Cerebrospinal fluid kappa free light chains for the diagnosis of multiple sclerosis: A consensus statement

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 substitut...

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Autores principales: Hegen, Harald, Arrambide, Georgina, Gnanapavan, Sharmilee, Kaplan, Batia, Khalil, Michael, Saadeh, Ruba, Teunissen, Charlotte, Tumani, Hayrettin, Villar, Luisa Maria, Willrich, Maria Alice V, Zetterberg, Henrik, Deisenhammer, Florian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9925908/
https://www.ncbi.nlm.nih.gov/pubmed/36527368
http://dx.doi.org/10.1177/13524585221134217
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author Hegen, Harald
Arrambide, Georgina
Gnanapavan, Sharmilee
Kaplan, Batia
Khalil, Michael
Saadeh, Ruba
Teunissen, Charlotte
Tumani, Hayrettin
Villar, Luisa Maria
Willrich, Maria Alice V
Zetterberg, Henrik
Deisenhammer, Florian
author_facet Hegen, Harald
Arrambide, Georgina
Gnanapavan, Sharmilee
Kaplan, Batia
Khalil, Michael
Saadeh, Ruba
Teunissen, Charlotte
Tumani, Hayrettin
Villar, Luisa Maria
Willrich, Maria Alice V
Zetterberg, Henrik
Deisenhammer, Florian
author_sort Hegen, Harald
collection PubMed
description 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.
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spelling pubmed-99259082023-02-15 Cerebrospinal fluid kappa free light chains for the diagnosis of multiple sclerosis: A consensus statement Hegen, Harald Arrambide, Georgina Gnanapavan, Sharmilee Kaplan, Batia Khalil, Michael Saadeh, Ruba Teunissen, Charlotte Tumani, Hayrettin Villar, Luisa Maria Willrich, Maria Alice V Zetterberg, Henrik Deisenhammer, Florian Mult Scler Personal Viewpoint 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. SAGE Publications 2022-12-17 2023-02 /pmc/articles/PMC9925908/ /pubmed/36527368 http://dx.doi.org/10.1177/13524585221134217 Text en © The Author(s), 2022 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Personal Viewpoint
Hegen, Harald
Arrambide, Georgina
Gnanapavan, Sharmilee
Kaplan, Batia
Khalil, Michael
Saadeh, Ruba
Teunissen, Charlotte
Tumani, Hayrettin
Villar, Luisa Maria
Willrich, Maria Alice V
Zetterberg, Henrik
Deisenhammer, Florian
Cerebrospinal fluid kappa free light chains for the diagnosis of multiple sclerosis: A consensus statement
title Cerebrospinal fluid kappa free light chains for the diagnosis of multiple sclerosis: A consensus statement
title_full Cerebrospinal fluid kappa free light chains for the diagnosis of multiple sclerosis: A consensus statement
title_fullStr Cerebrospinal fluid kappa free light chains for the diagnosis of multiple sclerosis: A consensus statement
title_full_unstemmed Cerebrospinal fluid kappa free light chains for the diagnosis of multiple sclerosis: A consensus statement
title_short Cerebrospinal fluid kappa free light chains for the diagnosis of multiple sclerosis: A consensus statement
title_sort cerebrospinal fluid kappa free light chains for the diagnosis of multiple sclerosis: a consensus statement
topic Personal Viewpoint
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9925908/
https://www.ncbi.nlm.nih.gov/pubmed/36527368
http://dx.doi.org/10.1177/13524585221134217
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