Abstract
AbstractThe demonstration of intrathecal immunoglobulin synthesis by detection of oligoclonal bands in cerebrospinal fluid contributes to the diagnosis of multiple sclerosis as defined in the Mc Donald’s criteria, revised in 2017. Although being considered as a gold standard technique (sensitive and specific) for identifying oligoclonal bands in cerebrospinal fluid, isoelectric focusing remains time-consuming, requires skilled technician and its interpretation is operator-dependent. An alternative lies in measuring κ and λ free light chains, secreted by plasma cells in cerebrospinal fluid and serum. The assay, performed by immunonephelometry or immunoturbidimetry on automated systems, allows a quantitative measurement and is faster than detection of oligoclonal bands. Preliminary studies have shown similar performances of intrathecal κ free light chains measurement as compared to oligoclonal bands results in multiple sclerosis diagnosis. Further large studies in routine practice are now mandatory to confirm the potential of this approach.
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