Research: KAPLAN and COLLEAGUES,

Listed in Issue 232

Abstract

KAPLAN and COLLEAGUES, (1)Heller Institute of Medical Research, Sheba Medical Center, Tel-Hashomer, Israel. batiakaplan@gmail.com the authors, in the search for new biomarkers for multiple sclerosis (MS), characterized and evaluated the diagnostic utility of the immunoglobulin (Ig) free light chains (FLC) in patients' cerebrospinal fluid (CSF) and serum.

Background

In search of new biomarkers for multiple sclerosis (MS), the authors aimed to characterize the immunoglobulin (Ig) free light chains (FLC) in patients' cerebrospinal fluid (CSF) and serum, and to evaluate the diagnostic utility of FLC monomer-dimer patterns for MS.

Methodology

FLC were analyzed by Western blotting and mass spectroscopy. CSF and serum samples were examined for the presence of oligoclonal Ig bands by a conventional laboratory test for MS.

Results

Three distinct pathological FLC monomer-dimer patterns, typical of MS but not of other neurological diseases, were revealed. In 31 out 56 MS patients the highly increased CSF levels of κ monomers and dimers were demonstrated. In 18 MS patients, the increased κ-FLC levels were accompanied by highly elevated λ dimers. Five MS cases showed no significant elevation in κ-FLC, but they displayed abnormally high λ dimer levels. The intensity of the immunoreactive FLC bands was measured to account for κ and λ monomer and dimer levels and their ratios in the CSF and serum. Combined usage of different FLC parameters allowed the determination of the appropriate FLC threshold values to diagnose MS. The developed method showed higher sensitivity and specificity (96% and 90%, respectively), as compared to those of the conventional OCB test (82% and 70%, respectively).

Conclusion

This study highlights the role of the differential analysis of monomeric and dimeric κ- and λ-FLC for the precise diagnosis of MS.

References

Kaplan B(1), Golderman S, Yahalom G, Yeskaraev R, Ziv T, Aizenbud BM, Sela BA, Livneh A. Free light chain monomer-dimer patterns in the diagnosis of multiple sclerosis. J Immunol Methods. 390(1-2):74-80. doi: 10.1016/j.jim.2013.01.010. Epub Jan 31 2013. Apr 30 2013.

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