Free Kappa light chains in neuroinflammatory disorders: Complement rather than substitute?

Autor:	Vincent Van Pesch, Jean-Louis Bayart, Nathalie Muls
Přispěvatelé:	UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - (SLuc) Service de neurologie, UCL - (SLuc) Service de biochimie médicale
Rok vydání:	2018
Předmět:	Adult Male 0301 basic medicine medicine.medical_specialty Multiple Sclerosis multiple sclerosis Intrathecal Immunoglobulin light chain Gastroenterology cerebrospinal fluid Immunoglobulin G Immunoglobulin kappa-Chains 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid Nephelometry and Turbidimetry Internal medicine medicine Humans Automated analyser free kappa light chains Retrospective Studies Inflammation biology neuroinflammatory disorders business.industry oligoclonal bands Multiple sclerosis Oligoclonal Bands General Medicine Middle Aged medicine.disease 030104 developmental biology Neurology biology.protein Female Immunoglobulin Light Chains Neurology (clinical) Turbidimetry Nervous System Diseases business Biomarkers 030217 neurology & neurosurgery Kappa
Zdroj:	Acta neurologica Scandinavica, Vol. 138, no. 4, p. 352-358 (2018)
ISSN:	0001-6314
DOI:	10.1111/ane.12969
Popis:	OBJECTIVES The detection of cerebrospinal fluid (CSF)-specific IgG oligoclonal bands (OCB) by isoelectric focusing (IEF) is widely used to help diagnose inflammatory neurological disorders (IND), including multiple sclerosis. However, the quantification of free light chains (FLC) is increasingly evaluated as a surrogate method to determine the presence of an intrathecal inflammatory process. The objective of this study was to evaluate the diagnostic performance of kappa (κ) FLC measurement in comparison with OCB detection by IEF. MATERIAL AND METHODS We measured serum and CSF κFLCs by turbidimetry using the SPAplus automated analyser and calculated the κ index in 142 samples from OCB-positive and negative MS, as well as from patients with inflammatory and non-inflammatory neurological disorders (IND and NIND). RESULTS The κFLC index was significantly increased in OCB-positive MS and IND patients versus OCB-negative patients. Its performance was relatively comparable to that of IEF for MS diagnosis. When using a κFLC index cutoff value of 6.29, sensitivity increased from 61.2% to 75.7% in comparison with IEF for diagnosing IND (P = .0051), with a slightly lower non-statistically significant specificity (82.1% vs 100%). When considering both OCB status positivity or a κFLC index superior to 6.29 to diagnose IND status, sensitivity raised to 80.6% (P
Databáze:	OpenAIRE
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