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Kennedy PGE, George W, Yu X. The elusive nature of the oligoclonal bands in multiple sclerosis. J Neurol 2024; 271:116-124. [PMID: 37945762 DOI: 10.1007/s00415-023-12081-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 11/12/2023]
Abstract
Intrathecal immunoglobulin G (IgG) and oligoclonal bands (OCBs) detected in both the brain and cerebrospinal fluid (CSF) are seminal features of multiple sclerosis (MS). The presence of OCBs correlates with elevated disease burden and severity and supports the diagnosis of MS. Despite numerous investigations into the potential viral and autoantigen targets, the precise antigenic specificity of OCBs has remained elusive. We have little knowledge of the nature regarding these oligoclonal IgG bands. Here, we present compelling evidence highlighting the key findings that both OCBs and intrathecal IgG antibodies are under genetic control and that OCBs originate from clonal B-cells in both the periphery and CNS. We propose that MS OCBs are IgG immune complexes composed of IgG1 and IgG3 antibodies and that the pathological role of OCB stems from the IgG effector functions of these complexes, leading to demyelination and axonal injuries. We present additional evidence regarding the nature of MS OCBs: (1) disease-modifying therapies have been shown to affect CSF OCB; (2) OCBs have also been detected in several neuroinfectious diseases; (3) Epstein-Barr virus (EBV) has been particularly linked with MS pathogenesis, and its association with OCB is an important area of study. Although OCBs are closely associated with MS, more meticulously planned research is necessary to clarify the precise role of OCB in MS, both in terms of disease pathogenesis and diagnosis.
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Affiliation(s)
- Peter G E Kennedy
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, G61 1QH, Scotland, UK
| | - Woro George
- Department of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Xiaoli Yu
- Department of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA.
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2
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Belimezi M, Kalliaropoulos A, Mentis AFA, Chrousos GP. Diagnostic significance of IgG and albumin indices versus oligoclonal band types in demyelinating disorders. J Clin Pathol 2023; 76:166-171. [PMID: 34526372 DOI: 10.1136/jclinpath-2021-207766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/29/2021] [Indexed: 11/04/2022]
Abstract
AIMS The laboratory diagnosis of demyelinating inflammatory disorders (DIDs) relies on both intrathecal oligoclonal band (OCB) positivity and IgG index. Although OCB typing remains the gold-standard test for DIDs, it can be laborious and ambiguous, complicating diagnostics, and unduly increasing diagnostic time. We examined whether serum or cerebrospinal fluid (CSF) parameters can classify OCB types and, thus, be used as a replacement test to standard OCB typing. METHODS We retrospectively analysed >1000 prospectively collected samples of patients with DIDs and quantified albumin and IgG levels in the CSF and serum. We determined OCB types by isoelectric focusing combined with immunofixation and evaluated the diagnostic accuracies of IgG and albumin indices in discriminating OCB types by receiver operating characteristic curves and multinomial regression. RESULTS An IgG index cut-off of 0.589 differentiated types 2/3 from types 1/4 (area under the curve 0.780, 95% CI 0.761 to 0.812, p<0.001; specificity: 71.10%, sensitivity: 73.45%). Albumin quotient cut-off values of 6.625 and of 6.707 discriminated type 1 from type 4 and type 2 from type 3, respectively (specificity: <55%, sensitivity: <75%). Female sex, age, IgG index, CSF IgG and serum albumin were associated with different OCB types. CONCLUSIONS Our study reveals that IgG and albumin index can differentiate OCB types with adequate accuracy, especially if refined by age and gender.
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Affiliation(s)
- Maria Belimezi
- Diagnostic Services Laboratory, Hellenic Pasteur Institute, Athens, Greece
| | | | - Alexios-Fotios A Mentis
- Diagnostic Services Laboratory, Hellenic Pasteur Institute, Athens, Greece .,University Research Institute of Maternal and Child Health and Precision Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - George P Chrousos
- University Research Institute of Maternal and Child Health and Precision Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Marlas M, Bost C, Dorcet G, Delourme A, Biotti D, Ciron J, Renaudineau Y, Puissant-Lubrano B. Kappa-index: Real-life evaluation of a new tool for multiple sclerosis diagnosis. Clin Immunol 2022; 241:109066. [PMID: 35705146 DOI: 10.1016/j.clim.2022.109066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/03/2022] [Accepted: 06/08/2022] [Indexed: 11/29/2022]
Abstract
The intrathecal production of oligoclonal immunoglobulin bands (OCB) is a prognostic factor for multiple sclerosis (MS) evolution in clinically isolated syndrome (CIS) patients and a diagnostic factor for MS. The kappa free light chain (K)-index represents a quantitative automated alternative to OCB. We retrospectively evaluated OCB and K-index results in 274 patients with MS (n = 48) or CIS (n = 29) at diagnosis, non-MS inflammatory central nervous diseases (n = 35), and non-inflammatory central/peripheral nervous diseases (n = 162). Several cut-offs were established: a pathophysiological cut-off (K-index: 3.3) useful for differential diagnosis (negative predictive value for MS >99%), an optimised cut-off (K-index: 9.1) with better sensitivity and equivalent specificity than OCB for the diagnosis of MS, and a high-risk cut-off (K-index: >55.0) allowing prediction of MS (specificity 100%). We developed a scaled interpretation of the K-index and we discuss the usefulness of testing OCB only when the K-index is positive >3.3 to obtain a better specificity.
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Affiliation(s)
- Mathilde Marlas
- Laboratoire d'Immunologie, Institut Fédératif de Biologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
| | - Chloé Bost
- Laboratoire d'Immunologie, Institut Fédératif de Biologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; INFINITy, Institut Toulousain des Maladies Infectieuses et Inflammatoires, INSERM U1291, CNRS U5051, Université Toulouse III, Toulouse, France.
| | - Guillaume Dorcet
- Laboratoire d'Immunologie, Institut Fédératif de Biologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Département de Neurologie CRC-SEP, Hôpital Paul-Pierre Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Adrien Delourme
- Département de Neurologie CRC-SEP, Hôpital Paul-Pierre Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
| | - Damien Biotti
- INFINITy, Institut Toulousain des Maladies Infectieuses et Inflammatoires, INSERM U1291, CNRS U5051, Université Toulouse III, Toulouse, France; Département de Neurologie CRC-SEP, Hôpital Paul-Pierre Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
| | - Jonathan Ciron
- INFINITy, Institut Toulousain des Maladies Infectieuses et Inflammatoires, INSERM U1291, CNRS U5051, Université Toulouse III, Toulouse, France; Département de Neurologie CRC-SEP, Hôpital Paul-Pierre Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
| | - Yves Renaudineau
- Laboratoire d'Immunologie, Institut Fédératif de Biologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; INFINITy, Institut Toulousain des Maladies Infectieuses et Inflammatoires, INSERM U1291, CNRS U5051, Université Toulouse III, Toulouse, France.
| | - Bénédicte Puissant-Lubrano
- Laboratoire d'Immunologie, Institut Fédératif de Biologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; INFINITy, Institut Toulousain des Maladies Infectieuses et Inflammatoires, INSERM U1291, CNRS U5051, Université Toulouse III, Toulouse, France.
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Giedraitiene N, Drukteiniene E, Kizlaitiene R, Cimbalas A, Asoklis R, Kaubrys G. Cognitive Decline in Multiple Sclerosis Is Related to the Progression of Retinal Atrophy and Presence of Oligoclonal Bands: A 5-Year Follow-Up Study. Front Neurol 2021; 12:678735. [PMID: 34326806 PMCID: PMC8315759 DOI: 10.3389/fneur.2021.678735] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/14/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Brain atrophy, which is associated with cognitive impairment and retinal nerve fiber layer (RNFL) atrophy, is the main biomarker of neurodegeneration in multiple sclerosis (MS). However, data on the relationship between inflammatory markers, such as oligoclonal bands (OCBs) in the cerebrospinal fluid (CSF), and cognition, RNFL atrophy, and brain atrophy are scarce. The aim of this study was to assess the influence of RNFL thickness, brain atrophy markers, intrathecal OCBs, and the immunoglobulin G (IgG) index on cognitive decline over a 5-year period in patients with MS. Methods: This prospective, single-center, observational cohort study included 49 patients with relapsing MS followed up over 5 years. At baseline, the patients underwent brain magnetic resonance imaging (MRI). Cognitive evaluation was performed using the Brief International Cognitive Assessment for MS (BICAMS), and RNFL thickness was assessed using optical coherence tomography (OCT). OCBs and IgG levels in the CSF were evaluated at baseline. The BICAMS, OCT, and MRI findings were re-evaluated after 5 years. Results: A significant reduction in information processing speed, visual learning, temporal RNFL thickness, the Huckman index, and third ventricle mean diameter was found in all 49 patients with relapsing MS over the observation period (p < 0.05). Of the patients, 63.3% had positive OCBs and 59.2% had elevated IgG indices. The atrophy of the temporal segment and papillomacular bundle and the presence of OCBs were significantly related to a decline in information processing speed in these patients (p < 0.05). However, brain atrophy markers were not found to be significant on the general linear models. Conclusions: RNFL atrophy and the presence of OCBs were related to cognitive decline in patients with MS over a 5-year follow-up period, thereby suggesting their utility as potential biomarkers of cognitive decline in MS.
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Affiliation(s)
- Natasa Giedraitiene
- Center of Neurology, Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Egle Drukteiniene
- Center of Eye Diseases, Clinic of Ear, Nose, Throat, and Eye Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Rasa Kizlaitiene
- Center of Neurology, Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Andrius Cimbalas
- Center of Eye Diseases, Clinic of Ear, Nose, Throat, and Eye Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Rimvydas Asoklis
- Center of Eye Diseases, Clinic of Ear, Nose, Throat, and Eye Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Gintaras Kaubrys
- Center of Neurology, Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Zheng Y, Cai MT, Yang F, Zhou JP, Fang W, Shen CH, Zhang YX, Ding MP. IgG Index Revisited: Diagnostic Utility and Prognostic Value in Multiple Sclerosis. Front Immunol 2020; 11:1799. [PMID: 32973754 PMCID: PMC7468492 DOI: 10.3389/fimmu.2020.01799] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 07/06/2020] [Indexed: 12/22/2022] Open
Abstract
Objective: Early and accurate diagnosis of multiple sclerosis (MS) remains a clinical challenge. The main objective is to evaluate the diagnostic and prognostic value of the routinely performed immunoglobulin G (IgG) index for MS patients in the Asian population. Methods: A retrospective study was conducted among a cohort of clinically isolated syndrome (CIS) patients in China with known oligoclonal band (OCB) status and IgG index at baseline. We first evaluated the predictive value of IgG index for OCB status. Secondly, the diagnostic utility and prognostic value of IgG index alone were tested. Lastly, we incorporated IgG index into the 2017 McDonald criteria by replacing OCB with either “IgG index or OCB” (modified criteria 1), “IgG index and OCB” (modified criteria 2), or “IgG index” (modified criteria 3). The diagnostic utility of different criteria was calculated and compared. Results: In a CIS cohort in China (n = 105), IgG index > 0.7 forecasted OCB positivity (X2 = 22.90, P < 0.001). An elevated IgG index was highly prognostic of more clinical relapses [1-year adjusted odds ratio [OR] = 1.32, P = 0.015; 2-years adjusted OR = 1.69, P = 0.013] and Expanded Disability Status Scale worsening (1-year adjusted OR = 1.76, P = 0.040; 2-years adjusted OR = 1.85, P = 0.032). Under the 2017 McDonald criteria (Positive Likelihood Ratio = 1.54, Negative Likelihood Ratio = 0.56), an IgG index > 0.7 in CIS patients increased the likelihood of developing MS within 2 years, either when OCB status was unknown (Positive Likelihood Ratio = 2.11) or with OCB positivity (Positive Likelihood Ratio = 2.11) at baseline; An IgG index ≤ 0.7, along with a negative OCB, helped rule out the MS diagnosis (Negative Likelihood Ratio = 0.53). Conclusions: IgG index > 0.7 predicts OCB positivity at the initial attack of MS and is prognostic of early disease activity. IgG index serves as an easily-obtainable and accurate OCB surrogate for MS diagnosis in the Asian population.
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Affiliation(s)
- Yang Zheng
- Department of Neurology, School of Medicine, Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Meng-Ting Cai
- Department of Neurology, School of Medicine, Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Fan Yang
- Department of Neurology, School of Medicine, Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Ji-Ping Zhou
- Harvard University School of Public Health, Boston, MA, United States
| | - Wei Fang
- Department of Neurology, School of Medicine, Fourth Affiliated Hospital, Zhejiang University, Yiwu, China
| | - Chun-Hong Shen
- Department of Neurology, School of Medicine, Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Yin-Xi Zhang
- Department of Neurology, School of Medicine, Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Mei-Ping Ding
- Department of Neurology, School of Medicine, Second Affiliated Hospital, Zhejiang University, Hangzhou, China
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Simonsen CS, Flemmen HØ, Lauritzen T, Berg-Hansen P, Moen SM, Celius EG. The diagnostic value of IgG index versus oligoclonal bands in cerebrospinal fluid of patients with multiple sclerosis. Mult Scler J Exp Transl Clin 2020; 6:2055217319901291. [PMID: 32030196 PMCID: PMC6977237 DOI: 10.1177/2055217319901291] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/26/2019] [Accepted: 12/23/2019] [Indexed: 12/22/2022] Open
Abstract
Background Diagnostic criteria for multiple sclerosis have been developed to guide the diagnostic process. In the latest revision of the McDonald criteria, the presence of oligoclonal bands may replace the need for dissemination in time. The aim of this study is to investigate if the less time-consuming analysis of immunoglobulin G index in cerebrospinal fluid can safely predict the findings of oligoclonal bands. Methods This is a retrospective study of patients with multiple sclerosis at three hospitals in South-East Norway where lumbar puncture is performed routinely. We included patients diagnosed with multiple sclerosis after 2005 with known oligoclonal band status and an immunoglobulin G index score. Results Of 1295 patients diagnosed during or after 2005, 93.8% were oligoclonal band positive at diagnosis. Of 842 multiple sclerosis patients with known immunoglobulin G index and oligoclonal band status, 93.3% were oligoclonal band positive and 76.7% had an elevated immunoglobulin G index. The positive predictive value of a high immunoglobulin G index when oligoclonal bands are positive was 99.4% (95% confidence interval 98.4–99.8%). The negative predictive value of a normal immunoglobulin G index when oligoclonal bands are negative was 26.5% (95% confidence interval 23.5–29.9%). Conclusion An immunoglobulin G index >0.7 has a positive predictive value >99% for oligoclonal bands. An elevated immunoglobulin G index adds diagnostic value versus oligoclonal bands and saves time in the diagnostic process.
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Affiliation(s)
| | | | | | | | | | - Elisabeth Gulowsen Celius
- Department of Neurology, Oslo University Hospital, Norway.,Institute of Clinical Medicine, University of Oslo, Norway
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7
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Relevance of KFLC quantification to differentiate clinically isolated syndrome from multiple sclerosis at clinical onset. Clin Neurol Neurosurg 2018; 174:220-229. [DOI: 10.1016/j.clineuro.2018.09.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 09/13/2018] [Accepted: 09/22/2018] [Indexed: 11/22/2022]
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8
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Evaluation of Cobas 8000® for the quantification of albumin and IgG in serum and cerebrospinal fluid. Clin Biochem 2018; 56:105-108. [DOI: 10.1016/j.clinbiochem.2018.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 04/03/2018] [Accepted: 04/06/2018] [Indexed: 11/22/2022]
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The complex relationship between oligoclonal bands, lymphocytes in the cerebrospinal fluid, and immunoglobulin G antibodies in multiple sclerosis: Indication of serum contribution. PLoS One 2017; 12:e0186842. [PMID: 29059249 PMCID: PMC5653326 DOI: 10.1371/journal.pone.0186842] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 10/09/2017] [Indexed: 01/29/2023] Open
Abstract
Introduction Intrathecal immunoglobulin G (IgG) and oligoclonal bands (OCBs) are the most consistent and characteristic features of Multiple Sclerosis (MS). OCBs in MS are considered products of clonally expanded B cells in the cerebrospinal fluid (CSF), representing the sum of contributions from B cells in the brain. However, large amounts of IgG can be eluted from MS plaques in which lymphocytes are absent, and there is no correlation between levels of plaque-associated IgG and the presence of lymphocytes. It is calculated that it would take 3.2 billion lymphocytes to generate such large amounts of intrathecal IgG (30 mg in 500 ml CSF) in MS patients. Therefore, circulating lymphocytes in CSF could only account for <0.1% of the extra IgG in MS. Methods We analyzed clinical laboratory parameters from sera and CSF of 115 patients including 91 patients with MS and 24 patients with other inflammatory central nervous system (CNS) disorders (IC). We investigated the relationship between oligoclonal bands, IgG antibodies, CSF cells, IgG Index, albumin, and total protein. Results MS patients have significantly elevated serum concentrations of IgG antibodies, albumin, and total protein, lower levels of lymphocytes, albumin, and total protein in the cerebrospinal fluid, but no difference in CSF IgG concentration compared to those with other inflammatory neurological disorders. Furthermore, in MS there was no linear relationship between the numbers of OCBs, CSF lymphocytes, CSF IgG, and IgG Index, and between serum IgG and serum albumin, but significant correlation between IgG in CSF and serum, and between CSF IgG and CSF albumin. Conclusion There are unique differences between MS and patients with other inflammatory neurological disorders. Our data suggest that in MS patient (a) B cells and their products in the CSF may not be the sole source of intrathecal IgG; (b) oligoclonal bands may not be the products of single B cell clones in the CSF; and (c) there is a strong connection between serum components in the peripheral circulation and the central nervous system.
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Benard C, Chauzeix J, Blancher A, Puissant-Lubrano B. Analytical performances of SPAPLUS® turbidimeter for the quantification of albumin and IgG in serum and cerebrospinal fluid. Clin Biochem 2016; 49:828-31. [DOI: 10.1016/j.clinbiochem.2016.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 03/24/2016] [Accepted: 03/26/2016] [Indexed: 11/29/2022]
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Menéndez-Valladares P, García-Sánchez MI, Cuadri Benítez P, Lucas M, Adorna Martínez M, Carranco Galán V, García De Veas Silva JL, Bermudo Guitarte C, Izquierdo Ayuso G. Free kappa light chains in cerebrospinal fluid as a biomarker to assess risk conversion to multiple sclerosis. Mult Scler J Exp Transl Clin 2015; 1:2055217315620935. [PMID: 28607709 PMCID: PMC5433434 DOI: 10.1177/2055217315620935] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 11/13/2015] [Indexed: 01/21/2023] Open
Abstract
Background Multiple 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. Objective The 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. Methods FLC 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. Results κ 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. Conclusion CIS 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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Affiliation(s)
- P Menéndez-Valladares
- Unidad de Gestión Clínica Bioquímica Clínica, Hospital Universitario Virgen Macarena, Spain
| | - M I García-Sánchez
- Biobanco Hospitalario Virgen Macarena, Biobanco del Sistema Sanitario Público de Andalucía, Spain
| | - P Cuadri Benítez
- Biobanco Hospitalario Virgen Macarena, Biobanco del Sistema Sanitario Público de Andalucía, Spain
| | - M Lucas
- Departamento de Bioquímica Médica y Biología Molecular, Universidad de Sevilla, Spain
| | - M Adorna Martínez
- Unidad de Gestión Clínica Neurociencias, Hospital Universitario Virgen Macarena, Spain
| | - V Carranco Galán
- Departamento de Bioquímica Médica y Biología Molecular, Universidad de Sevilla, Spain
| | | | - C Bermudo Guitarte
- Unidad de Gestión Clínica Bioquímica Clínica, Hospital Universitario Virgen Macarena, Spain
| | - G Izquierdo Ayuso
- Unidad de Gestión Clínica Neurociencias, Hospital Universitario Virgen Macarena, Spain
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Duranti F, Pieri M, Centonze D, Buttari F, Bernardini S, Dessi M. Determination of kFLC and K Index in cerebrospinal fluid: A valid alternative to assessintrathecal immunoglobulin synthesis. J Neuroimmunol 2013; 263:116-20. [DOI: 10.1016/j.jneuroim.2013.07.006] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 07/04/2013] [Accepted: 07/08/2013] [Indexed: 10/26/2022]
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13
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Sladkova V, Mares J, Hlustik P, Langova J, Kanovsky P. Intrathecal synthesis in particular types of multiple sclerosis. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2012; 158:124-6. [PMID: 23073520 DOI: 10.5507/bp.2012.054] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Accepted: 05/09/2012] [Indexed: 11/23/2022] Open
Abstract
AIM The aim of this study was to determine whether there were any differences in intrathecal synthesis of immunoglobulin G (IgG) (IgG index) and number of oligoclonal bands (OCB) among particular types of multiple sclerosis (MS). METHODS 120 cerebrospinal fluid (CSF) samples were examined from 29 clinically isolated syndrome (CIS) patients and 91 MS patients (77 patients with relapsing-remitting MS (RR), 6 patients with primary progressive course of the disease (PP) and 8 patients in secondary progression (SP)); mean age = 42 years (range = 18 to 70 years). Albumin and IgG in serum and CSF was evaluated using nephelometry; an albumin quotient (CSF albumin/serum albumin), an IgG quotient (CSF IgG/serum IgG) and an IgG index (IgG quotient / albumin quotient) were then calculated. OCB were assessed using isoelectric focusing (IEF) on agarose gel, followed by immunoblotting. All patients were evaluated using the Kurtzke Expanded Disability Status Scale (EDSS). RESULTS No statistically significant differences between the IgG index and OC bands relative to particular types of MS were found. Further, there were no significant correlations between EDSS values and intrathecal synthesis (IgG index: QIgG / Qalbumin) and OC bands. CONCLUSION No difference in intrathecal synthesis (IgG index) and the number of OCB between different types of MS was confirmed.
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