; Xiaopei Ji; Xiaobo Sun; Qiuming Zeng; Xiaoni Liu; Jingguo Wang; Huining Li; Xiaoyan He; Jing Yang; Yarong Li; Shuangshuang Liu; Alexander Y Lau; Feng Gao; Shimin Hu; Shuguang Chu; Ding Ding; Hongyu Zhou; Haifeng Li; Xiangjun Chen

doi:10.3389/fimmu.2023.1280020

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

Front Immunol. 2023 Nov 16:14:1280020. doi: 10.3389/fimmu.2023.1280020. eCollection 2023.

Authors

Xiang Zhang¹, Hongjun Hao², Tao Jin³, Wei Qiu⁴, Huan Yang⁵, Qun Xue⁶, Jian Yin⁷, Ziyan Shi⁸, Hai Yu¹, Xiaopei Ji⁶, Xiaobo Sun⁴, Qiuming Zeng⁵, Xiaoni Liu¹, Jingguo Wang¹, Huining Li⁹, Xiaoyan He¹⁰, Jing Yang¹¹, Yarong Li¹, Shuangshuang Liu¹², Alexander Y Lau¹³, Feng Gao², Shimin Hu^{12

14}, Shuguang Chu¹⁵, Ding Ding¹, Hongyu Zhou⁸, Haifeng Li¹², Xiangjun Chen¹

Affiliations

¹ Department of Neurology, Huashan Hospital, Fudan University and Institute of Neurology, Fudan University, National Center for Neurological Disorders, Shanghai, China.
² Department of Neurology, Peking University First Hospital, Beijing, China.
³ Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, China.
⁴ Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
⁵ Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.
⁶ Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China.
⁷ Department of Neurology, Beijing Hospital, Beijing, China.
⁸ Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
⁹ Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China.
¹⁰ Department of Neurology, The Xinjiang Uygur Autonomous Region People's Hospital, Urumqi, China.
¹¹ Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
¹² Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
¹³ Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.
¹⁴ Department of Clinical Epidemiology and Evidence-Based Medicine, Xuanwu Hospital Capital Medical University, Beijing, China.
¹⁵ Department of Radiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.

Abstract

Background: 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).

Methods: 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.

Findings: 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%.

Interpretation: 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.

Keywords: China; cerebrospinal fluid; diagnostic performance; multiple sclerosis; oligoclonal bands; prevalence.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

East Asian People
Humans
Multiple Sclerosis* / diagnosis
Multiple Sclerosis* / epidemiology
Oligoclonal Bands / cerebrospinal fluid
Prevalence
Prospective Studies
Retrospective Studies

Substances

Oligoclonal Bands

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the Clinical Research Plan of SHDC (No. SHDC2020CR2027B), 2020 Medical Service and Support Capacity Improvement Project: Construction of the Cohort-Based Multidisciplinary Accurate Diagnosis and Treatment Platform for Neurological Autoimmune and Infectious Diseases, and Shanghai Municipal Science and Technology Major Project (No. 2017SHZDZX01) and State Key Laboratory of Genetic Engineering, Human Phenome Institute, Zhangjiang Fudan International Innovation Center, Fudan University.