Cerebrospinal fluid kappa free light chains for the diagnosis of multiple sclerosis : A consensus statement
Hegen, Harald (Medical University of Innsbruck)
Arrambide, Georgina (Hospital Universitari Vall d'Hebron)
Gnanapavan, Sharmilee (Queen Mary University of London)
Kaplan, Batia (Sheba Medical Center)
Khalil, Michael (Medical University of Graz)
Saadeh, Ruba (Mayo Clinic (Rochester))
Teunissen, Charlotte E (Amsterdam UMC)
Tumani, Hayrettin (University of Ulm)
Villar, Luisa Maria (Hospital Universitario Ramón y Cajal (Madrid))
Willrich, Maria Alice V (Mayo Clinic)
Zetterberg, Henrik (Sahlgrenska University Hospital (Suècia))
Deisenhammer, Florian (Medical University of Innsbruck)
Universitat Autònoma de Barcelona

Data:	2022
Resum:	Cerebrospinal fluid (CSF) analysis is of utmost importance for diagnosis and differential diagnosis of patients with suspected multiple sclerosis (MS). Evidence of intrathecal immunoglobulin G (IgG) synthesis proves the inflammatory nature of the disease, increases diagnostic certainty and substitutes for dissemination in time according to current diagnostic criteria. The gold standard to determine intrathecal IgG synthesis is the detection of CSF-restricted oligoclonal bands (OCBs). However, advances in laboratory methods brought up κ-free light chains (FLCs) as a new biomarker, which are produced in excess over intact immunoglobulins and accumulate in CSF in the case of central nervous system-derived inflammation. Overwhelming evidence showed a high diagnostic accuracy of intrathecal κ-FLC synthesis in MS with sensitivity and specificity of approximately 90% similar to OCB. κ-FLCs have advantages as its detection is fast, easy, cost-effective, reliable, rater-independent and returning quantitative results which might also improve the value of predicting MS disease activity. An international panel of experts in MS and CSF diagnostics developed a consensus of all participants. Six recommendations are given for establishing standard CSF evaluation in patients suspected of having MS. The panel recommended to include intrathecal κ-FLC synthesis in the next revision of MS diagnostic criteria as an additional tool to measure intrathecal immunoglobulin synthesis.
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, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Cerebrospinal fluid ; Kappa-free light chains ; Multiple sclerosis ; Clinically isolated syndrome ; Diagnosis ; Disease activity ; Prediction ; Biomarker ; Index ; Consensus
Publicat a:	Multiple sclerosis, Vol. 29 (december 2022) , p. 182-195, ISSN 1477-0970

DOI: 10.1177/13524585221134217
PMID: 36527368

14 p, 1.1 MB

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