Highlights
- •Immunoglobulin free light chains (FLC) are promising intrathecal biomarkers of MS.
- •As lumbar puncture is an invasive procedure, it is not applicable for disease monitoring.
- •We assessed the utility of saliva FLC as a potential biomarker of MS.
- •Results show that saliva FLC levels may discriminate between stable remission and active disease.
- •The test may serve as a new, non-invasive, and inexpensive tool for monitoring disease activity.
Abstract
Background
Immunoglobulin free light chains (FLC) have recently gained considerable interest
as new promising intrathecal biomarkers of multiple sclerosis (MS). However, lumbar
puncture is invasive and not practical for monitoring disease course. This study aimed
to assess the utility of saliva FLC as a biomarker of disease activity and response
to treatment in MS
Methods
Western blotting was used to study saliva FLC monomers and dimers. The intensity of
immunoreactive FLC bands was quantified by electrophoresis analysis, and the obtained
values were used as FLC indices to account for kappa and lambda FLC monomer and dimer
levels. Firth's logistic regression analysis suitable to study small cohorts was applied
to compare FLC levels between M.S. patients in relapse, MS patients in remission,
and healthy controls. Association between FLC levels and clinical and radiological
parameters was analyzed.
Results
55 MS patients and 40 healthy controls were evaluated. Saliva FLC levels were significantly higher in relapse compared to remission. Logistic
regression analysis employing a combination of FLC indices confirmed the significant
difference between these two groups. The FLC levels were significantly reduced by
treatment with corticosteroids. During remission, patients treated with disease-modifying
therapies had lower levels of FLC compared to untreated patients. The increased FLC
levels were associated with the presence of gadolinium-enhancing lesions, but not
with MRI T2 lesion load and EDSS scores. During individual patient follow-up, the
changes of the saliva FLC levels were in concordance with the disease activity status.
Conclusions
Saliva FLC levels may be a useful biomarker for discriminating between stable remission
and active disease. The developed test may serve as a new, non-invasive, and inexpensive
tool for monitoring disease activity and response to treatment in MS.
Keywords
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Article info
Publication history
Published online: June 24, 2020
Accepted:
June 23,
2020
Received in revised form:
June 14,
2020
Received:
May 1,
2020
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
