Institute of Pediatric Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Front Immunol. 2022 Apr 5;13:821499. doi: 10.3389/fimmu.2022.821499. eCollection 2022.
Development of new safe methods of monitoring disease activity in the pediatric onset multiple sclerosis (POMS) is a challenging task, especially when trying to refrain from frequent MRI usage. In our recent study, the immunoglobulin free light chains (FLC) were suggested as biomarkers to discriminate between remission and active MS in adults.
To assess utility of saliva FLC measurements for monitoring disease activity in POMS.
We used semiquantitative Western blot analysis to detect immunoreactive FLC monomers and dimers and to calculate the intensity of their bands. Statistical tests included Firth logistic regression analysis suitable for small sample sizes, and Spearman's non-parametric correlation.
In POMS patients, the saliva levels of FLC in relapse were significantly higher than those in remission. Significant correlation was found between FLC levels (monomers, dimers or both) and the load of enhanced lesions in MRI scans. FLC levels may be reduced under treatment, especially as result of corticosteroids therapy. Follow-up of individual patients showed the correspondence of changes in the FLC levels to MRI findings.
Our results show the potential of the non-invasive saliva FLC test, as a new tool for monitoring the disease activity in POMS.
开发新的安全方法来监测儿科发病多发性硬化症（POMS）的疾病活动是一项具有挑战性的任务，尤其是在试图避免频繁进行 MRI 检查时。在我们最近的研究中，免疫球蛋白游离轻链（FLC）被认为是区分成人缓解期和活动期 MS 的生物标志物。
评估唾液 FLC 测量在监测 POMS 疾病活动中的效用。
我们使用半定量 Western blot 分析来检测免疫反应性 FLC 单体和二聚体，并计算其条带的强度。统计检验包括适合小样本量的 Firth 逻辑回归分析和 Spearman 非参数相关性分析。
在 POMS 患者中，复发时的唾液 FLC 水平明显高于缓解期。FLC 水平（单体、二聚体或两者）与 MRI 扫描中增强病变的负荷之间存在显著相关性。FLC 水平可能会因治疗而降低，尤其是皮质类固醇治疗的结果。对个别患者的随访表明，FLC 水平的变化与 MRI 结果相符。
我们的结果表明，非侵入性唾液 FLC 测试具有监测 POMS 疾病活动的潜力，是一种新的工具。
