Immunoglobulins oligoclonal bands

Demyelinated plaques, both active and inactive Active demyelinating plaques Oligoclonal bands of immunoglobulin G Elevated immunoglobulin G index Slowed nerve impulse conduction... 

Oligoclonal bands Two to five bands of immunoglobulins on protein electrophoresis of cerebrospinal fluid. 

The most characteristic abnormality in patients with multiple sclerosis is certainly the intrathecal synthesis of IgG. It can be demonstrated—with different sensitivity— by various methods, which can be divided into qualitative and quantitative methods. The gold standard for the demonstration of intrathecal synthesis of IgG is the detection of oligoclonal bands, which are not present in CSF, in the appropriately diluted serum (i.e., to the same concentration of IgG) by isoelectric focusing. This is a qualitative method and the description of its different modifications and interpretations goes beyond the scope of this chapter. This method is by far the most sensitive, and its sensitivity is reported between 90 and 100%. Here it is suitable to repeat that the detection of plasmocytic forms in cerebrospinal fluid may also be regarded as qualitative proof of intrathecal synthesis of immunoglobulins— although in this case the proof is obviously not specific for IgG from the theoretical point of view. 

Increased intrathecal synthesis of IgG causes an increase in the CSF/serum immunoglobulin concentration ratio and the appearance of oligoclonal immunoglobulin bands on electrophoretic separations of CSF. Investigation of these changes has now become routine when multiple sclerosis is... 

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