Performances comparatives des tests immunologiques du liquide céphalo-rachidien dans le diagnostic de la sclérose en plaques

Mejdoub, Sabrina; Feki, S.; Dammak, Mariem; Farhat, Nouha; Hachicha, H.; Mhiri, Chokri; Masmoudi, Hatem

doi:10.1016/s1773-035x(19)30332-6

Cited by 1 publication

(2 citation statements)

References 34 publications

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“…These values are within the correspondent range of values reported for this parameter in different populations 25 , 39 – 41 , 66 , 67 . Interestingly, both sensitivity and specificity of the κFLC index were higher than OCB detection (using the Isofocusing test) for MS diagnosis in our same Tunisian population (77.6% and 81.8%, respectively as mentioned in our previous published study) 68 . By focusing on our MS group, there were 6 cases of OCB-positive patients with a high κ index (> 14.9)/normal IgG index and no MS cases with the inverse profile.…”

Section: Discussionsupporting

confidence: 60%

“…Finally, we aimed to optimize the algorithm of routine CSF investigation for MS diagnosis and prognosis by adding the new effective, simple, available, and standardizable laboratory parameters. Based on our previous 68 , 69 and present findings and the above literature data, we suggest that: Initial measurement of automatized κ-FLC in CSF allows obviating OCB testing in case of undetectable levels in patients with suspicion of MS unless there is strong clinical suspicion. Complete Calculation of IgG index, κ-index values, and evaluation of FLC-κ Reibergram (κFLC IF) as the next automatized, relatively simple, rapid, and standardizable step of effective screening for IS detection and therefore, MS diagnosis to obtain the highest sensitivity and accuracy.…”

Section: Discussionsupporting

confidence: 51%

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Intrathecal B cell-related markers for an optimized biological investigation of multiple sclerosis patients

Feki

Damak

Sakka

et al. 2022

Sci Rep

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In multiple sclerosis (MS) disease, the importance of the intrathecal B cell response classically revealed as IgG oligoclonal bands (OCB) in cerebrospinal fluid (CSF) was reaffirmed again in the recently revised diagnostic criteria. We aimed to optimize Laboratory investigation by testing the performance of new B cell-related molecules in CSF (Ig free light chains (FLCκ and λ) and CXCL13 (B-Cell Attracting chemokine1)) for MS diagnosis. 320 paired (CSF-serum) samples were collected from 160 patients with MS (n = 82) and non-MS diseases (n = 78). All patients benefited from IgG index determination, OCB detection, CSF CXCL13 and FLC (κ and λ) measurement in CSF and serum for metrics calculation (κ/λ ratio, FLC-related indexes, and κFLC-intrathecal fraction (IF)). CXCL13 and FLC metrics in CSF were higher in patients with MS and positive OCB. As expected, κFLC metrics—in particular, κFLC index and κFLC IF—had the highest accuracy for MS diagnosis. κ index showed the best performance (sensitivity 83% and specificity 91.7%) at a cut-off of 14.9. Most of the FLC-related parameters were positively correlated with IgG index and the level of CXCL13. In conclusion, the quantitative, standardizable, and technically simple CSF FLCκ metrics seem to be reliable for MS diagnosis, but could not replace OCB detection. CXCL13 appears to be an effective parameter reflecting the intrathecal B cell response. An optimized way for CSF testing combining the conventional and the new B cell-related parameters is proposed in this study.

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