Association of cerebrospinal fluid kappa free light chains with the intrathecal polyspecific antiviral immune response in multiple sclerosis

Clin Chim Acta. 2019 Nov:498:148-153. doi: 10.1016/j.cca.2019.08.016. Epub 2019 Aug 19.

Abstract

The polyspecific B-lymphocyte response to neurotropic viruses such as measles (M), rubella (R) and varicella zoster (Z), known as MRZ reaction, is to-date the most specific neurochemical marker for multiple sclerosis (MS). The aim of this study was to investigate a possible association of immunoglobulin (Ig) kappa (κ-) and lambda (λ-) free light chains (FLC) with the presence of the MRZ reaction in multiple sclerosis. Immunoglobulin κ- and λ-FLC, MRZ reaction, oligoclonal IgG bands (OCB), and cerebrospinal fluid (CSF) routine parameters were measured in 65 MS patients. OCB were detected in 97% of MS patients, intrathecal IgG synthesis according to Reiber was detectable in 57%, an elevated IgG index (>0.7) in 66% and the MRZR was positive in 45%. All investigated κ-values (CSF κFLC, CSF-serum ratio of κFLCs (QκFLC), and κFLC index (κFLC/QAlbumin)) were significantly higher in patients with positive MRZ reaction as compared to MRZ negative MS patients. In contrast, λ-values showed no significant differences. Additionally to the putative diagnostic sensitivity and prognostic value of κFLC, the association of κFLC with a highly specific neurochemical marker for MS - the MRZ reaction, especially the determination of κFLCs is an informative tool to assess the B-cell response and determine its extent in MS patients.

Keywords: B-cell response; Free light chains; MRZ reaction; Multiple sclerosis.

MeSH terms

  • Adult
  • Antibodies, Viral / immunology
  • B-Lymphocytes / immunology
  • Biomarkers / cerebrospinal fluid
  • Female
  • Humans
  • Immunoglobulin Light Chains / cerebrospinal fluid*
  • Immunoglobulin kappa-Chains / cerebrospinal fluid*
  • Immunoglobulin lambda-Chains / cerebrospinal fluid
  • Male
  • Middle Aged
  • Multiple Sclerosis / cerebrospinal fluid*
  • Multiple Sclerosis / immunology*

Substances

  • Antibodies, Viral
  • Biomarkers
  • Immunoglobulin Light Chains
  • Immunoglobulin kappa-Chains
  • Immunoglobulin lambda-Chains