In particular, the high levels of IFNγ and TNF in the CSF of OCB+ MS patients with higher CL load is in agreement with the finding of increased IFNγ and TNF gene and protein expression in paired post-mortem meninges and CSF obtained from secondary progressive multiple sclerosis (SPMS) cases with increased meningeal inflammation, cortical damage and rapid disease progression [38]. Here, TNF is linked to secondary progressive multiple sclerosis.