title: Latitude and HLA-DRB1 alleles independently affect the emergence of cerebrospinal fluid IgG abnormality in multiple sclerosis.
abstract: BACKGROUND
  It is unclear whether the prevalence of oligoclonal IgG bands (OCBs) in multiple sclerosis (MS) is different between northern and southern regions of Asia.
  
  
  OBJECTIVE
  This study aimed to compare the prevalence of OCBs and positive cerebrospinal fluid (CSF) findings between northern and southern regions of Japan and to investigate the association of these CSF findings with HLA-DRB1 alleles.
  
  
  METHODS
  The study included 180 MS patients from Hokkaido (northern Japan) and 184 patients from Kyushu (southern Japan). The IgG index was defined as increased if it was >0.658. Presence of CSF OCBs and/or increased IgG index was defined as positive CSF findings.
  
  
  RESULTS
  Positive CSF findings and OCB positivity were significantly higher in MS patients from Hokkaido than in those from Kyushu (p < 0.0001 for both). Logistic regression analysis revealed that after adjusting for covariates that can be related to abnormal CSF IgG production, the geographic region (Hokkaido) showed odds ratios (ORs) of 4.08 and 2.57, whereas the HLA-DRB1*04:05 allele showed ORs of 0.36 and 0.30 for positive CSF findings and OCB positivity, respectively.
  
  
  CONCLUSIONS
  The results indicate that latitude and HLA-DRB1 alleles independently affect the emergence of CSF IgG abnormalities in Japanese patients with MS.
authors.affiliation: Department of Clinical Research, Hokkaido Medical Center, Japan niino@hok-mc.hosp.go.jp.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Niino
authors.affiliation: Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Sato
authors.affiliation: Sapporo Neurology Clinic, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Fukazawa
authors.affiliation: Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yoshimura
authors.affiliation: Department of Neurology, School of Medicine, Sapporo Medical University, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Hisahara
authors.affiliation: Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Matsushita
authors.affiliation: Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Isobe
authors.affiliation: Department of Neurology, Asahikawa Red Cross Hospital, Japan.
authors.forename: Kazuto
authors.initials: K
authors.lastname: Yoshida
authors.affiliation: Department of Neurology, Obihiro Kosei General Hospital, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Houzen
authors.affiliation: Department of Clinical Research, Hokkaido Medical Center, Japan/Department of Neurology, Hokkaido Medical Center, Japan.
authors.forename: Yusei
authors.initials: Y
authors.lastname: Miyazaki
authors.affiliation: Department of Neurology, School of Medicine, Sapporo Medical University, Japan.
authors.forename: Shun
authors.initials: S
authors.lastname: Shimohama
authors.affiliation: Department of Neurology, Hokkaido Medical Center, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Kikuchi
authors.affiliation: Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Japan.
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Kira
mesh_terms: D000328:Adult; D000483:Alleles; D005260:Female; D020022:Genetic Predisposition to Disease / Q000453:epidemiology / Q000235:genetics; D005838:Genotype; D059811:HLA-DRB1 Chains / Q000235:genetics*; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid*; D007525:Isoelectric Focusing; D007564:Japan / Q000453:epidemiology; D008297:Male; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid / Q000453:epidemiology* / Q000235:genetics*; D016017:Odds Ratio; D043025:Oligoclonal Bands / Q000134:cerebrospinal fluid*; D015995:Prevalence
chemical_list: D059811:HLA-DRB1 Chains; D007074:Immunoglobulin G; D043025:Oligoclonal Bands
keywords: IgG index; MRI; Multiple sclerosis; cerebrospinal fluid; human leukocyte antigen; oligoclonal IgG band