| Autor: |
Maglio G; Unit of Clinical and Molecular Pathology, A.O.U. University of Campania 'Luigi Vanvitelli', 80138 Naples, Italy., D'Agostino M; Unit of Clinical and Molecular Pathology, A.O.U. University of Campania 'Luigi Vanvitelli', 80138 Naples, Italy., Caronte FP; Unit of Clinical and Molecular Pathology, A.O.U. University of Campania 'Luigi Vanvitelli', 80138 Naples, Italy., Pezone L; Unit of Clinical and Molecular Pathology, A.O.U. University of Campania 'Luigi Vanvitelli', 80138 Naples, Italy., Casamassimi A; Department of Precision Medicine, University of Campania 'Luigi Vanvitelli', 80138 Naples, Italy., Rienzo M; Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania 'Luigi Vanvitelli', 81100 Caserta, Italy., Di Zazzo E; Department of Medicine and Health Sciences 'V. Tiberio', University of Molise, 86100 Campobasso, Italy., Nappo C; Unit of Clinical and Molecular Pathology, A.O.U. University of Campania 'Luigi Vanvitelli', 80138 Naples, Italy., Medici N; Unit of Clinical and Molecular Pathology, A.O.U. University of Campania 'Luigi Vanvitelli', 80138 Naples, Italy.; Department of Precision Medicine, University of Campania 'Luigi Vanvitelli', 80138 Naples, Italy., Molinari AM; Unit of Clinical and Molecular Pathology, A.O.U. University of Campania 'Luigi Vanvitelli', 80138 Naples, Italy.; Department of Precision Medicine, University of Campania 'Luigi Vanvitelli', 80138 Naples, Italy., Abbondanza C; Unit of Clinical and Molecular Pathology, A.O.U. University of Campania 'Luigi Vanvitelli', 80138 Naples, Italy.; Department of Precision Medicine, University of Campania 'Luigi Vanvitelli', 80138 Naples, Italy. |
| Abstrakt: |
Multiple sclerosis is a chronic immune-mediated disorder of the central nervous system with a high heterogeneity among patients. In the clinical setting, one of the main challenges is a proper and early diagnosis for the prediction of disease activity. Current diagnosis is based on the integration of clinical, imaging, and laboratory results, with the latter based on the presence of intrathecal IgG oligoclonal bands in the cerebrospinal fluid whose detection via isoelectric focusing followed by immunoblotting represents the gold standard. Intrathecal synthesis can also be evidenced by the measurement of kappa free light chains in the cerebrospinal fluid, which has reached similar diagnostic accuracy compared to that of oligoclonal bands in the identification of patients with multiple sclerosis; moreover, recent studies have also highlighted its value for early disease activity prediction. This strategy has significant advantages as compared to using oligoclonal band detection, even though some issues remain open. Here, we discuss the current methods applied for cerebrospinal fluid analysis to achieve the most accurate diagnosis and for follow-up and prognosis evaluation. In addition, we describe new promising biomarkers, currently under investigation, that could contribute both to a better diagnosis of multiple sclerosis and to its monitoring of the therapeutic treatment response. |
