Background: Detection of oligoclonal (OB) bands in the cerebrospinal fluid (CSF) is an essential tool in the diagnosis of autoimmune inflammatory conditions of the CNS and particularly multiple sclerosis (MS). This method is known to have significant limitations: it is labour intensive, interpretation and evaluation should be restricted to experienced specialists (subjective), standards for testing are frequently absent creating difficulties with reproducibility across labs, it is qualitative, and potentially can be affected by patient's use of therapeutic monoclonal immunoglobulins. Free κ light chain production is known to increase with immune system activation, including autoimmune diseases and can be used for their detection. κ light chains are known to be present in the CSF of patients with MS.
Our study's goal was to perform an analysis of κ light chains in CSF and compare results with findings of OB evaluation in the spectrum of neurological conditions including MS.
200 CSF samples from the regional laboratory were analyzed for both OB bands and κ light chain concentrations. The sensitivity and specificity of each method were evaluated concerning the clinical diagnosis of MS.
κ light chain concentration can be reliably performed in a hospital laboratory setting. This test has excellent sensitivity and specificity to the clinical diagnosis of MS.
Introducing routine reporting of κ light chains CSF concentration will increase confidence in the reproducibility of results, it will help to firmly establish quantitative normative values, and their relationship to meaningful clinical outcomes. κ light chains test is a useful complement to OB bands testing. It has the capacity to replace it over time and provide a quantitative dimension to the evaluation of CNS inflammation.