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A New Laboratory Workflow Integrating the Free Light Chains Kappa Quotient into Routine CSF Analysis
- We performed this cohort study to test whether further analysis of intrathecal inflammation can be omitted if the free light chain kappa (FLCκ) quotient is within the reference range in the corresponding quotient diagram. FLCκ concentrations were measured in serum and cerebrospinal fluid (CSF) samples. The intrathecal fraction (IF) of FLCκ was calculated in relation to the hyperbolic reference range. 679 patient samples were used as a discovery cohort (DC). The sensitivity and negative predictive value (NPV) of the FLCκ-IF for the detection of an intrathecal humoral immune response (CSF-specific OCB and/or IF IgG/A/M > 0%) was determined. Based on these data, a diagnostic algorithm was developed and prospectively validated in an independent validation cohort (VC, n = 278). The sensitivity of the FLCκ-IF was 98% in the DC and 97% in the VC with a corresponding NPV of 99%. The use of the FLCκ-IF as a first line analysis would have reduced the Ig and OCB analysis by 62% in the DC and 74% in the VC. The absence of a FLCκ-IF predicts the absence of a humoral intrathecal immune response with a very high NPV of 99%. Thus, integration of our proposed algorithm into routine CSF laboratory analysis could help to reduce analytical efforts.
Author: | Malte Johannes Hannich, Mohammed R. Abdullah, Kathrin Budde, Astrid Petersmann, Matthias NauckORCiD, Alexander Dressel, Marie Süße |
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URN: | urn:nbn:de:gbv:9-opus-94463 |
DOI: | https://doi.org/10.3390/biom12111690 |
ISSN: | 2218-273X |
Parent Title (English): | Biomolecules |
Publisher: | MDPI |
Place of publication: | Basel |
Document Type: | Article |
Language: | English |
Date of first Publication: | 2022/11/15 |
Release Date: | 2024/04/22 |
Tag: | cerebrospinal fluid; free light chain kappa; immunoglobulin; laboratory workflow; protein analytic |
Volume: | 12 |
Issue: | 11 |
Article Number: | 1690 |
Page Number: | 10 |
Faculties: | Universitätsmedizin / Institut für Klinische Chemie und Laboratoriumsmedizin |
Universitätsmedizin / Friedrich-Loeffler-Institut für Medizinische Mikrobiologie | |
Universitätsmedizin / Klinik und Poliklinik für Neurologie | |
Collections: | weitere DFG-förderfähige Artikel |
Licence (German): | Creative Commons - Namensnennung 4.0 International |