title: Immunoglobulin M oligoclonal bands: biomarker of targetable inflammation in primary progressive multiple sclerosis.
abstract: OBJECTIVE
  To identify a biomarker distinguishing patients who, despite a primary progressive multiple sclerosis (PPMS) clinical course, may nonetheless benefit from immune therapy.
  
  
  METHODS
  The presence or absence of both immunoglobulin (Ig) G and IgM oligoclonal bands (OCB) was blindly examined in paired cerebrospinal fluid (CSF) and serum samples from a large PPMS patient cohort, and related to clinical and imaging evidence of focal inflammatory disease activity.
  
  
  RESULTS
  Using both cross-sectional samples and serial sampling in a subgroup of patients followed prospectively as part of the placebo-controlled OLYMPUS study of rituximab in PPMS, we found that the presence of CSF-restricted IgM OCB (but not of IgG OCB) is associated with an active inflammatory disease phenotype in PPMS patients. This finding was confirmed in an independent, multicenter validation cohort.
  
  
  CONCLUSIONS
  The presence of CSF IgM OCB may be a biomarker for a subset of PPMS patients with more active inflammatory disease, who may benefit from immune-directed treatments.
authors.affiliation: Immunology and Neurology Service, Multiple Sclerosis Unit, Ramón y Cajal University Hospital, Madrid, Spain.
authors.forename: Luisa M
authors.initials: LM
authors.lastname: Villar
authors.forename: Bonaventura
authors.initials: B
authors.lastname: Casanova
authors.forename: Nadia
authors.initials: N
authors.lastname: Ouamara
authors.forename: Manuel
authors.initials: M
authors.lastname: Comabella
authors.forename: Farzaneh
authors.initials: F
authors.lastname: Jalili
authors.forename: David
authors.initials: D
authors.lastname: Leppert
authors.forename: Clara
authors.initials: C
authors.lastname: de Andrés
authors.forename: Guillermo
authors.initials: G
authors.lastname: Izquierdo
authors.forename: Rafael
authors.initials: R
authors.lastname: Arroyo
authors.forename: Timuçin
authors.initials: T
authors.lastname: Avşar
authors.forename: Sergey V
authors.initials: SV
authors.lastname: Lapin
authors.forename: Trina
authors.initials: T
authors.lastname: Johnson
authors.forename: Xavier
authors.initials: X
authors.lastname: Montalbán
authors.forename: Oscar
authors.initials: O
authors.lastname: Fernández
authors.forename: Roberto
authors.initials: R
authors.lastname: Álvarez-Lafuente
authors.forename: Donna
authors.initials: D
authors.lastname: Masterman
authors.forename: María I
authors.initials: MI
authors.lastname: García-Sánchez
authors.forename: Francisco
authors.initials: F
authors.lastname: Coret
authors.forename: Aksel
authors.initials: A
authors.lastname: Siva
authors.forename: Evgeniy
authors.initials: E
authors.lastname: Evdoshenko
authors.forename: José C
authors.initials: JC
authors.lastname: Álvarez-Cermeño
authors.forename: Amit
authors.initials: A
authors.lastname: Bar-Or
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000134:cerebrospinal fluid; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000134:cerebrospinal fluid*; D007249:Inflammation / Q000134:cerebrospinal fluid / Q000276:immunology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000134:cerebrospinal fluid / Q000276:immunology*; D043025:Oligoclonal Bands / Q000134:cerebrospinal fluid*; D010641:Phenotype
chemical_list: D015415:Biomarkers; D007075:Immunoglobulin M; D043025:Oligoclonal Bands