Catene leggere libere nella diagnostica liquorale della sclerosi multipla: possibile alternativa alla ricerca delle bande oligoclonali?
Free light chains in diagnosis of multiple sclerosis: an alternative to oligoclonal bands?

AUTORI

ABSTRACT

Free light chains in diagnosis of multiple sclerosis: an alternative to oligoclonal bands?

Multiple sclerosis (MS) is one of the most common causes of neurological disability in young adults. MS presents heterogeneous clinical manifestations and both genetic and environmental factors are considered involved in the risk of developing the disease. The clinical diagnosis is rather complex reflecting the heterogeneity of the pathology. The diagnostic criteria, frequently modified over the years, require clinical symptoms, presence of typical lesions detected by magnetic resonance imaging and laboratory findings. The laboratory examination of the cerebrospinal fluid (CSF) allows an evaluation of inflammatory processes confined to the central nervous system reflecting the changes in the immunological pattern due to the progression of the pathology, playing thus an important role in the diagnosis and monitoring of MS. The detection of the oligoclonal bands (OCBs) is recognized as a “gold standard” for laboratory diagnosis of MS, although it suffers from methodological limitations. Indeed, OCBs assay is a manual multistep procedure, time-consuming that requires a subjective interpretation. In the last years, the measurement of the free light chains (FLC) in CSF appeared to assist in the diagnosis of MS. This procedure has been presented as a simpler and cheaper tool than the qualitative detection of OCBs. This article examines the current knowledge about the laboratory diagnostic of CSF, investigating both the validated method (OCBs) and the alternative biomarkers of immunoglobulins intrathecal synthesis, as the quantification of FLC in CSF.

BIBLIOGRAFIA