Prognostic value of intratechal IgG synthesis in multiple sclerosis

Background: Despite an increased understanding of the underlying patho mechanisms in multiple sclerosis(MS), the immunological parameters that faithfully mirror disease activity are only emerging. However, the ability to predict the subsequent clinical course of MS on the basis of clinical and other supportive data at presentation would be invaluable. Objective: We examine the oligoclonal band (OCB) pattern and intrathecal IgG production (IgG index) to ascertain if these are useful in predicting the subsequent clinical course of MS. We also assess the influence of some clinical features (such as course of the disease) in the laboratory results, in order to identify which factors might be related with the disease progression. Methods: IgG index was measured in 54 MS patients. Progression index (PI), type of disease course and the presence of OCBs were compared in patients with normal, high and very high IgG Index. Results: Patients with very high IgG index had a higher PI (0.1 plus or minus 0.13) in comparison with the two other groups (0.06 plus or minus 0.05 in high IgG index group and 0.05 plus or minus 0.07 in normal IgG index group, P>0.05). Secondary progressive (SP) patients had a higher IgG index than relapsing-remitting (RR) patients (2.04 plus or minus 1.24 for SP vs. 1.78 plus or minus 1.45 for RR, P > 0.05). PI was higher in OCB positive MS patients (0.08 plus or minus 0.10) vs. OCB negative ones (0.05 plus or minus 0.04). Conclusions: Our results did not reveal significant prognostic value for IgG index in MS patients. However, they indicate a trend towards better prognosis of the disease in patients with lower values of IgG index.