The Diagnostic Value of Oligoclonal Band Detection in Viral Encephalitis

Objective: This study aims to explore the differences in cerebrospinal fluid oligoclonal band (CSF-OCB) expression among different age groups in viral encephalitis and its reference value for diagnosis. Methods: Forty-two patients with viral encephalitis were divided into two groups: 25 adults and 17 children. The presence of oligoclonal bands in the cerebrospinal fluid (CSF) was detected using polyacrylamide gel electrophoresis, and CSF routine analysis was conducted for comparative analysis. Results: The CSF-OCB positivity rate was higher in the adult group (48%) compared with the pediatric group (11.76%), with a statistically significant difference (P Conclusion: 1) The expression of CSF-OCB positivity in patients with viral encephalitis is age-related, with higher positivity rates observed in adults compared to children. 2) Although CSF oligoclonal band detection is not a specific diagnostic marker for viral encephalitis in adults, it still holds certain reference value.

TCRb REPERTOIRE IN TIL AND PBL OF PATIENTS WITH COLORECTAL CANCER

Objective: To study T cell immunology in patients with colorectal cancer, the molecular features of clonal expanded T cell in TIL and PBL were analyzed by assessment of TCRb gene reopertoire. Methods: The rearranged V-J genes of TCRb chain were amplified by RT-PCR and separated with denaturation polyacrylamide sequencing gel eletrophoresis. The PCR products were sequenced directly to determine the characteristics of the clonal expanded transcripts. Results: There were oligoclonal expanded transcripts of TCRb V genes both in TIL and PBL from pre- operation patients, which all disappeared in PBL after operation. The amino acid sequences of the CDR3 regions in these oligoclonal expanded T cells suggested that they related with the tumor peptide-specific activation. Existence of clonal expanded T cells in PBL may have relevance with the recurrence. Conclusion: Tumor peptide-specific Activated T cell clones were found not only in TIL of colorectal cancer tissue, but also in PBL of tumor-bearing patients. The activation of systemic T cell immunology may play an important role in the prognosis of patients.

Clinical Features of Patients with Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders

Background： Neuromyelitis optica spectrum disorder （NMOSD） was long believed to be an aggressive form of multiple sclerosis （MS）. This study aimed to describe the clinical features of patients with MS and NMOSD to assist in differential diagnoses in clinical practice. Methods： Data including the patients＇ serum and cerebrospinal fluid （CSF） tests, image findings, and clinical information from 175 patients with MS or NMOSD at Xuanwu Hospital, Capital Medical University from November 2012 to May 2014 were collected and analyzed retrospectively. An enzyme-linked immunosorbent assay was performed to detect the myelin oligodendrocyte glycoprotein （MOG） autoantibodies in CSF and serum. Cell-based assays were used to detect aquaporin-4-antibody （AQP4-Ab）. The Chi-square test was used to compare the categorical variables. Wilcoxon rank sum test was peribrmed to analyze the continuous variables. Results： Totally 85 MS patients （49%） and 90 NMOSD patients （51%） were enrolled, including 124 （71%） women and 51 （29%） men. Fewer MS patients （6%） had autoinamune diseases compared to NMOSD （19%） （x2= 6.9, P 〈 0.01 ）. Patients with NMOSD had higher Expanded Disability Status Scale scores （3.5 [3]） than MS group （2 [2]） （x2= -3.69, P 〈 0.01）. The CSF levels of white cell count and protein in both two groups were slightly elevated titan the normal range, without significant difference between each other. Positivity of serum AQP4-Ab in NMOSD patients was higher than that in MS patients （MS： 0, NMOSD： 67%; x2= 63.9, P 〈 0.01 ）. Oligoclonal bands in CSF among NMOSD patients were remarkably lower than that among MS （MS： 59%, NMOSD： 20%; x2= 25.7, P 〈 0.01）. No significant difference of MOG autoantibodies was found between the two groups. Conclusion： The different CSF features combined with clinical, magnetic resonance imaging, and serum characteristics between Chinese patients with MS and NMOSD could assist in the differential diagnosis.

CSF biomarkers in multiple sclerosis:beyond neuroinflammation

For many years,quantifiable biomarkers in neurological diseases have represented a hot topic.In multiple sclerosis(MS),cerebrospinal fluid biomarkers have played a diagnostic role since the introduction of Poser's criteria in 1983,with IgG oligoclonal bands playing a supporting role in an epoch prior to magnetic resonance imaging and a complementary one after the introduction of McDonald criteria in 2001.Nowadays,that supporting role has turned into a main one in substituting for dissemination in time and defining the diagnosis of MS in patients with a first clinical event,according to the 2017 revised McDonald criteria.Possibly kappa free light chains,N-CAM,chitinase 3-like protein 1 and IgM oligoclonal bands,not yet implemented in clinical practice,could similarly gain importance in the near future.Furthermore,the increasing knowledge of molecular mechanisms leading to chronic inflammation has enhanced interest in looking for biomarkers of disease activity,better defining the MS phenotype and patients with highly active disease.Accordingly,myelin proteins,intermediate filaments,metalloproteinases and other molecules involved in the inflammatory cascade,are currently under investigation.Finally,it has long been known that axonal loss occurs from the early phases,leading to a progressive neurological deterioration.Since established criteria to assess treatment failure and transition to progressive forms are still lacking,both treatment response and prognostic biomarkers would be useful to predict MS course,and neurofilaments seem to have this potential.The purpose of this review article was to illustrate biomarkers that have been already validated or require further validation after proving to be useful in exploratory studies and potentially could prove useful in clinical practice in the coming years.