Utility of oligoclonal IgG band detection for MS diagnosis in daily clinical practice

Abraira, Víctor; Alvarez‐Cermeño, J. C.; Arroyo, Rafael; Cámara, Carmen; Casanova, Bonaventura; Cubillo, S.; Andrés, Clara de; Espejo, Carmen; Fernández, Óscar; Ferrer, Joana M.; Figueredo, M. Á.; García‐Merino, Antonio; García-Sánchez, M. I.; García-Trujillo, José Antonio; Gómez, Miguel Ángel Sánchez; González-Oria, C.; Gosis, A.; Izquierdo, Guillermo; Jiménez, Juana Jiménez; López-Trascasa, Margarita; Montalbán, Xavier; Moreno, Marta; Muñoz, Delicias; Núñez, Vanessa; Muriel, Alfonso; Navarro, J.; Olascoaga, Javier; Oreja‐Guevara, Celia; Prada, Álvaro; Ramil, Elvira; Ramo-Tello, Cristina; Rodrı́guez, Carmen; Rodríguez, E. Alonso; Rodríguez‐Frías, Francisco; Antigüedad, Alfredo Rodríguez; Rodrı́guez-Molina, J.; Ruiz, Ernestina Menasalvas; Sáiz, Albert; Sarasola, E.; Simó, Magdolna; Yagúe, José Artola; Villar, Luisa M.

doi:10.1016/j.jim.2011.06.009

Cited by 27 publications

(15 citation statements)

References 11 publications

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“…33 Moreover, inter-laboratory agreement is reported to be good for OCB, for example an inter-laboratory agreement of kappa > 0.8 between 19 participating laboratories in Spain was observed. 34 One more important note is that the best set up for the study would have been if the test population should be suspected MS cases and not already diagnosed with MS. Still, as provided in Supplemental Table 2B, we included various INDC and quite some patients initially suspected for demyelinating disease.…”

Section: Discussionmentioning

confidence: 99%

Kappa free light chains is a valid tool in the diagnostics of MS: A large multicenter study

et al. 2019

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Objective: To validate kappa free light chain (KFLC) and lambda free light chain (LFLC) indices as a diagnostic biomarker in multiple sclerosis (MS). Methods: We performed a multicenter study including 745 patients from 18 centers (219 controls and 526 clinically isolated syndrome (CIS)/MS patients) with a known oligoclonal IgG band (OCB) status. KFLC and LFLC were measured in paired cerebrospinal fluid (CSF) and serum samples. Gaussian mixture modeling was used to define a cut-off for KFLC and LFLC indexes. Results: The cut-off for the KFLC index was 6.6 (95% confidence interval (CI) = 5.2–138.1). The cut-off for the LFLC index was 6.9 (95% CI = 4.5–22.2). For CIS/MS patients, sensitivity of the KFLC index (0.88; 95% CI = 0.85–0.90) was higher than OCB (0.82; 95%CI = 0.79–0.85; p < 0.001), but specificity (0.83; 95% CI = 0.78–0.88) was lower (OCB = 0.92; 95% CI = 0.89–0.96; p < 0.001). Both sensitivity and specificity for the LFLC index were lower than OCB. Conclusion: Compared with OCB, the KFLC index is more sensitive but less specific for diagnosing CIS/MS. Lacking an elevated KFLC index is more powerful for excluding MS compared with OCB but the latter is more important for ruling in a diagnosis of CIS/MS.

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Section: Discussionmentioning

confidence: 99%

Kappa free light chains is a valid tool in the diagnostics of MS: A large multicenter study

et al. 2019

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“…The interpretation of results is rater-dependent, albeit quite high interrater agreement has been reported [10]. Several studies have indicated a potential diagnostic value of free light chains (FLC) in MS [11–13].…”

Section: Introductionmentioning

confidence: 97%

Free Light Chains and Intrathecal B Cells Activity in Multiple Sclerosis: A Prospective Study and Meta-Analysis

Passerini¹,

Costa²,

Sangalli³

et al. 2016

Multiple Sclerosis International

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Background. The presence of CSF oligoclonal bands (OBs) is an independent prognostic factor for multiple sclerosis (MS), but the difficulties in the standardization of the test and the interlaboratory variation in reporting have contributed to its limited use in the diagnosis of the disease. Standard nephelometric assays to measure free light chains (FLC) levels have been recently developed and the test may improve the detection of intrathecal B cells activity. Methods. The presence of OBs, kappa and lambda FLC levels, and standard indices of intrathecal inflammation were assessed in 100 consecutive patients, including patients with MS, clinically isolated syndromes (CIS), other inflammatory diseases of the CNS, and other noninflammatory diseases. Results. Both KFLC and LFLC correlated strongly with the presence of OCBs and with all common tests for intrathecal inflammation (p < 0.001 for all comparisons). KFLC and LFLC were significantly different in patients with MS and CIS compared to the other groups (p < 0.001 and p < 0.001, resp.) and had a better diagnostic accuracy than all the other tests (area under the curve 82.3 % for KFLC index and 79.3 % for LFLC index). Conclusion. Nephelometric assays for KFLC in CSF reliably detect intrathecal immunoglobulin synthesis and discriminate MS patients.

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“…The best results are obtained with the high-sensitivity technique based on IgG detection with antibodies labelled with alkaline phosphatase, which was the one used in our study. 16 …”

Section: Introductionmentioning

confidence: 99%

Free kappa light chains in cerebrospinal fluid as a biomarker to assess risk conversion to multiple sclerosis

Menéndez-Valladares

García-Sánchez

Benítez

et al. 2015

Multiple Sclerosis Journal - Experimental, Translational and Cl

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BackgroundMultiple sclerosis (MS) initiates with a first attack or clinically isolated syndrome (CIS). The importance of an early treatment in MS leads to the search, as soon as possible, for novel biomarkers which can predict conversion from CIS to MS.ObjectiveThe purpose of this study was to assess the predictive value of the kappa index (κ index), using kappa free light light chains (κFLCs) in cerebrospinal fluid (CSF), for the conversion of CIS patients to MS, and compare its accuracy with other parameters used in clinical practice.MethodsFLC levels were analysed in CSF from 176 patients: 70 as control group, 77 CIS, and 29 relapsing–remitting MS. FLC levels were quantified by nephelometry.Resultsκ Index sensitivity and specificity (93.1%; 95.7%) was higher than those from the immunoglobulin G (IgG) index (75.9%; 94.3%), and lower than those from oligoclonal IgG bands (OCGBs) (96.5%; 98.6%). The optimal cut-off for κ index was 10.62. Most of the CIS patients with κ index >10.62 presented OCGBs, IgG index >0.56 and fulfilled magnetic resonance imaging (MRI) criteria.ConclusionCIS patients above κ index cut-off of 10.62 present 7.34-fold risk of conversion to MS than CIS below this value. The κ index correlated with positive OCGBs, IgG index above 0.56 and MRI criteria.

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Utility of oligoclonal IgG band detection for MS diagnosis in daily clinical practice

Cited by 27 publications

References 11 publications

Kappa free light chains is a valid tool in the diagnostics of MS: A large multicenter study

Kappa free light chains is a valid tool in the diagnostics of MS: A large multicenter study

Free Light Chains and Intrathecal B Cells Activity in Multiple Sclerosis: A Prospective Study and Meta-Analysis

Free kappa light chains in cerebrospinal fluid as a biomarker to assess risk conversion to multiple sclerosis

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