Concentrations of immunoglobulin free light chains in cerebrospinal fluid predict increased level of brain atrophy in multiple sclerosis

Назаров, В. Д.; Makshakov, Gleb; Kalinin, I. V.; Лапин, С. В.; Суркова, Е. А.; Михайлова, Л. Р.; Gilburd, Boris; Скоромец, А А; Evdoshenko, Evgeniy

doi:10.1007/s12026-018-9058-8

Cited by 11 publications

(9 citation statements)

References 20 publications

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“…Results are heterogeneous concerning the correlation of KFLC concentrations or calculated KFLC measurements like quotients or indices with MRI parameters of inflammation of the CNS. In some studies, a significant correlation between elevated KFLC concentrations in CSF or KFLC indices and brain atrophy, brain lesion pattern, or T2-lesion volume was observed [45,69,135]. In contrast, other studies have not shown a significant correlation between KFLC and brain damage according to MRI or localization and load of MRI abnormalities [43,56,62,66,72,76,77].…”

Section: Correlation Of Flc With Brain Mri and Disability Progression In Msmentioning

confidence: 95%

“…In addition, most studies were performed retrospectively, which hazard the risk of a selection bias for the inclusion of patients. Furthermore, the reported results might be influenced by the inclusion of MS patients with different disease duration and disease-related disabilities, the limited number of investigated patients, or the short follow-up time [43,45,62,66,69,72,76,77,135]. Thus, heterogeneity of the reported results of different studies and limited comparability might be expected.…”

Section: Correlation Of Flc With Brain Mri and Disability Progression In Msmentioning

confidence: 99%

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The Increasing Role of Kappa Free Light Chains in the Diagnosis of Multiple Sclerosis

Konen

Schwenkenbecher

Jendretzky

et al. 2021

Cells

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Free light chains (FLC) are a promising biomarker to detect intrathecal inflammation in patients with inflammatory central nervous system (CNS) diseases, including multiple sclerosis (MS). The diagnostic use of this biomarker, in particular the kappa isoform of FLC (“KFLC”), has been investigated for more than 40 years. Based on an extensive literature review, we found that an agreement on the correct method for evaluating KFLC concentrations has not yet been reached. KFLC indices with varying cut-off values and blood-CSF-barrier (QAlbumin) related non-linear formulas for KFLC interpretation have been investigated in several studies. All approaches revealed high diagnostic sensitivity and specificity compared with the oligoclonal bands, which are considered the gold standard for the detection of intrathecally synthesized immunoglobulins. Measurement of KFLC is fully automated, rater-independent, and has been shown to be stable against most pre-analytic influencing factors. In conclusion, the determination of KFLC represents a promising diagnostic approach to show intrathecal inflammation in neuroinflammatory diseases. Multicenter studies are needed to show the diagnostic sensitivity and specificity of KFLC in MS by using the latest McDonald criteria and appropriate, as well as standardized, cut-off values for KFLC concentrations, preferably considering non-linear formulas such as Reiber’s diagram.

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Section: Correlation Of Flc With Brain Mri and Disability Progression In Msmentioning

confidence: 95%

Section: Correlation Of Flc With Brain Mri and Disability Progression In Msmentioning

confidence: 99%

The Increasing Role of Kappa Free Light Chains in the Diagnosis of Multiple Sclerosis

Konen

Schwenkenbecher

Jendretzky

et al. 2021

Cells

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“…For instance, studies by Rosenstein et al [96], Ramsden [101], Messaoudani et al [107] and Martins et al [112] found that there was a higher concentration of κ-FLCs in patients with clinically validated multiple sclerosis. Overall, eight studies (Mead et al [49], Han et al [52], Nazarov et al [59], Kaplan et al [60], Vecchio et al [62], Annunziata et al [94], Saadeh et al [98], Arneth et al [111]) reported that free light chains could be effectively utilized in the diagnosis of multiple sclerosis.…”

Section: The Efficiency Of Kappa Free Light Chains In Diagnosing Mult...mentioning

confidence: 99%

The Use of Kappa Free Light Chains to Diagnose Multiple Sclerosis

Arneth

Kraus

2022

Medicina

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Background: The positive implications of using free light chains in diagnosing multiple sclerosis have increasingly gained considerable interest in medical research and the scientific community. It is often presumed that free light chains, particularly kappa and lambda free light chains, are of practical use and are associated with a higher probability of obtaining positive results compared to oligoclonal bands. The primary purpose of the current paper was to conduct a systematic review to assess the up-to-date methods for diagnosing multiple sclerosis using kappa and lambda free light chains. Method: An organized literature search was performed across four electronic sources, including Google Scholar, Web of Science, Embase, and MEDLINE. The sources analyzed in this systematic review and meta-analysis comprise randomized clinical trials, prospective cohort studies, retrospective studies, controlled clinical trials, and systematic reviews. Results: The review contains 116 reports that includes 1204 participants. The final selection includes a vast array of preexisting literature concerning the study topic: 35 randomized clinical trials, 21 prospective cohort studies, 19 retrospective studies, 22 controlled clinical trials, and 13 systematic reviews. Discussion: The incorporated literature sources provided integral insights into the benefits of free light chain diagnostics for multiple sclerosis. It was also evident that the use of free light chains in the diagnosis of clinically isolated syndrome (CIS) and multiple sclerosis is relatively fast and inexpensive in comparison to other conventional state-of-the-art diagnostic methods, e.g., using oligoclonal bands (OCBs).

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“…Recently, Nazarov, V. et al showed an association between kFLC and the degree of irreversible disability in MS patients. In particular, the authors showed that MS patients with high levels of kFLC reached disability faster than patients who had low kFLC levels, suggesting that it can be a good prognostic marker in MS [44,45]. Goffette et al studied 33 patients with clinically suspected MS and no detectable OCB and reported that 54% of them were positive for kFLC.…”

Section: Csf Diagnosticsmentioning

confidence: 99%

Cerebrospinal Fluid Analysis in Multiple Sclerosis Diagnosis: An Update

et al. 2019

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Multiple sclerosis (MS) is an immune-mediated demyelinating disease of the central nervous system (CNS) with brain neurodegeneration. MS patients present heterogeneous clinical manifestations in which both genetic and environmental factors are involved. The diagnosis is very complex due to the high heterogeneity of the pathophysiology of the disease. The diagnostic criteria have been modified several times over the years. Basically, they include clinical symptoms, presence of typical lesions detected by magnetic resonance imaging (MRI), and laboratory findings. The analysis of cerebrospinal fluid (CSF) allows an evaluation of inflammatory processes circumscribed to the CNS and reflects changes in the immunological pattern due to the progression of the pathology, being fundamental in the diagnosis and monitoring of MS. The detection of the oligoclonal bands (OCBs) in both CSF and serum is recognized as the “gold standard” for laboratory diagnosis of MS, though presents analytical limitations. Indeed, current protocols for OCBs assay are time-consuming and require an operator-dependent interpretation. In recent years, the quantification of free light chain (FLC) in CSF has emerged to assist clinicians in the diagnosis of MS. This article reviews the current knowledge on CSF biomarkers used in the diagnosis of MS, in particular on the validated assays and on the alternative biomarkers of intrathecal synthesis.

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Concentrations of immunoglobulin free light chains in cerebrospinal fluid predict increased level of brain atrophy in multiple sclerosis

Cited by 11 publications

References 20 publications

The Increasing Role of Kappa Free Light Chains in the Diagnosis of Multiple Sclerosis

The Increasing Role of Kappa Free Light Chains in the Diagnosis of Multiple Sclerosis

The Use of Kappa Free Light Chains to Diagnose Multiple Sclerosis

Cerebrospinal Fluid Analysis in Multiple Sclerosis Diagnosis: An Update

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