Abstract
Background:
Free light chains (FLC) have been proposed as diagnostic biomarker in patients with inflammatory central nervous system diseases. The objective of this study was to investigate the diagnostic utility of intrathecal κ- and λ-FLC synthesis in patients with neuroborreliosis.
Methods:
κ- and λ-FLC were measured by nephelometry under blinded conditions in cerebrospinal fluid (CSF) and serum sample pairs of 34 patients with neuroborreliosis and compared to a cohort of 420 control patients. κ-FLC index was calculated as [CSF κ-FLC/serum κ-FLC]/[CSF albumin/serum albumin], and λ-FLC index in analogy.
Results:
κ-FLC and λ-FLC index were significantly elevated in patients with neuroborreliosis compared to the control group. At a specificity level of 95%, κ-FLC and λ-FLC index showed a diagnostic sensitivity of 88.2% and 100%. In comparison, IgM and IgG synthesis according to Reiber formula, IgG index >0.7 and OCB status reached a sensitivity of 83.9%, 44.1%, 58.8% and 64.7%.
Conclusion:
These findings support the diagnostic value of intrathecal FLC synthesis in neuroborreliosis patients and demonstrate a valid, easy and rater-independent alternative for the detection of an intrathecal immunoglobulin production.
Author contributions: H. Hegen has participated in the conception and design of the study, acquisition and statistical analysis of the data, and in drafting the manuscript. D. Milosavljevic has participated in acquisition of the data and in reviewing the manuscript for intellectual content. C. Schnabl has participated in reviewing the manuscript for intellectual content. A. Manowiecka has participated in acquisition of the data and in reviewing the manuscript for intellectual content. J. Walde has participated in statistical analysis of the data and in reviewing the manuscript for intellectual content. F. Deisenhammer has participated in reviewing the manuscript for intellectual content. S. Presslauer has participated in the conception and design of the study and in reviewing the manuscript for intellectual content. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: The study was supported by Siemens, who provided the free light chain immunoassays.
Employment or leadership: None declared.
Honorarium: None declared.
Disclosures: H. Hegen has participated in meetings sponsored by, received speaker honoraria or travel funding from Bayer Schering, Biogen, Merck Serono and Novartis, and received honoraria for acting as consultant for Teva Pharmaceuticals Europe. D. Milosavljevic reports no disclosures. C. Schnabl reports no disclosures. A. Manowiecka reports no disclosures. J. Walde reports no disclosures. F. Deisenhammer has participated in meetings sponsored by or received honoraria for acting as an advisor/speaker for Biogen, Celgene, Genzyme-Sanofi, Merck, Novartis, Roche, and Teva-Ratiopharm, and received unrestricted research grants from Biogen and Genzyme-Sanofi. S. Presslauer has participated in meetings sponsored by Bayer Schering, Biogen Idec, Merck Serono, Novartis and Teva.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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Supplementary Material:
The online version of this article offers supplementary material (https://doi.org/10.1515/cclm-2018-0028).
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