High sensitivity and specificity of elevated cerebrospinal fluid kappa free light chains in suspected multiple sclerosis

G Hassan-Smith; L Durant; A Tsentemeidou; L K Assi; J M Faint; S Kalra; M R Douglas; S J Curnow

doi:10.1016/j.jneuroim.2014.08.003

High sensitivity and specificity of elevated cerebrospinal fluid kappa free light chains in suspected multiple sclerosis

J Neuroimmunol. 2014 Nov 15;276(1-2):175-9. doi: 10.1016/j.jneuroim.2014.08.003. Epub 2014 Aug 8.

Authors

G Hassan-Smith¹, L Durant¹, A Tsentemeidou², L K Assi³, J M Faint³, S Kalra⁴, M R Douglas⁵, S J Curnow⁶

Affiliations

¹ Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
² University Witten/Herdecke, Germany.
³ The Binding Site Group Ltd, Birmingham, UK.
⁴ Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK; Neurology Department, University Hospital North Staffordshire, Stoke-on-Trent, UK.
⁵ Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK; Department of Neurology, Dudley Group NHS Foundation Trust, Russells Hall Hospital, Dudley, UK.
⁶ Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK. Electronic address: s.j.curnow@bham.ac.uk.

PMID: 25146968
DOI: 10.1016/j.jneuroim.2014.08.003

Abstract

Cerebrospinal fluid (CSF) analysis is routinely used in the diagnostic work-up of multiple sclerosis (MS), by detecting CSF-specific oligoclonal bands (OCB). More recently, several studies have reported CSF free light chains (FLC) as an alternative. We show that absolute CSF κFLC concentrations were highly sensitive - more than OCB testing - and specific for clinically isolated syndrome, relapsing remitting and primary progressive MS. Measurement of κFLC alone was sufficient. Our results suggest that CSF κFLC levels measured by nephelometry, if validated in a larger series, are a preferred test to OCB analysis in the diagnostic work-up of patients suspected of having MS.

Keywords: Free light chains; Multiple sclerosis; Oligoclonal bands.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Female
Humans
Immunoglobulin kappa-Chains / cerebrospinal fluid*
Male
Middle Aged
Multiple Sclerosis / cerebrospinal fluid*
Nephelometry and Turbidimetry
Oligoclonal Bands / cerebrospinal fluid*
Sensitivity and Specificity
Young Adult

Substances

Immunoglobulin kappa-Chains
Oligoclonal Bands