Multiple Sclerosis

Liquor diagnostics

Intrathekal Detection of Immunglobulins (silver stain) in Liquor (CSF) 
(Multiple sclerosis analysis with the new ProPhyl Air matrix) 

Liquor diagnostics

figure 1

Multiple sclerosis analysis by improved isoelectric focusing
with ProPhyl Air for the detection of oligoclonal bands (IgG) in cerebrospinal fluid (CSF – Liquor diagnostics)

Samples:
Prof. Dr. med. Brigitte Wildemann / Prof. Dr. rer. nat. Jürgen Haas
Neurologie und Poliklinik
Otto-Meyerhof-Zentrum für Ambulante Medizin und Klinische Forschung
Im Neuenheimer Feld 350 
69120 Heidelberg

figure 2 Horizontal isoelectric focusing (click on image to enlarge it)
Gel matrix: ProPhyl Air
Gel thickness: 750µm
Carrier ampholyt: Sepalyte pH 3-10 (CSF)
Plastic carrier support: GelStick polyester sheet
Stain: silver stain

CSF (Liquor diagnostics) examination in clinical research

As a service and supportive analysis, ProTec Bioseparation offers cost-effective examinations of CSF samples (liquor) for research laboratories.

This could be helpful for supportive protection in suspected cases (multiple sclerosis), as preclinical analysis or as a first guiding measure for neurodegenerative diseases.

This requires sending the most up-to-date sample material possible (CSF) and, in the event of suspected cases of MS, the corresponding serum.

The examination is carried out promptly after consultation and has the purpose to support the research laboratory with electrophoretic protein separations (reference material required) as the first orienting aid

What is Multiple Sclerosis?

Multiple sclerosis (MS) is a neuroinflammatory disease that affects myelin , a substance that makes up the membrane (called the myelin sheath) that wraps around nerve fibers (axons). Myelinated axons are commonly called white matter. Researchers have learned that MS also damages the nerve cell bodies, which are found in the brain’s gray matter, as well as the axons themselves in the brain, spinal cord, and optic nerve (the nerve that transmits visual information from the eye to the brain). As the disease progresses, the brain’s cortex shrinks (cortical atrophy).

The term multiple sclerosis refers to the distinctive areas of scar tissue (sclerosis or plaques) that are visible in the white matter of people who have MS. Plaques can be as small as a pinhead or as large as the size of a golf ball.

What causes MS?

The ultimate cause of MS is damage to myelin, nerve fibers, and neurons in the brain and spinal cord, which together make up the central nervous system (CNS). But how that happens, and why, are questions that challenge researchers. Evidence appears to show that MS is a disease caused by genetic vulnerabilities combined with environmental factors.

Although there is little doubt that the immune system contributes to the brain and spinal cord tissue destruction of MS, the exact target of the immune system attacks and which immune system cells cause the destruction isn’t fully understood.

Researchers have several possible explanations for what might be going on. The immune system could be:

  • fighting some kind of infectious agent (for example, a virus) that has components which mimic components of the brain (molecular mimickry)
  • destroying brain cells because they are unhealthy
  • mistakenly identifying normal brain cells as foreign.

The last possibility has been the favored explanation for many years. Research now suggests that the first two activities might also play a role in the development of MS. There is a special barrier, called the blood-brain barrier, which separates the brain and spinal cord from the immune system. If there is a break in the barrier, it exposes the brain to the immune system for the first time. When this happens, the immune system may misinterpret the brain as “foreign.”

Diagnosis of multiple sclerosis

 

 
The clinical diagnosis of multiple sclerosis can be supported by analysis of cerebrospinal fluid (CSF). Oligoclonal bands are IgG immunoglobulins secreted by plasma cells that are resident within the CNS in multiple sclerosis. They are secreted into the CSF and can be detected using isoelectric focusing (IEF). It is necessary to analyse both serum and CSF collected from a patient at the same time. IgG antibodies from the cerebrospinal fluid and serum are applied side by side and appear as several (oligoclonal IgG) bands. Similar band patterns from both sources characterize the diffusion of the antibodies from the blood into the cerebrospinal fluid.
 
 
Oligoclonal bands that only occur in CSF indicate antibody formation in the central nervous system (CNS) in acute and chronic inflammatory diseases of the CNS. Cases 2,3,4,6,7 and 8  (fig.1) are typical for patients with multiple sclerosis. Only the cerebrospinal fluid has oligoclonal bands. The immunoglobulins shown by the bands were produced intrathecally. The presence of oligoclonal bands points to an inflammatory CNS process. A typical feature of MS is that the inflammation can reoccur at different intervals in other parts of the nervous system. The name “multiple sclerosis” is derived from the fact that many (multiple) sites in the brain and spinal cord develop hardened scarring (sclerosis).
 

figure 3

ProPhyl Air made a decisive contribution to the discovery of α-Synuclein in cerebrospinal fluid using the isoelectric focusing method

Samples:
MVZ Labor Dr. Limbach & Kollegen GbR
Im Breitspiel 16
69126 Heidelberg

figure 4

Different MS and negative liquor (CSF) samples applied side by side.
Unusual protein pattern in Liquor 1 (CSF)

Samples:

MVZ Labor Dr. Limbach & Kollegen GbR
Im Breitspiel 16
69126 Heidelberg
Neurologie und Poliklinik
Ambulante Medizin und Klinische Forschung
Im Neuenheimer Feld 350 
69120 Heidelberg
SERVA Electrophoresis GmbH
Carl-Benz-Str.7 
69115 Heidelberg 



Comparison between ProPhyl Air and Acrylamide matrix

 

ProPhyl Air matrix with Sepalyte CSF

 

Acrylamide matrix (supplier of precast gels)

 


What is multiple sclerosis?
https://www.youtube.com/watch?v=SX7kHhmrelI

Cause of multiple sclerosis
https://www.dmsg.de/multiple-sklerose-infos/ms-verstehen/zusammenhaenge-erkennen/ursachen-der-ms/

Symptoms of multiple sclerosis
https://www.dmsg.de/multiple-sklerose-infos/ms-verstehen/vom-symptom-zur-therapie/symptome/

multiple sclerosis diagnosis
https://www.dmsg.de/multiple-sklerose-infos/ms-verstehen/vom-symptom-zur-therapie/diagnostik/