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Kamenskikh EM, Krygina AY, Gomboeva SC, Zhailebaeva D, Koval DP, Kicherov NA, Otchurzhap CN, Birulina YG, Alifirova VM. [Biobanking in clinical trials involving multiple sclerosis patients]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:7-15. [PMID: 39175234 DOI: 10.17116/jnevro20241240727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2024]
Abstract
Investigation of multiple sclerosis (MS) pathogenesis requires sophisticated analytical tools of precision medicine, such as omics research, which include genomics, microbiomics and metabolomics (proteomics, lipidomics and glycomics). Such sensitive methods are based on careful preanalytical work with biomaterials to maintain quality and obtain objective results. Implementation of biobanking as a universal method for working with biomaterials will help to standardize the stages of research, compare different scientific team's results. Collaboration of MS researchers with large biobanks can also help to conduct multicenter and long-term prospective studies, to include a wide number of patients. In this article, we analyze the experience of biobanking practice technologies in studies of MS patients and share the experience of partnership between the Center for MS of the Tomsk Region and the Bank of Biological Material of the Siberian State Medical University.
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Affiliation(s)
| | - A Yu Krygina
- Siberian State Medical University, Tomsk, Russia
| | | | | | - D P Koval
- Siberian State Medical University, Tomsk, Russia
| | - N A Kicherov
- Siberian State Medical University, Tomsk, Russia
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Castillo-Villalba J, Gil-Perotín S, Gasque-Rubio R, Cubas-Nuñez L, Carratalà-Boscà S, Alcalá C, Quintanilla-Bordás C, Pérez-Miralles F, Ferrer C, Cañada Martínez A, Tortosa J, Solís-Tarazona L, Campos L, Leivas A, Laíz Marro B, Casanova B. High Levels of Cerebrospinal Fluid Kappa Free Light Chains Relate to IgM Intrathecal Synthesis and Might Have Prognostic Implications in Relapsing Multiple Sclerosis. Front Immunol 2022; 13:827738. [PMID: 35330910 PMCID: PMC8940299 DOI: 10.3389/fimmu.2022.827738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
Cerebrospinal kappa free light chain (KFLC)-index is a marker of intrathecal immunoglobulin synthesis that aids in the diagnosis of multiple sclerosis (MS). However, little evidence exists on its prognostic role. Our aim is to analyze the relationship between KFLC-index and other MS biomarkers and to explore its prognostic role. This is a monocentric observational study in a cohort of 52 people with relapsing MS (pwRMS) performed on prospectively acquired clinical data and with retrospective evaluation of biomarkers. We measured KFLC-index, immunoglobulin intrathecal synthesis, cerebrospinal fluid (CSF) chitinase 3-like 1 (CHI3L1), and neurofilament light protein (NFL) and reviewed MRI to detect leptomeningeal contrast enhancement (LMCE). We compared time to Expanded Disability Status Scale (EDSS) 3 and to initiation of high-efficacy disease-modifying therapies (heDMTs) by multivariate Cox regression analysis. Median KFLC-index correlated with IgG/IgM indexes (p < 0.0001/p < 0.05) and IgG-oligoclonal bands (OCGBs) (p < 0.001). Patients with IgM-oligoclonal bands (OCMBs) had a higher KFLC-index (p = 0.049). KFLC-index was higher in patients with LMCE (p = 0.008) and correlated with CHI3L1 (p = 0.007), but disease activity had no effect on its value. Bivariate and multivariate analyses confirmed KFLC-index > 58 as an independent risk factor for reaching an EDSS of 3 (hazard ratio (HR) = 12.4; 95% CI = 1.1-147; p = 0.047) and for the need of treatment with heDMTs (HR = 3.0; 95% CI = 1.2-7.1; p = 0.0013). To conclude, our data suggest a potential prognostic role of the KFLC-index during the MS course.
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Affiliation(s)
- Jéssica Castillo-Villalba
- Neuroimmunology Unit, Neurology Department and Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Sara Gil-Perotín
- Neuroimmunology Unit, Neurology Department and Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Raquel Gasque-Rubio
- Neuroimmunology Unit, Neurology Department and Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Laura Cubas-Nuñez
- Neuroimmunology Unit, Neurology Department and Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Sara Carratalà-Boscà
- Neuroimmunology Unit, Neurology Department and Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Carmen Alcalá
- Neuroimmunology Unit, Neurology Department and Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Carlos Quintanilla-Bordás
- Neuroimmunology Unit, Neurology Department and Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Francisco Pérez-Miralles
- Neuroimmunology Unit, Neurology Department and Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Cristina Ferrer
- Neuroimmunology Unit, Neurology Department and Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Antonio Cañada Martínez
- Data Science, Biostatistics and Bioinformatics, Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Jordi Tortosa
- Clinical Laboratory, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - Luisa Campos
- Scientific Department, The Binding Site Iberia, Barcelona, Spain
| | - Alberto Leivas
- Scientific Department, The Binding Site Iberia, Barcelona, Spain
| | - Begoña Laíz Marro
- Clinical Laboratory, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Bonaventura Casanova
- Neuroimmunology Unit, Neurology Department and Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
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Konen FF, Schwenkenbecher P, Jendretzky KF, Gingele S, Sühs KW, Tumani H, Süße M, Skripuletz T. The Increasing Role of Kappa Free Light Chains in the Diagnosis of Multiple Sclerosis. Cells 2021; 10:3056. [PMID: 34831279 PMCID: PMC8622045 DOI: 10.3390/cells10113056] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/26/2021] [Accepted: 11/04/2021] [Indexed: 12/03/2022] Open
Abstract
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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Affiliation(s)
- Franz Felix Konen
- Department of Neurology, Hannover Medical School, 30625 Hannover, Germany; (F.F.K.); (P.S.); (K.F.J.); (S.G.); (K.-W.S.)
| | - Philipp Schwenkenbecher
- Department of Neurology, Hannover Medical School, 30625 Hannover, Germany; (F.F.K.); (P.S.); (K.F.J.); (S.G.); (K.-W.S.)
| | - Konstantin Fritz Jendretzky
- Department of Neurology, Hannover Medical School, 30625 Hannover, Germany; (F.F.K.); (P.S.); (K.F.J.); (S.G.); (K.-W.S.)
| | - Stefan Gingele
- Department of Neurology, Hannover Medical School, 30625 Hannover, Germany; (F.F.K.); (P.S.); (K.F.J.); (S.G.); (K.-W.S.)
| | - Kurt-Wolfram Sühs
- Department of Neurology, Hannover Medical School, 30625 Hannover, Germany; (F.F.K.); (P.S.); (K.F.J.); (S.G.); (K.-W.S.)
| | | | - Marie Süße
- Department of Neurology, University Medicine Greifswald, 17475 Greifswald, Germany;
| | - Thomas Skripuletz
- Department of Neurology, Hannover Medical School, 30625 Hannover, Germany; (F.F.K.); (P.S.); (K.F.J.); (S.G.); (K.-W.S.)
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