Oligoclonal bands are bands of immunoglobulins that are seen when a patient's blood serum, gained from blood plasma

Blood plasma

Blood plasma is the straw-colored liquid component of blood in which the blood cells in whole blood are normally suspended. It makes up about 55% of the total blood volume. It is the intravascular fluid part of extracellular fluid...

, or cerebrospinal fluid

Cerebrospinal fluid

Cerebrospinal fluid , Liquor cerebrospinalis, is a clear, colorless, bodily fluid, that occupies the subarachnoid space and the ventricular system around and inside the brain and spinal cord...

 (CSF) is analyzed.

Two methods of analysis are possible: (a) protein electrophoresis

Protein electrophoresis

Protein electrophoresis is a method for analysing the proteins in a fluid or an extract. The electrophoresis may be performed with a small volume of sample in a number of alternative ways with or without a supporting medium: SDS polyacrylamide gel electrophoresis Protein electrophoresis is a method...

, a method of analyzing the composition of fluids, also known as "agarose gel electrophoresis/Coomassie Blue staining", and (b) the combination of isoelectric focusing/silver staining. The latter is more sensitive.

For the analysis of cerebrospinal fluid, a patient has a lumbar puncture

Lumbar puncture

A lumbar puncture is a diagnostic and at times therapeutic procedure that is performed in order to collect a sample of cerebrospinal fluid for biochemical, microbiological, and cytological analysis, or very rarely as a treatment to relieve increased intracranial pressure.-Indications:The...

 performed, which removes some of his cerebrospinal fluid.

Each of the two to five oligoclonal bands seen by protein electrophoresis represent proteins (or protein fragments) secreted by plasma cell

Plasma cell

Plasma cells, also called plasma B cells, plasmocytes, and effector B cells, are white blood cells which produce large volumes of antibodies. They are transported by the blood plasma and the lymphatic system...

s, although why exactly these bands are present, and which protein

Protein

Proteins are biochemical compounds consisting of one or more polypeptides typically folded into a globular or fibrous form, facilitating a biological function. A polypeptide is a single linear polymer chain of amino acids bonded together by peptide bonds between the carboxyl and amino groups of...

s these bands represent, has not yet been elucidated.

Diagnostic value

The presence of oligoclonal bands in cerebrospinal fluid combined with their absence in blood serum often indicates that immunoglobulins are produced in central nervous system. Therefore it is normal to subtract bands in serum from bands in CSF when investigating CNS diseases.

Oligoclonal bands are an important indicator in the diagnosis of multiple sclerosis

Multiple sclerosis

Multiple sclerosis is an inflammatory disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged, leading to demyelination and scarring as well as a broad spectrum of signs and symptoms...

. Approximately 79%-90% of all patients with multiple sclerosis have permanently observable oligoclonal bands.

The presence of one band (a monoclonal band) may be considered serious, such as lymphoproliferative disease, or may simply be normal—it must be interpreted in the context of each specific patient. More bands may reflect the presence of a disease. The bands tend to disappear from the cerebrospinal fluid as a person recovers from the neurological disease.

Diseases associated

Oligoclonal bands are also found in:

• Multiple sclerosis
  Multiple sclerosis
  Multiple sclerosis is an inflammatory disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged, leading to demyelination and scarring as well as a broad spectrum of signs and symptoms...
  
  
• Lyme Disease
  Lyme disease
  Lyme disease, or Lyme borreliosis, is an emerging infectious disease caused by at least three species of bacteria belonging to the genus Borrelia. Borrelia burgdorferi sensu stricto is the main cause of Lyme disease in the United States, whereas Borrelia afzelii and Borrelia garinii cause most...
  
  
• Devic's disease
  Devic's disease
  Neuromyelitis optica , also known as Devic's disease or Devic's syndrome, is an autoimmune, inflammatory disorder in which a person's own immune system attacks the optic nerves and spinal cord. This produces an inflammation of the optic nerve and the spinal cord...
  
  
• Systemic lupus erythematosus
  Systemic lupus erythematosus
  Systemic lupus erythematosus , often abbreviated to SLE or lupus, is a systemic autoimmune disease that can affect any part of the body. As occurs in other autoimmune diseases, the immune system attacks the body's cells and tissue, resulting in inflammation and tissue damage...
  
  
• Neurosarcoidosis
  Neurosarcoidosis
  Neurosarcoidosis refers to sarcoidosis, a condition of unknown cause featuring granulomas in various tissues, involving the central nervous system . It can have many manifestations, but abnormalities of the cranial nerves are the most common...
  
  
• Subacute sclerosing panencephalitis
  Subacute sclerosing panencephalitis
  Subacute sclerosing panencephalitis is a rare chronic, progressive encephalitis that affects primarily children and young adults, caused by a persistent infection of immune resistant measles virus . No cure for SSPE exists, but the condition can be managed by medication if treatment is started at...
  
  
• Subarachnoid haemorrhage
• Syphilis
  Syphilis
  Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...
  
  
• Primary central nervous system lymphoma
  Primary central nervous system lymphoma
  A primary central nervous system lymphoma , also known as microglioma and primary brain lymphoma, is a primary intracranial tumor appearing mostly in patients with severe immunosuppression . PCNSLs represent around 20% of all cases of lymphomas in HIV infections...
  
  
• Sjögren's Syndrome
  Sjögren's syndrome
  Sjögren's syndrome , also known as "Mikulicz disease" and "Sicca syndrome", is a systemic autoimmune disease in which immune cells attack and destroy the exocrine glands that produce tears and saliva....
  
  
• Guillain-Barre Syndrome
  Guillain-Barré syndrome
  Guillain–Barré syndrome , sometimes called Landry's paralysis, is an acute inflammatory demyelinating polyneuropathy , a disorder affecting the peripheral nervous system. Ascending paralysis, weakness beginning in the feet and hands and migrating towards the trunk, is the most typical symptom...
  
  

External links

• The Medical School, Birmingham University - Abid R Karim, Birmingham UK, Presentation of real world examples and further insights
• Oligoclonal band pattern for MS
• Oligoclonal Bands in CSF - ClinLab Navigator