Evaluating the role of HLA DRB1 alleles and oligoclonal bands in influencing clinical course of multiple sclerosis – A study from the Mangalore demyelinating disease registry

Background: The possible interaction between genetic and immunological factors in influencing clinical course of multiple sclerosis (MS) has not been studied previously in Indian population. Aim: In this study we evaluated the association of HLA alleles and OCB in affecting clinical course and disability of MS. Methods: Clinical and demographic features of 145 MS patients who had CSF oligoclonal bands (OCB) tested by isoelectric focussing technique were analyzed, disability status estimated, and HLA DRB1 alleles were genotyped. Results: OCBs were positive in 53.8% (78/145) of all MS cases. Patients with CSF OCB had more frequent relapses and an association with HLA DRB1*15. Early disease onset and a high annualized relapse rate was associated with HLA DRB1*03 allele. A relapsing remitting course for MS was seen with HLA DRB1*03 & 15 while a progressive disease was associated with DRB1*01. Presence of both OCB and HLA DRB1*13 was significantly associated with disability in this cohort. Conclusion: The results of our study suggest that an interaction between immunological and genetic factors may influence disease onset, course, and disability in MS