Genetic variants are major determinants of CSF antibody levels in multiple sclerosis

An Goris, Ine Pauwels, Marte W. Gustavsen, Brechtje Van Son, Kelly Hilven, Steffan D. Bos, Elisabeth Gulowsen Celius, Pal Berg-Hansen, Jan Aarseth, Kjell Morten Myhr, Sandra D'Alfonso, Nadia Barizzone, Maurizio A. Leone, Filippo Martinelli Boneschi, Melissa Sorosina, Giuseppe Liberatore, Ingrid Kockum, Tomas Olsson, Jan Hillert, Lars AlfredssonSahl Khalid Bedri, Bernhard Hemmer, Dorothea Buck, Achim Berthele, Benjamin Knier, Viola Biberacher, Vincent Van Pesch, Christian Sindi, Annette Bang Oturai, Helle Bach Søndergaard, Finn Sellebjerg, Poul Erik H Jensen, Manuel Comabella, Xavier Montalban, Jennifer Pérez-Boza, Sunny Malhotra, Jeannette Lechner-Scott, Simon Broadley, Mark Slee, Bruce Taylor, Allan G. Kermode, Pierre Antoine Gourraud, Stephen J. Sawcer, Bettina Kullle Andreassen, Bénédicte Dubois, Hanne F. Harbo

Research output: Contribution to journalArticlepeer-review


Immunological hallmarks of multiple sclerosis include the production of antibodies in the central nervous system, expressed as presence of oligoclonal bands and/or an increased immunoglobulin G index-the level of immunoglobulin G in the cerebrospinal fluid compared to serum. However, the underlying differences between oligoclonal band-positive and-negative patients with multiple sclerosis and reasons for variability in immunoglobulin G index are not known. To identify genetic factors influencing the variation in the antibody levels in the cerebrospinal fluid in multiple sclerosis, we have performed a genome-wide association screen in patients collected from nine countries for two traits, presence or absence of oligoclonal bands (n = 3026) and immunoglobulin G index levels (n = 938), followed by a replication in 3891 additional patients. We replicate previously suggested association signals for oligoclonal band status in the major histocompatibility complex region for the rs9271640∗A-rs6457617∗G haplotype, correlated with HLA-DRB1∗1501, and rs34083746∗G, correlated with HLA-DQA1∗0301 (P comparing two haplotypes = 8.88 × 10-16). Furthermore, we identify a novel association signal of rs9807334, near the ELAC1/SMAD4 genes, for oligoclonal band status (P = 8.45 × 10-7). The previously reported association of the immunoglobulin heavy chain locus with immunoglobulin G index reaches strong evidence for association in this data set (P = 3.79 × 10-37). We identify two novel associations in the major histocompatibility complex region with immunoglobulin G index: the rs9271640∗A-rs6457617∗G haplotype (P = 1.59 × 10-22), shared with oligoclonal band status, and an additional independent effect of rs6457617∗G (P = 3.68 × 10-6). Variants identified in this study account for up to 2-fold differences in the odds of being oligoclonal band positive and 7.75% of the variation in immunoglobulin G index. Both traits are associated with clinical features of disease such as female gender, age at onset and severity. This is the largest study population so far investigated for the genetic influence on antibody levels in the cerebrospinal fluid in multiple sclerosis, including 6950 patients. We confirm that genetic factors underlie these antibody levels and identify both the major histocompatibility complex and immunoglobulin heavy chain region as major determinants.

Original languageEnglish
Pages (from-to)632-643
Number of pages12
Issue number3
Publication statusPublished - 2015


  • CSF
  • Genetics
  • Immunoglobulin
  • Multiple sclerosis
  • Oligoclonal bands

ASJC Scopus subject areas

  • Clinical Neurology
  • Arts and Humanities (miscellaneous)


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