Modification of CSF findings in multiple sclerosis in the era of rapidly expanding treatment options

Expert Review of Neurotherapeutics
Ioanna GiotakiMartin S Weber

Abstract

The detection of cerebrospinal fluid (CSF)-specific oligoclonal bands (OCB) as well as an elevated antibody production directed against neurotrophic viruses remain hallmark findings in multiple sclerosis (MS). In general, individual patients show a unique pattern of OCB, which is believed to persist over time. Here, the authors revisited this assumption and investigated to what extent common anti-inflammatory MS medications can alter the level of immunoglobulins produced within the CSF. The authors analyzed three patients and compared CSF findings longitudinally. Two of these patients received corticosteroids, either systemically or intrathecally, the third patient was treated continuously with natalizumab. In line with reports from other groups, the authors observed that continuous natalizumab treatment dampened the intrathecal immunoglobulin production in our patient. Exceeding this anticipated scenario, the authors detected that the continued administration of corticosteroids similarly reduced the production of CSF immunoglobulins, down to a level at which these parameters are considered normal. These observations suggest that inflammatory CSF findings are more accessible to immunomodulatory MS treatment than previously thou...Continue Reading

References

Apr 23, 2002·Journal of Neurology·Jorge Correale, María de los Milagros Bassani Molinas
Sep 5, 2009·European Neurology·Trygve Holmøy
Nov 2, 2011·Multiple Sclerosis : Clinical and Laboratory Research·Felipe von GlehnCarlos Otávio Brandão
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Dec 26, 2017·Lancet Neurology·Alan J ThompsonJeffrey A Cohen
May 21, 2018·Lancet Neurology·Paulus S Rommer, Uwe K Zettl

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