oligoclonal band

7/29/2019 Oligoclonal Band

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Oligoclonal band

Oligoclonal bands are bands of immunoglobulins that are seen when a patient'sblood serum, gained fromblood plasma, orcerebrospinal fluid(CSF) is analyzed.

Two methods of analysis are possible: (a) protein electrophoresis, a method ofanalyzing the composition of fluids, also known as "agarose gel

electrophoresis/Coomassie Blue staining", and (b) the combination of isoelectricfocusing/silver staining. The latter is more sensitive.[1]

For the analysis of cerebrospinal fluid, a patient has a lumbar punctureperformed,which collects some of his or her cerebrospinal fluid.

Each of the two to five oligoclonal bands seen by protein electrophoresis representproteins (or protein fragments) secreted byplasma cells, although why exactly thesebands are present, and which proteins these bands represent, has not yet beenelucidated.

Diagnostic value

The presence of oligoclonal bands in cerebrospinal fluid combined with their absencein blood serum often indicates that immunoglobulins are produced in central nervoussystem. Therefore it is normal to subtract bands in serum from bands in CSF wheninvestigating CNS diseases.

Oligoclonal bands are an important indicator in the diagnosis of multiple sclerosis.Approximately 79%-90% of all patients with multiple sclerosis have permanentlyobservable oligoclonal bands.

The presence of one band (a monoclonal band) may be considered serious, such aslymphoproliferative disease, or may simply be normalit must be interpreted in thecontext 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

Lyme Disease

Devic's disease

Systemic lupus erythematosus

Neurosarcoidosis

Subacute sclerosing panencephalitis

Subarachnoid hemorrhage

Syphilis

Primary central nervous system lymphoma

Sjgren's Syndrome

Guillain-Barre Syndrome

CSF oligoclonal banding is a test to look for inflammation-related proteins in thecerebrospinal fluid (CSF), the clear fluid that flows in the space surrounding thespinal cord and brain.

Oligoclonal bands are proteins called immunoglobulins, which suggest inflammationof the central nervous system. The presence of oligoclonal bands may be a sign of

multiple sclerosis.
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Granulocytes are a category ofwhite blood cellscharacterized by the presence ofgranulesin theircytoplasm.[1] They are also called polymorphonuclear leukocytes(PMN or PML) because of the varying shapes of thenucleus, which is usually lobedinto three segments. In common parlance, the term polymorphonuclear leukocyteoften refers specifically to neutrophil granulocytes,[2] the most abundant of thegranulocytes. Granulocytes are produced via granulopoeisis in the bone marrow bythe regulatorycomplementproteins.

Types of granulocytes

There are three types of granulocytes, distinguished by their appearance underWright's stain:

Neutrophil granulocytes

Eosinophil granulocytes

Basophil granulocytes

Their names are derived from their staining characteristics; for example, the mostabundant granulocyte is the neutrophil granulocyte, which has neutrally staining

cytoplasmicgranules.Other white blood cells that are not granulocytes ("agranulocytes") are mainlylymphocytesandmonocytes.

Neutrophils[edit source|editbeta]

Main article:Neutrophil

A neutrophil with a segmented nucleus (center and surrounded byerythrocytes), theintra-cellular granules are visible in the cytoplasm (Giemsa-stained highmagnification)Neutrophils are normally found in thebloodstreamand are the most abundant type ofphagocyte, constituting 50% to 60% of the total circulating white blood cells.[3] Onelitre of human blood contains about five billion neutrophils 5x10 9,[4] which are about12-15micrometersin diameter,[5] and live approximately 6 days.[5] Once neutrophilshave received the appropriate signals, it takes them about thirty minutes to leave theblood and reach the site of an infection.[6] Neutrophils do not return to the blood;they turn into puscells and die.[6] Mature neutrophils are smaller than monocytes,and have a segmented nucleus with several sections(two to five segments); eachsection is connected by chromatin filaments. Neutrophils do not normally exit the

bone marrow until maturity, but during an infection neutrophil precursors calledmyelocytesandpromyelocytesare released.[7]
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Neutrophils have three strategies for directly attacking micro-organisms:phagocytosis (ingestion), release of soluble anti-microbials (including granuleproteins), and generation of neutrophil extracellular traps(NETs).[8] Neutrophils areprofessional phagocytes:[9] they are ferocious eaters and rapidly engulf invaderscoated with antibodiesand complement, and damaged cells or cellular debris. Theintra-cellular granules of the human neutrophil have long been recognized for theirprotein-destroying and bactericidal properties.[10] Neutrophils can secrete productsthat stimulate monocytes andmacrophages; these secretions increase phagocytosisand the formation of reactive oxygen compounds involved in intracellular killing. [11]Neutrophils have two types of granules; primary (azurophilic) granules (found inyoung cells) andspecific granules (which are found in more mature cells). Primarygranules contain cationic proteins and defensins that are used to kill bacteria,proteolytic enzymes and cathepsin G to break down (bacterial) proteins, lysozyme tobreak down bacterial cell walls, and myeloperoxidase (used to generate toxicbacteria-killing substances).[12] In addition, secretions from the primary granulesofneutrophils stimulate the phagocytosis of IgG antibody-coated bacteria.[13] Thesecondary granules contain compounds that are involved in the formation of toxic

oxygen compounds, lysozyme, and lactoferrin (used to take essential iron frombacteria).[12] Neutrophil extracellular traps (NETs) comprise a web of fiberscomposed of chromatin and serine proteases that trap and kill microbesextracellularly. Trapping of bacteria is a particularly important role for NETs in sepsis,where NET are formed within blood vessels.[14]

Eosinophils[edit source|editbeta]

Main article:Eosinophil

An eosinophil surrounded by erythrocytesEosinophils also have lobed nuclei (two to four lobes). The number of granules in aneosinophil can vary because they have a tendency todegranulatewhile in the bloodstream.[15] Eosinophils play a crucial part in the killing of parasites (e.g., enteric

nematodes) because their granules contain a unique, toxic basic protein and cationicprotein (e.g.,cathepsin[12]);[16] receptors that bind toIgEare used to help with thistask.[17] These cells also have a limited ability to participate in phagocytosis,[18]they are professional antigen-presenting cells, they regulate other immune cellfunctions (e.g.,CD4+ T cell,dendritic cell,B cell,mast cell,neutrophil, andbasophilfunctions),[19] they are involved in the destruction of tumor cells,[15] and theypromote the repair of damaged tissue.[20] A polypeptide calledinterleukin-5interactswith eosinophils and causes them to grow and differentiate; this polypeptide isproduced by basophils.[16]

Basophils[edit source|editbeta]

Main article:Basophil
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A basophil with lobed nuclei surrounded byerythrocytesBasophils are one of the least abundant cells inbone marrowandblood(occurring atless than two percent of all cells). Like neutrophils and eosinophils, they have lobednuclei; however, they have only two lobes, and thechromatinfilaments that connectthem are not very visible. Basophils have receptors that can bind to IgE, IgG,

complement, andhistamine. Thecytoplasmof basophils contains a varied amount ofgranules; these granules are usually numerous enough to partially conceal thenucleus. Granule contents of basophils are abundant with histamine, heparin,chondroitin sulfate,peroxidase,platelet-activating factor, and other substances.

When an infection occurs, mature basophils will be released from the bone marrowand travel to the site of infection.[21] When basophils are injured, they will releasehistamine, which contributes to the inflammatory response that helps fight invadingorganisms. Histamine causes dilation and increased permeability ofcapillariescloseto the basophil. Injured basophils and other leukocytes will release anothersubstance called prostaglandins that contributes to an increased blood flow to thesite of infection. Both of these mechanisms allow blood-clotting elements to bedelivered to the infected area (this begins the recovery process and blocks the travelofmicrobesto other parts of the body). Increased permeability of the inflamed tissuealso allows for more phagocyte migration to the site of infection so that they canconsume microbes.[18]

Granulopoiesis: the genesis of granulocytes[edit source|editbeta]

Granulocytes are derived from stem cells residing in the bone marrow. Thedifferentiation of these stem cells from pluripotent hematopoietic stem cell intogranulocytes is termed granulopoiesis. Multiple intermediate cell types exist in thisdifferentiation process, includingmyeloblastsandpromyelocytes.

Toxic materials produced or released[edit source|editbeta]

Examples of toxic materials produced or released by degranulationby granulocyteson the ingestion of microorganism includes:

Low pHvesicles(3.5-4.0)

Toxic oxygen-derived products (e.g., superoxide, hydrogen peroxide, hydroxyradicals, singlet oxygen,hypohalite)

Toxicnitrogenoxides (nitric oxide)

Antimicrobialagents (DefensinsandEosinophil cationic protein)

Enzymes

Lysozyme: dissolves cell walls of somegram positive bacteria

Acid hydrolases: further digest bacteria

Pathology[edit source|editbeta]Granulocytopenia is an abnormally low concentration of granulocytes in the blood.
http://en.wikipedia.org/wiki/Erythrocyteshttp://en.wikipedia.org/wiki/Erythrocyteshttp://en.wikipedia.org/wiki/Erythrocyteshttp://en.wikipedia.org/wiki/Bone_marrowhttp://en.wikipedia.org/wiki/Bone_marrowhttp://en.wikipedia.org/wiki/Bone_marrowhttp://en.wikipedia.org/wiki/Bloodhttp://en.wikipedia.org/wiki/Bloodhttp://en.wikipedia.org/wiki/Bloodhttp://en.wikipedia.org/wiki/Cell_nucleushttp://en.wikipedia.org/wiki/Cell_nucleushttp://en.wikipedia.org/wiki/Chromatinhttp://en.wikipedia.org/wiki/Chromatinhttp://en.wikipedia.org/wiki/Chromatinhttp://en.wikipedia.org/wiki/IgEhttp://en.wikipedia.org/wiki/IgEhttp://en.wikipedia.org/wiki/IgGhttp://en.wikipedia.org/wiki/IgGhttp://en.wikipedia.org/wiki/Complement_systemhttp://en.wikipedia.org/wiki/Complement_systemhttp://en.wikipedia.org/wiki/Histaminehttp://en.wikipedia.org/wiki/Histaminehttp://en.wikipedia.org/wiki/Histaminehttp://en.wikipedia.org/wiki/Cytoplasmhttp://en.wikipedia.org/wiki/Cytoplasmhttp://en.wikipedia.org/wiki/Cytoplasmhttp://en.wikipedia.org/wiki/Granule_(cell_biology)http://en.wikipedia.org/wiki/Granule_(cell_biology)http://en.wikipedia.org/wiki/Heparinhttp://en.wikipedia.org/wiki/Heparinhttp://en.wikipedia.org/wiki/Chondroitin_sulfatehttp://en.wikipedia.org/wiki/Chondroitin_sulfatehttp://en.wikipedia.org/wiki/Peroxidasehttp://en.wikipedia.org/wiki/Peroxidasehttp://en.wikipedia.org/wiki/Peroxidasehttp://en.wikipedia.org/wiki/Platelet-activating_factorhttp://en.wikipedia.org/wiki/Platelet-activating_factorhttp://en.wikipedia.org/wiki/Platelet-activating_factorhttp://en.wikipedia.org/wiki/Inflammatory_responsehttp://en.wikipedia.org/wiki/Inflammatory_responsehttp://en.wikipedia.org/wiki/Capillarieshttp://en.wikipedia.org/wiki/Capillarieshttp://en.wikipedia.org/wiki/Capillarieshttp://en.wikipedia.org/wiki/Leukocyteshttp://en.wikipedia.org/wiki/Leukocyteshttp://en.wikipedia.org/wiki/Prostaglandinshttp://en.wikipedia.org/wiki/Prostaglandinshttp://en.wikipedia.org/wiki/Microbeshttp://en.wikipedia.org/wiki/Microbeshttp://en.wikipedia.org/wiki/Microbeshttp://en.wikipedia.org/wiki/Phagocytehttp://en.wikipedia.org/wiki/Phagocytehttp://en.wikipedia.org/w/index.php?title=Granulocyte&action=edit&section=5http://en.wikipedia.org/w/index.php?title=Granulocyte&action=edit&section=5http://en.wikipedia.org/w/index.php?title=Granulocyte&action=edit&section=5http://en.wikipedia.org/w/index.php?title=Granulocyte&veaction=edit&section=5http://en.wikipedia.org/w/index.php?title=Granulocyte&veaction=edit&section=5http://en.wikipedia.org/w/index.php?title=Granulocyte&veaction=edit&section=5http://en.wikipedia.org/wiki/Hematopoietic_stem_cellhttp://en.wikipedia.org/wiki/Hematopoietic_stem_cellhttp://en.wikipedia.org/wiki/Granulopoiesishttp://en.wikipedia.org/wiki/Granulopoiesishttp://en.wikipedia.org/wiki/Myeloblastshttp://en.wikipedia.org/wiki/Myeloblastshttp://en.wikipedia.org/wiki/Myeloblastshttp://en.wikipedia.org/wiki/Promyelocytehttp://en.wikipedia.org/wiki/Promyelocytehttp://en.wikipedia.org/wiki/Promyelocytehttp://en.wikipedia.org/w/index.php?title=Granulocyte&action=edit&section=6http://en.wikipedia.org/w/index.php?title=Granulocyte&action=edit&section=6http://en.wikipedia.org/w/index.php?title=Granulocyte&action=edit&section=6http://en.wikipedia.org/w/index.php?title=Granulocyte&veaction=edit&section=6http://en.wikipedia.org/w/index.php?title=Granulocyte&veaction=edit&section=6http://en.wikipedia.org/w/index.php?title=Granulocyte&veaction=edit&section=6http://en.wikipedia.org/wiki/Degranulationhttp://en.wikipedia.org/wiki/Degranulationhttp://en.wikipedia.org/wiki/Vesicle_(biology)http://en.wikipedia.org/wiki/Vesicle_(biology)http://en.wikipedia.org/wiki/Vesicle_(biology)http://en.wikipedia.org/wiki/Oxygenhttp://en.wikipedia.org/wiki/Oxygenhttp://en.wikipedia.org/wiki/Superoxidehttp://en.wikipedia.org/wiki/Superoxidehttp://en.wikipedia.org/wiki/Hydrogen_peroxidehttp://en.wikipedia.org/wiki/Hydrogen_peroxidehttp://en.wikipedia.org/wiki/Hydroxylhttp://en.wikipedia.org/wiki/Hydroxylhttp://en.wikipedia.org/wiki/Hypohalitehttp://en.wikipedia.org/wiki/Hypohalitehttp://en.wikipedia.org/wiki/Hypohalitehttp://en.wikipedia.org/wiki/Nitrogenhttp://en.wikipedia.org/wiki/Nitrogenhttp://en.wikipedia.org/wiki/Nitrogenhttp://en.wikipedia.org/wiki/Nitric_oxidehttp://en.wikipedia.org/wiki/Nitric_oxidehttp://en.wikipedia.org/wiki/Nitric_oxidehttp://en.wikipedia.org/wiki/Antimicrobialhttp://en.wikipedia.org/wiki/Antimicrobialhttp://en.wikipedia.org/wiki/Defensinhttp://en.wikipedia.org/wiki/Defensinhttp://en.wikipedia.org/wiki/Defensinhttp://en.wikipedia.org/wiki/Eosinophil_cationic_proteinhttp://en.wikipedia.org/wiki/Eosinophil_cationic_proteinhttp://en.wikipedia.org/wiki/Eosinophil_cationic_proteinhttp://en.wikipedia.org/wiki/Enzymehttp://en.wikipedia.org/wiki/Enzymehttp://en.wikipedia.org/wiki/Lysozymehttp://en.wikipedia.org/wiki/Lysozymehttp://en.wikipedia.org/wiki/Gram_positive_bacteriahttp://en.wikipedia.org/wiki/Gram_positive_bacteriahttp://en.wikipedia.org/wiki/Gram_positive_bacteriahttp://en.wikipedia.org/wiki/Acid_hydrolasehttp://en.wikipedia.org/wiki/Acid_hydrolasehttp://en.wikipedia.org/w/index.php?title=Granulocyte&action=edit&section=7http://en.wikipedia.org/w/index.php?title=Granulocyte&action=edit&section=7http://en.wikipedia.org/w/index.php?title=Granulocyte&action=edit&section=7http://en.wikipedia.org/w/index.php?title=Granulocyte&veaction=edit&section=7http://en.wikipedia.org/w/index.php?title=Granulocyte&veaction=edit&section=7http://en.wikipedia.org/w/index.php?title=Granulocyte&veaction=edit&section=7http://en.wikipedia.org/wiki/File:PBBasophil.jpghttp://en.wikipedia.org/w/index.php?title=Granulocyte&veaction=edit&section=7http://en.wikipedia.org/w/index.php?title=Granulocyte&action=edit&section=7http://en.wikipedia.org/wiki/Acid_hydrolasehttp://en.wikipedia.org/wiki/Gram_positive_bacteriahttp://en.wikipedia.org/wiki/Lysozymehttp://en.wikipedia.org/wiki/Enzymehttp://en.wikipedia.org/wiki/Eosinophil_cationic_proteinhttp://en.wikipedia.org/wiki/Defensinhttp://en.wikipedia.org/wiki/Antimicrobialhttp://en.wikipedia.org/wiki/Nitric_oxidehttp://en.wikipedia.org/wiki/Nitrogenhttp://en.wikipedia.org/wiki/Hypohalitehttp://en.wikipedia.org/wiki/Hydroxylhttp://en.wikipedia.org/wiki/Hydrogen_peroxidehttp://en.wikipedia.org/wiki/Superoxidehttp://en.wikipedia.org/wiki/Oxygenhttp://en.wikipedia.org/wiki/Vesicle_(biology)http://en.wikipedia.org/wiki/Degranulationhttp://en.wikipedia.org/w/index.php?title=Granulocyte&veaction=edit&section=6http://en.wikipedia.org/w/index.php?title=Granulocyte&action=edit&section=6http://en.wikipedia.org/wiki/Promyelocytehttp://en.wikipedia.org/wiki/Myeloblastshttp://en.wikipedia.org/wiki/Granulopoiesishttp://en.wikipedia.org/wiki/Hematopoietic_stem_cellhttp://en.wikipedia.org/w/index.php?title=Granulocyte&veaction=edit&section=5http://en.wikipedia.org/w/index.php?title=Granulocyte&action=edit&section=5http://en.wikipedia.org/wiki/Phagocytehttp://en.wikipedia.org/wiki/Microbeshttp://en.wikipedia.org/wiki/Prostaglandinshttp://en.wikipedia.org/wiki/Leukocyteshttp://en.wikipedia.org/wiki/Capillarieshttp://en.wikipedia.org/wiki/Inflammatory_responsehttp://en.wikipedia.org/wiki/Platelet-activating_factorhttp://en.wikipedia.org/wiki/Peroxidasehttp://en.wikipedia.org/wiki/Chondroitin_sulfatehttp://en.wikipedia.org/wiki/Heparinhttp://en.wikipedia.org/wiki/Granule_(cell_biology)http://en.wikipedia.org/wiki/Cytoplasmhttp://en.wikipedia.org/wiki/Histaminehttp://en.wikipedia.org/wiki/Complement_systemhttp://en.wikipedia.org/wiki/IgGhttp://en.wikipedia.org/wiki/IgEhttp://en.wikipedia.org/wiki/Chromatinhttp://en.wikipedia.org/wiki/Cell_nucleushttp://en.wikipedia.org/wiki/Bloodhttp://en.wikipedia.org/wiki/Bone_marrowhttp://en.wikipedia.org/wiki/Erythrocytes


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This condition reduces the body's resistance to many infections. Closely relatedterms includeagranulocytosis(no granulocytes at all) andneutropenia(deficiency ofneutrophil granulocytes). Granulocytes live only one to two days in circulation (fourdays in spleen or other tissue), so transfusion of granulocytes as a therapeuticstrategy would confer a very short-lasting benefit. In addition, there are manycomplications associated with such a procedure.

There is usually a granulocyte chemotactic defect in individuals suffering frominsulin-dependent diabetes mellitus.
http://en.wikipedia.org/wiki/Agranulocytosishttp://en.wikipedia.org/wiki/Agranulocytosishttp://en.wikipedia.org/wiki/Agranulocytosishttp://en.wikipedia.org/wiki/Neutropeniahttp://en.wikipedia.org/wiki/Neutropeniahttp://en.wikipedia.org/wiki/Neutropeniahttp://en.wikipedia.org/wiki/Neutrophil_granulocytehttp://en.wikipedia.org/wiki/Neutrophil_granulocytehttp://en.wikipedia.org/wiki/Spleenhttp://en.wikipedia.org/wiki/Spleenhttp://en.wikipedia.org/wiki/Blood_transfusionhttp://en.wikipedia.org/wiki/Blood_transfusionhttp://en.wikipedia.org/wiki/Chemotactichttp://en.wikipedia.org/wiki/Chemotactichttp://en.wikipedia.org/wiki/Insulin-dependent_diabetes_mellitushttp://en.wikipedia.org/wiki/Insulin-dependent_diabetes_mellitushttp://en.wikipedia.org/wiki/Insulin-dependent_diabetes_mellitushttp://en.wikipedia.org/wiki/Chemotactichttp://en.wikipedia.org/wiki/Blood_transfusionhttp://en.wikipedia.org/wiki/Spleenhttp://en.wikipedia.org/wiki/Neutrophil_granulocytehttp://en.wikipedia.org/wiki/Neutropeniahttp://en.wikipedia.org/wiki/Agranulocytosis

oligoclonal band

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