IgG and kappa free light chain CSF/serum indices: evaluating intrathecal immunoglobulin production in HIV infection in comparison with multiple sclerosis-Reference-Cited by-同舟云学术

IgG and kappa free light chain CSF/serum indices: evaluating intrathecal immunoglobulin production in HIV infection in comparison with multiple sclerosis

Published:2024-04-04 Issue:10 Volume:62 Page:2024-2029
ISSN:1434-6621
Container-title:Clinical Chemistry and Laboratory Medicine (CCLM)
language:en
Short-container-title:

Author:

Hagberg Lars¹²,Rosenstein Igal²³,Lycke Jan²³,Zetterberg Henrik²⁴⁵⁶⁷,Yilmaz Aylin¹²,Edén Arvid¹²,Gisslén Magnus¹²⁸

Affiliation:

1. Department of Infectious Diseases , 70712 Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden

2. Region Västra Götaland, Sahlgrenska University Hospital , Gothenburg , Sweden

3. Department of Clinical Neuroscience , 70712 Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden

4. Department of Psychiatry and Neurochemistry , Institute of Neuroscience and Physiology, University of Gothenburg , Mölndal , Sweden

5. Department of Neurodegenerative Disease , UCL Institute of Neurology , London , UK

6. UK Dementia Research Institute at UCL , London , UK

7. Hong Kong Center for Neurodegenerative Diseases , Hong Kong , China

8. Public Health Agency of Sweden , Solna , Sweden

Abstract

Abstract Objectives To study intrathecal kappa free light chain (KFLC) synthesis in people living with HIV (PLWH) in comparison with multiple sclerosis (MS). Methods Cross-sectional analysis including 56 untreated and 150 well treated PLWH, and compared with 58 controls, and 223 MS patients. Results Elevated serum/cerebrospinal fluid (CSF) IgG and KFLC indices were observed in untreated PLWH. Seventy percent of untreated PLWH had KFLC index above 6.1, a threshold associated with clinically isolated syndrome/MS diagnosis. No association was found between KFCL index and CSF markers of neuronal injury in either PLWH or MS patients. Conclusions HIV-related immune system dysfunction is often associated with an elevated KFLC index akin to those observed in MS. HIV infection should be considered as a differential diagnosis for patients presenting with neurological symptoms and increased intrathecal immunoglobulin synthesis.

Funder

the Swedish state, under an agreement between the Swedish government and the county councils

Edith Jacobson’s Foundation and Helena Ahlin’s Foundation. European Union’s Horizon Europe research and innovation programme under grant. agreement

Publisher

Walter de Gruyter GmbH

Link

https://www.degruyter.com/document/doi/10.1515/cclm-2023-1018/pdf

Reference32 articles.

1. Elovaara, I, Seppala, I, Poutiainen, E, Suni, J, Valle, SL. Intrathecal humoral immunologic response in neurologically symptomatic and asymptomatic patients with human immunodeficiency virus infection. Neurology 1988;38:1451–6. https://doi.org/10.1212/wnl.38.9.1451.

2. Elovaara, I, Seppala, I, Kinnunen, E, Laaksovirta, H. Increased occurrence of free immunoglobulin light chains in cerebrospinal fluid and serum in human immunodeficiency virus-1 infection. J Neuroimmunol 1991;35:65–77. https://doi.org/10.1016/0165-5728(91)90162-z.

3. Chiodi, F, Asjo, B, Fenyo, EM, Norkrans, G, Hagberg, L, Albert, J. Isolation of human immunodeficiency virus from cerebrospinal fluid of antibody-positive virus carrier without neurological symptoms. Lancet 1986;2:1276–7. https://doi.org/10.1016/s0140-6736(86)92699-1.

4. Gisslen, M, Fuchs, D, Svennerholm, B, Hagberg, L. Cerebrospinal fluid viral load, intrathecal immunoactivation, and cerebrospinal fluid monocytic cell count in HIV-1 infection. J Acquir Immune Defic Syndr 1999;21:271–6. https://doi.org/10.1097/00126334-199908010-00003.

5. Gallo, P, Piccinno, MG, De Rossi, A, Pagni, S, Amadori, A, Chieco-Bianchi, L, et al.. Free light chains of immunoglobulins in the cerebrospinal fluid of human immunodeficiency virus type 1-infected patients. J Neuroimmunol 1990;26:229–38. https://doi.org/10.1016/0165-5728(90)90005-8.