Jingluan Tian , Xiaoni Liu , Yarong Li , Yuehua Gu , Bo Deng , Wenbo Yang , Hai Yu , Xiang Zhang , Xiangjun Chen
{"title":"脑脊液寡克隆免疫球蛋白G带镜像模式在周围神经病变中的临床意义","authors":"Jingluan Tian , Xiaoni Liu , Yarong Li , Yuehua Gu , Bo Deng , Wenbo Yang , Hai Yu , Xiang Zhang , Xiangjun Chen","doi":"10.1016/j.cca.2025.120145","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>CSF (cerebrospinal fluid) oligoclonal immunoglobulin G bands (IgG-OCBs) analysis plays a crucial role in diagnosis of various neurological disorders. However, the clinical significance of mirror pattern bands remains unclear, and their precise application is not well understood.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed a total of 7597 IgG-OCB records detected using isoelectric focusing from May 2020 and August 2023 at Huashan Hospital. Among these, 121 mirror pattern bands (62 type IV and 59 type V) were identified in patients with neurological disorders. Basic clinical data, including discharge diagnosis, gender, and age, were collected. Additionally, CSF and serum immunological parameters, as well as monoclonal protein (M protein) detection, were reviewed.</div></div><div><h3>Results</h3><div>Although mirror pattern bands are rarely observed in neurological diseases, approximately half of these patterns were found in patients with peripheral neuropathy (PN). In the type IV group, 40.74 % of cases were associated with immune-mediated PN, while type V pattern was predominantly observed in cancer-related/lymphoproliferative PN, comprising 63.33 % of the cases. Patients with cancer-related or lymphoproliferative PN showed significantly higher IgG-CSF concentrations (<em>p</em> = 0.017) and 24-h intrathecal IgG synthesis rate (<em>p</em> = 0.022), indicating a stronger humoral immune response. Additionally, both patients with immune-mediated PN and cancer-related/lymphoproliferative PN exhibited abnormal intrathecal synthesis rate and moderate to severe blood–brain barrier impairment. Furthermore, the type V group also exhibited a high prevalence of M protein positivity.</div></div><div><h3>Conclusions</h3><div>The differential immunological responses and distinct patterns of OCBs observed in our study underscore the critical role of OCB analysis in the diagnostic workup of PN.</div></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":"569 ","pages":"Article 120145"},"PeriodicalIF":3.2000,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The clinical significance of mirror patterns of cerebrospinal fluid oligoclonal immunoglobulin G bands (IgG-OCBs) in peripheral neuropathy disorders\",\"authors\":\"Jingluan Tian , Xiaoni Liu , Yarong Li , Yuehua Gu , Bo Deng , Wenbo Yang , Hai Yu , Xiang Zhang , Xiangjun Chen\",\"doi\":\"10.1016/j.cca.2025.120145\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>CSF (cerebrospinal fluid) oligoclonal immunoglobulin G bands (IgG-OCBs) analysis plays a crucial role in diagnosis of various neurological disorders. However, the clinical significance of mirror pattern bands remains unclear, and their precise application is not well understood.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed a total of 7597 IgG-OCB records detected using isoelectric focusing from May 2020 and August 2023 at Huashan Hospital. Among these, 121 mirror pattern bands (62 type IV and 59 type V) were identified in patients with neurological disorders. Basic clinical data, including discharge diagnosis, gender, and age, were collected. Additionally, CSF and serum immunological parameters, as well as monoclonal protein (M protein) detection, were reviewed.</div></div><div><h3>Results</h3><div>Although mirror pattern bands are rarely observed in neurological diseases, approximately half of these patterns were found in patients with peripheral neuropathy (PN). In the type IV group, 40.74 % of cases were associated with immune-mediated PN, while type V pattern was predominantly observed in cancer-related/lymphoproliferative PN, comprising 63.33 % of the cases. Patients with cancer-related or lymphoproliferative PN showed significantly higher IgG-CSF concentrations (<em>p</em> = 0.017) and 24-h intrathecal IgG synthesis rate (<em>p</em> = 0.022), indicating a stronger humoral immune response. Additionally, both patients with immune-mediated PN and cancer-related/lymphoproliferative PN exhibited abnormal intrathecal synthesis rate and moderate to severe blood–brain barrier impairment. Furthermore, the type V group also exhibited a high prevalence of M protein positivity.</div></div><div><h3>Conclusions</h3><div>The differential immunological responses and distinct patterns of OCBs observed in our study underscore the critical role of OCB analysis in the diagnostic workup of PN.</div></div>\",\"PeriodicalId\":10205,\"journal\":{\"name\":\"Clinica Chimica Acta\",\"volume\":\"569 \",\"pages\":\"Article 120145\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-01-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinica Chimica Acta\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0009898125000245\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICAL LABORATORY TECHNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinica Chimica Acta","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0009898125000245","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICAL LABORATORY TECHNOLOGY","Score":null,"Total":0}
The clinical significance of mirror patterns of cerebrospinal fluid oligoclonal immunoglobulin G bands (IgG-OCBs) in peripheral neuropathy disorders
Background
CSF (cerebrospinal fluid) oligoclonal immunoglobulin G bands (IgG-OCBs) analysis plays a crucial role in diagnosis of various neurological disorders. However, the clinical significance of mirror pattern bands remains unclear, and their precise application is not well understood.
Methods
We retrospectively reviewed a total of 7597 IgG-OCB records detected using isoelectric focusing from May 2020 and August 2023 at Huashan Hospital. Among these, 121 mirror pattern bands (62 type IV and 59 type V) were identified in patients with neurological disorders. Basic clinical data, including discharge diagnosis, gender, and age, were collected. Additionally, CSF and serum immunological parameters, as well as monoclonal protein (M protein) detection, were reviewed.
Results
Although mirror pattern bands are rarely observed in neurological diseases, approximately half of these patterns were found in patients with peripheral neuropathy (PN). In the type IV group, 40.74 % of cases were associated with immune-mediated PN, while type V pattern was predominantly observed in cancer-related/lymphoproliferative PN, comprising 63.33 % of the cases. Patients with cancer-related or lymphoproliferative PN showed significantly higher IgG-CSF concentrations (p = 0.017) and 24-h intrathecal IgG synthesis rate (p = 0.022), indicating a stronger humoral immune response. Additionally, both patients with immune-mediated PN and cancer-related/lymphoproliferative PN exhibited abnormal intrathecal synthesis rate and moderate to severe blood–brain barrier impairment. Furthermore, the type V group also exhibited a high prevalence of M protein positivity.
Conclusions
The differential immunological responses and distinct patterns of OCBs observed in our study underscore the critical role of OCB analysis in the diagnostic workup of PN.
期刊介绍：
The Official Journal of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC)
Clinica Chimica Acta is a high-quality journal which publishes original Research Communications in the field of clinical chemistry and laboratory medicine, defined as the diagnostic application of chemistry, biochemistry, immunochemistry, biochemical aspects of hematology, toxicology, and molecular biology to the study of human disease in body fluids and cells.
The objective of the journal is to publish novel information leading to a better understanding of biological mechanisms of human diseases, their prevention, diagnosis, and patient management. Reports of an applied clinical character are also welcome. Papers concerned with normal metabolic processes or with constituents of normal cells or body fluids, such as reports of experimental or clinical studies in animals, are only considered when they are clearly and directly relevant to human disease. Evaluation of commercial products have a low priority for publication, unless they are novel or represent a technological breakthrough. Studies dealing with effects of drugs and natural products and studies dealing with the redox status in various diseases are not within the journal''s scope. Development and evaluation of novel analytical methodologies where applicable to diagnostic clinical chemistry and laboratory medicine, including point-of-care testing, and topics on laboratory management and informatics will also be considered. Studies focused on emerging diagnostic technologies and (big) data analysis procedures including digitalization, mobile Health, and artificial Intelligence applied to Laboratory Medicine are also of interest.
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