Tysabri can affect immune responses in the brain disappearence of oligoclonal bands

Mancuso R, Franciotta D, Rovaris M, Caputo D, Sala A, Hernis A, Agostini S, Calvo M, Clerici M. Effects of natalizumab on oligoclonal bands in the cerebrospinal fluid of multiple sclerosis patients: A longitudinal study. Mult Scler. 2014 Jun  pii: 1352458514538111. [Epub ahead of print]

Retrospective studies show that natalizumab modifies oligoclonal immunoglobulin (IgG) bands (OCBs) in the cerebrospinal fluid (CSF) of multiple sclerosis (MS) patients. In this study, we prospectively analyzed both serum and CSF samples from 24 MS patients, before and after 2 years of natalizumab-based therapy. Our results showed complete (55%) or partial (27%) disappearance of the OCBs in CSF samples that were taken after 2 years of therapy. Intrathecal IgG production, represented by the IgG index and IgGLoc, was also quantitatively reduced. Our data showed that natalizumab substantially modulates both intrathecal polyclonal and oligoclonal IgG production: This effect was much more potent than was previously reported


Oligoclonal bands are products of a restricted set of antibody producing cells which are often found int he brain of MSers. This is an indication of immune activation in the brain. Can it be stopped. In the past people have looked at the spinal fluid of people on tysabri and found a difference in this study they took a spinal tap before starting tysabri and looked again 2 years later and this study suggests that they disappear in 55% of people and indicates that blocking cells from entering the brain quells the immune system 

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  • Tysabri may prevent anti-body production but does this really matter? Is tysabri simply blocking the immune response but allowing the disease (and whatever antigens are produced) to continue unchecked. The more interesting question is whether antigen levels decrease with tysabri use? But what is the antigen?

  • But this is not the case with alemtuzumab. So it is less effective in sense of cooling down the immune processes inside the brain?

  • Is the longitudinal study only for 2 years? What of those of us who have been on the drug for 7 years? Might this initial response prove detrimental to other body and organ systems over time, as the antibody production and immune response are required for normal or optimal operations of those other systems?

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