Affiliation:
1. A.Ya. Kozhevnikov Clinic of Nervous System Diseases, Department of Nervous System Diseases and Neurosurgery, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Abstract
Objective: to determine the sensitivity and specificity of method of determining the concentration of immunoglobulin free light chains (FLCs) in cerebrospinal fluid (CSF) in the diagnosis and differential diagnosis of multiple sclerosis (MS).Material and methods. 80 patients participated in the study. The main group consisted of 54 patients diagnosed with MS according to the 2017 McDonald criteria. The comparison group (n=26) comprised patients with other diseases of the nervous system. An enzyme-linked immunosorbent assay (ELISA) was used to determine the concentration of FLCs (kappa- and lambda-chains) in the CSF.Results. In the group of patients with MS, an increase in the concentration of free kappa-chains (к-FLCs) in the CSF was found compared to the comparison group (p<0.001). With an increase in the concentration of κ-FLCs, a decrease in the sensitivity and an increase in the specificity of the method for the diagnosis of MS was observed. The к-FLCs cut-off value of 0.17 μg/ml had a sensitivity of 68.5 % and a specificity of 92.3 %. The cut-off value of 0.22 μg/ml had a sensitivity of 59.3 % and a specificity of 100 %. The concentrations of lambda-FLCs in the CSF in the MS group and in the comparison, group did not differ significantly (p=0.1).Conclusion. The results obtained indicate an increase in the concentration of к-FLCs in the CSF of MS patients. This biomarker showed a high specificity for this pathology. However, further development of optimal thresholds is required to clarify the diagnostic value of CSF к-FLCs concentration in MS patients.