Detection of oligoclonal immunoglobulins in cerebrospinal fluid by an immunofixation-peroxidase method.
BACKGROUND
The detection of intrathecal synthesis of immunoglobulins is used in the diagnosis of multiple sclerosis (MS). We tested the semiautomated immunofixation-peroxidase (IFPOD) technique, which uses high-resolution agarose gel electrophoresis (HRAGE) directly followed by immunofixation with a peroxidase-labeled anti-IgG antiserum to detect oligoclonal immunoglobulins in cerebrospinal fluid (CSF).


METHODS
We analyzed 230 consecutive matched serum/CSF pairs that arrived in the laboratory over a 6-month period with both IFPOD and our routine techniques, immunofixation electrophoresis (IFE) and HRAGE. For IFPOD, CSF samples were not concentrated before testing.


RESULTS
Among the 230 samples were 12 clinically definite MS, 33 clinically probable, and 20 clinically possible MS samples. IFPOD and HRAGE + IFE each detected oligoclonal IgG in CSF in 10, 16, and 7 cases of these respective groups. For clinically definite MS, sensitivity and specificity (95% confidence intervals) were, respectively, 83% (51-97%) and 79% (73-84%).


CONCLUSIONS
The IFPOD technique performs comparably to other analytical methods, without the requirement for sample concentration, and may represent an attractive alternative in testing for intrathecal immunoglobulin synthesis.
Richard
Sophie
S
Laboratory of Immunology, Centre Hospitalier Régional et Universitaire de Bordeaux, 33076 Bordeaux, France.
Miossec
Véronique
V
Moreau
Jean-François
JF
Taupin
Jean-Luc
JL
D000328:Adult; D015415:Biomarkers / Q000097:blood / Q000134:cerebrospinal fluid; D004587:Electrophoresis, Agar Gel; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007074:Immunoglobulin G / Q000097:blood / Q000134:cerebrospinal fluid; D007136:Immunoglobulins / Q000097:blood / Q000134:cerebrospinal fluid*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis; D043025:Oligoclonal Bands
D015415:Biomarkers; D007074:Immunoglobulin G; D007136:Immunoglobulins; D043025:Oligoclonal Bands