Educational Webinar with Dr Maria Di Cristinzi
Central Nervous System Inflammatory Disease
Inflammatory disease of the central nervous system comprises a large spectrum of autoimmune diseases. Multiple sclerosis is the most common chronic human inflammatory demyelinating disease of the central nervous system and causes of disability in young adults.
What is Multiple Sclerosis?
Multiple Sclerosis is characterized by the disseminated demyelination of nerve fibers of the brain and spinal cord and may lead to physical disability, cognitive impairment and decreased quality of life.
Usually, Multiple Sclerosis can progress with individual relapses (attacks or exacerbations) or more gradually.
The presence of intrathecal IgG may indicate an inflammatory disease of the Central Nervous System (CNS), such as caused by multiple sclerosis (MS).
Oligoclonal bands detection in CSF : the gold standard assay to objectively detect CNS local IgG synthesis.
20-40
years is the most common age of onset for Multiple Sclerosis
2.9
million people are affected by Multiple Sclerosis worldwide
3.2
months is the median time to diagnosis using the 2017 McDonald criteria
How do we diagnose Central Nervous System Inflammatory Disease?
Many disorders of the central nervous system are associated with increased concentration of Cerebral Spinal Fluid (CSF) proteins either due to increased permeability of blood-CSF barrier or to synthesis of immunoglobulins, primarily IgG, within the Central Nervous System (CNS).
Presence of intrathecal IgG synthesis suggests inflammatory disease of the CNS, such as caused by Multiple Sclerosis (MS).
According to the updated international guidelines, these revised criteria will notably allow diagnosing MS in asymptomatic individuals specifically, those who previously were classified as having radiologically isolated syndrome (RIS). People with RIS have MRI lesions suggestive of MS, but no clinical symptoms. The latest recommendations emphasize that the detection of disease-specific oligoclonal bands in the cerebrospinal fluid can replace the need to demonstrate dissemination in time, allowing for a confirmed diagnosis even after a single clinical event in certain cases.
Knowledge & Science
2005 Multiple sclerosis consensus criteria includes CSF IgG oligoclonal bands.
2024 Mc Donald Criteria for multiple sclerosis diagnosis includes CSF IgG oligoclonal bands.
Instrument for diagnosing Central Nervous System Inflammatory Disease
Large menu with high quality results on gel electrophoresis.
References
a) Filippi M, Amato MP, Centonze D, Gallo P, Gasperini C, Inglese M, Patti F, Pozzilli C, Preziosa P, Trojano M. Early use of high-efficacy disease‑modifying therapies makes the difference in people with multiple sclerosis: an expert opinion. J Neurol. 2022 Oct;269(10):5382-5394. doi: 10.1007/s00415-022-11193-w. Epub 2022 May 24. Erratum in: J Neurol. 2022 Dec;269(12):6690-6691. doi: 10.1007/s00415-022-11385-4. PMID: 35608658; PMCID: PMC9489547.