寡克隆区带检测在中枢神经系统疾病诊断中的应用

doi:10.3969/j.issn.1673-8640.2015.11.022

检验医学 ›› 2015, Vol. 30 ›› Issue (11): 1157-1160.DOI: 10.3969/j.issn.1673-8640.2015.11.022

寡克隆区带检测在中枢神经系统疾病诊断中的应用

孟俊¹, 彭奕冰¹, 张冬青²

1.上海交通大学医学院附属瑞金医院检验科,上海 200025
2.上海交通大学医学院上海市免疫学研究所,上海 200025

收稿日期:2017-06-14 出版日期:2015-11-30 发布日期:2015-12-03
作者简介:null
作者简介:孟俊,男,1982年生,学士,主管技师,主要从事免疫学检验相关研究。

通讯作者:张冬青,联系电话:021-63846590-776556。
基金资助:
国家自然科学基金面上项目(31270963);上海市科委重点连续资助项目(10JC1408500);上海市科委生物医药领域科技支撑项目(14431903700);上海交通大学医学院附属瑞金医院优青项目(8003)

Application of oligoclonal bands in the diagnosis of central nervous system diseases

MENG Jun¹, PENG Yibing¹, ZHANG Dongqing²

1.Department of Clinical Laboratory, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
2. Shanghai Institute of Immunology, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China

Received:2017-06-14 Online:2015-11-30 Published:2015-12-03

摘要/Abstract

摘要：

中枢神经系统(CNS)产生强免疫应答是某些自身免疫性神经系统疾病发生、发展的病理学基础,表现为脑脊液(CSF)中免疫球蛋白成分及含量的变化。CSF寡克隆区带(OCB)是数个B细胞系株(克隆)在CNS局部产生的特异抗体,是针对CNS内某些特定抗原的一种特异反应。CSF中OCB的出现往往高度提示有免疫球蛋白的鞘内合成。OCB 对 CNS 疾病的诊断及鉴别诊断有一定的临床意义,尤其对多发性硬化症(MS)等中枢神经脱髓鞘疾病的辅助诊断价值越来越受到人们瞩目。

关键词: 寡克隆区带, 中枢神经系统, 脑脊液, 诊断

Abstract:

The strong immune response produced by central nervous system(CNS)is the pathological basis on the occurrence and development of some autoimmune nervous diseases, characterized by immunoglobulin composition and content in cerebrospinal fluid(CSF).The CSF oligoclonal bands(OCB)are the specific antibodies produced by several B-cell strains(clone) located in CNS, which is a specific reaction for CNS.The presence of OCB in CSF often indicates that intrathecal immunoglobulin synthesis were produced in CNS.It has certain clinical significance to diagnose CNS diseases by OCB, especially for the diagnosis of CNS demyelinating diseases, like multiple sclerosis (MS).

Key words: Oligoclonal band, Central nervous system, Cerebrospinal fluid, Diagnosis

中图分类号:

R446.62

孟俊, 彭奕冰, 张冬青. 寡克隆区带检测在中枢神经系统疾病诊断中的应用[J]. 检验医学, 2015, 30(11): 1157-1160.

MENG Jun, PENG Yibing, ZHANG Dongqing. Application of oligoclonal bands in the diagnosis of central nervous system diseases[J]. Laboratory Medicine, 2015, 30(11): 1157-1160.

图/表 1

图1 常见的CSF-OCB 注:(a)患者CSF及血清样本中都未出现OCB,提示患者CNS未出现相关的免疫性疾病;(b)CSF样本中出现狭窄的、不连续的OCB,而血清样本相对应的位置并无区带,提示存在IgG鞘内合成;(c)患者CSF及血清样本均出现了同样的条带,且CSF还存在额外的区带,显示同时存在血脑屏障损伤及IgG鞘内合成;(d)CSF及血清样本均出现了完全相同的OCB,提示存在血脑屏障损伤;(e)CSF及血清样本出现了完全相同的连续均一的条带,为单克隆区带。虽然(b)、(c)、(d)和(e)图均提示产生了体液免疫反应,但仅(b)和(c)图提示存在IgG鞘内合成,是反映CNS病变的重要标志,可以判断为阳性结果[11]

参考文献 22

[1]	DEISENHAMMER F,BARTOS A,EGG R,et al.Guidelines on routine cerebrospinal fluid analysis.Report from an EFNS task force[J].Eur J Neurol,2006,13(9):913-922.
[2]	ANDERSSON M,ALVAREZS-CERMENO J, BERNARDI G, et al.Cerebrospinal fluid in the diagnosis of multiple sclerosis: a consensus report[J].J Neurol Neurosurg Psychiatry, 1994,57(8):897-902.
[3]	SOUVERJIN JH,SERREE HM,PEET R,et al.Intrathecal immunoglobulin synthssis.Comparison of various formulae with the 'gold standard' of isoelectric focusing[J].J Neurol Sci,1991,102(1):11-16.
[4]	CORREALE J,DE LOS MILAGROS BASSANI MOLINAS M. Oligoclonal bands and antibody responses in multiple sclerosis[J].J Neurol,2002,249(4):375-389.
[5]	HOLMOY T.The discovery of oligoclonal bands: a 50-year anniversary[J]. Eur Neurol, 2009, 62(5):311-315.
[6]	DISANTO G, MORAHAN JM, BARNETT MH, et al.The evidence for a role of B cells in multiple sclerosis[J].Neurology,2012,78(11):823-832.
[7]	KARUSSIS D, VOURKA-KARUSSIS U, MIZRACHI-KOLL R, et al.Acute/relapsing experimental autoimmune encephalomyelitis: induction of long lasting,antigen-specific tolerance by syngeneic bone marrow transplantation[J]. Mult Scler, 1999, 5(1): 17-21.
[8]	SKOV AG, SKOV T, FREDERIKSEN JL.Oligoclonal bands predict multiple sclerosis after optic neuritis: a literature survey[J].Mult Scler,2011 ,17(4):404-410.
[9]	PETZOLD A.Intrathecal oligoclonal IgG synthesis in multiple sclerosis[J].J Neuroimmunol,2013, 262(1-2):1-10.
[10]	吕礼应. 免疫透射比浊测定脑脊液免疫球蛋白[J].检验医学,2003 ,18(4): 223-225.
[11]	FRANCIOTTA D,BERGAMASCHI R, AMATO MP,et al.Clinical correlations of CSF single IgG bands[J].J Neurol,2005,252(10):1274-1275.
[12]	POLMAN CH,REINGOLD SC,EDAN G,et al.Diagnostic criteria for multiple sclerosis:2005 revisions to the"McDonald Criteria"[J]. Ann Neurol,2005,58(6):840-846.
[13]	方明,乔健.寡克隆区带和IgG指数对多发性硬化的诊断价值[J].临床神经病学杂志,2004,17(4):247-249.
[14]	NAKASHIMA I,FUJIHARA K,MISU T,et al.A comparative study of Japanese multiple sclerosis patients with and without oligoclonal IgG bands[J].Mult Scler,2002,8(6):459-462.
[15]	FUKAZAWA T,KIKUEHI S,SASAKI H,et al.The significance of oligoclonal bands in multiple sclerosis in Japan:relevance of immunogenetic backgrounds[J].J Neurol Sci,1998 ,158(2):209-214.
[16]	KIKUCHI S,FUKAZAWA T,NIINO M,et al.HLA-related subpopulations of MS in Japanese with and without oligoclonal IgG bands.Human leukocyte antigen[J].Neurology,2003, 60(4):647-651.
[17]	NAKASHIMA I,FUJIHARA K,MIYAZAWA H.Relevance of callosal and periventrieular MRI lesions to oligoelonal bands in multiple sclerosis[J].Acta Neurol Scand,2006,113(2):125-131.
[18]	HUTTNER HB, SCHELLINGER PD, STRUFFERT T, et al. MRI criteria in MS patients with negative and positive oligoclonal bands:equal fulfill-ment of Barkho's criteria but different lesion patterns[J].J Neurol,2009,256(7):1121-1125.
[19]	DOBSON R, RAMAGOPALAN S, DAVIS A, et al.Cerebrospinal fluid oligoclonal bands in multiple sclerosis and clinically isolated syndromes: a meta-analysis of prevalence, prognosis and effect of latitude[J].J Neurol Neurosurg Psychiatry,2013,84(8):909-914.
[20]	ZAFFARONI M.Cerebrospinal fluid fingings in Devic's neuromyelitis optica[J]. Neurol Sci,2004,25(Suppl 4):S368-S370.
[21]	JURYN'CZYK M, CRANER M, PALACE J.Overlapping CNS inflammatory diseases: differentiating features of NMO and MS[J].J Neurol Neurosurg Psychiatry,2015,86(1):20-25.
[22]	MOULIN D,PATY DW,EBERS GC.The predictive value of cerebrospinal fluid electrophoresis in 'possible'multiple sclerosis[J].Brain,1983,106(Pt 4):809-816.

寡克隆区带检测在中枢神经系统疾病诊断中的应用

Application of oligoclonal bands in the diagnosis of central nervous system diseases

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