Konen Franz Felix, Schwenkenbecher Philipp, Jendretzky Konstantin Fritz, Gingele Stefan, Witte Torsten, Sühs Kurt-Wolfram, Grothe Matthias, Hannich Malte Johannes, Süße Marie, Skripuletz Thomas
Department of Neurology, Hannover Medical School, 30625 Hannover, Germany.
Department of Clinical Immunology & Rheumatology, Hannover Medical School, 30625 Hannover, Germany.
Brain Sci. 2022 Apr 3;12(4):475. doi: 10.3390/brainsci12040475.
Oligoclonal bands represent intrathecal immunoglobulin G (IgG) synthesis and play an important role in the diagnosis of multiple sclerosis (MS). Kappa free light chains (KFLC) are increasingly recognized as an additional biomarker for intrathecal Ig synthesis. However, there are limited data on KFLC in neurological diseases other than MS.
This study, conducted at two centers, retrospectively enrolled 346 non-MS patients. A total of 182 patients were diagnosed with non-inflammatory and 84 with inflammatory neurological diseases other than MS. A further 80 patients were classified as symptomatic controls. Intrathecal KFLC production was determined using different approaches: KFLC index, Reiber's diagram, Presslauer's exponential curve, and Senel's linear curve.
Matching results of oligoclonal bands and KFLC (Reiber's diagram) were frequently observed (93%). The Reiber's diagram for KFLC detected intrathecal KFLC synthesis in an additional 7% of the patient samples investigated (4% non-inflammatory; 3% inflammatory), which was not found by oligoclonal band detection.
The determination of both biomarkers (KFLC and oligoclonal bands) is recommended for routine diagnosis and differentiation of non-inflammatory and inflammatory neurological diseases. Due to the high sensitivity and physiological considerations, the assessment of KFLC in the Reiber's diagram should be preferred to other evaluation methods.
寡克隆带代表鞘内免疫球蛋白G（IgG）合成，在多发性硬化症（MS）的诊断中起重要作用。κ游离轻链（KFLC）越来越被认为是鞘内Ig合成的另一种生物标志物。然而，除MS外，关于KFLC在其他神经疾病中的数据有限。
本研究在两个中心进行，回顾性纳入346例非MS患者。其中182例被诊断为非炎症性疾病，84例被诊断为除MS外的炎症性神经疾病。另外80例患者被归类为症状对照。使用不同方法测定鞘内KFLC产生：KFLC指数、赖伯图、普雷斯劳尔指数曲线和塞内尔线性曲线。
经常观察到寡克隆带和KFLC（赖伯图）的匹配结果（93%）。KFLC的赖伯图在另外7%的研究患者样本中检测到鞘内KFLC合成（4%为非炎症性；3%为炎症性），而寡克隆带检测未发现。
建议同时测定这两种生物标志物（KFLC和寡克隆带）用于非炎症性和炎症性神经疾病的常规诊断和鉴别。由于高敏感性和生理学考虑，在赖伯图中评估KFLC应优于其他评估方法。
