Kappa free light chains is a valid tool in the diagnostics of MS : A large multicenter study
Leurs, C. E. (VU University Medical Center. Department of Neurology)
Twaalfhoven, Ham (Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry)
Lissenberg-Witte, B. I. (Department of Epidemiology and Biostatistics, Amsterdam UMC)
van Pesch, V (Department of Neurology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain)
Dujmovic, Irena (Clinic of Neurology, Clinical Centre of Serbia, School of Medicine, University of Belgrade)
Drulovic, Jelena (Clinic of Neurology, Clinical Centre of Serbia, School of Medicine, University of Belgrade)
Castellazzi, M. (Department of Biomedical and Specialty Surgical Sciences, University of Ferrara)
Bellini, T. (Department of Biomedical and Specialty Surgical Sciences, University of Ferrara)
Pugliatti, M. (Department of Biomedical and Specialty Surgical Sciences, University of Ferrara)
Kuhle, Jens (Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel)
Villar, L. M. (Hospital Ramón y Cajal. Departamento de Inmunologia)
Alvarez-Cermeño, José C (Hospital Ramón y Cajal. Departamento de Neurologia)
Alvarez-Lafuente, Roberto (Instituto de Investigación Sanitaria San Carlos)
Hegen, Harald (Department of Neurology, Medical University of Innsbruck)
Deisenhammer, Florian (Department of Neurology, Medical University of Innsbruck)
Walchhofer, L. M. (Department of Neurology, Medical University of Innsbruck)
Thouvenot, Eric (Hôpital Caremeau, Nîmes. Departement of Neurology)
Comabella, Manuel (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Montalban, Xavier (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Vécsei, L. (Department of Neurology, University of Szeged)
Rajda, C. (Department of Neurology, University of Szeged)
Galimberti, Daniela (Multiple Sclerosis Centre, University of Milan)
Scarpini, E. (Multiple Sclerosis Centre, University of Milan)
Altintas, Ayse (Koc University, School of Medicine, Neurology Department)
Rejdak, K. (Department of Neurology, Medical University of Lublin)
Frederiksen, J. L. (Department of Neurology, Rigshospitalet Glostrup and University of Copenhagen)
Pihl-Jensen, G. (Department of Neurology, Rigshospitalet Glostrup and University of Copenhagen)
Jensen, Peh (Danish Multiple Sclerosis Centre, Department of Neurology, Rigshospitalet, University of Copenhagen)
Khalil, Michael (Department of Neurology, Medical University of Graz)
Voortman, Margarete (Department of Neurology, Medical University of Graz)
Fazekas, F. (Department of Neurology, Medical University of Graz)
Saiz, Albert (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
La Puma, D. (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Vercammen, M. (Department of Laboratory Medicine, AZ Sint-Jan Brugge-Oostende)
Vanopdenbosch, L. (Department of Neurology, AZ Sint-Jan Brugge-Oostende)
Uitdehaag, BMJ (Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC)
Killestein, Joep (Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC)
Bridel, C. (Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry)
Teunissen, Charlotte E. (Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry)
Universitat Autònoma de Barcelona. Departament de Medicina

Data:	2019
Resum:	To validate kappa free light chain (KFLC) and lambda free light chain (LFLC) indices as a diagnostic biomarker in multiple sclerosis (MS). 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. 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. 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.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Multiple sclerosis ; KFLC ; OCB ; CSF ; Biomarkers
Publicat a:	Multiple sclerosis, Vol. 26 (may 2019) , p. 912-923, ISSN 1477-0970

DOI: 10.1177/1352458519845844
PMID: 31066634

12 p, 774.2 KB

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