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Editor-in-chief
Maria Stella Graziani
Deputy Director
Martina Zaninotto
Associate Editors
Ferruccio Ceriotti
Davide Giavarina
Bruna Lo Sasso
Giampaolo Merlini
Martina Montagnana
Andrea Mosca
Paola Pezzati
Rossella Tomaiuolo
Matteo Vidali
EIC Assistant
Francesco Busardò
International Advisory Board
Khosrow Adeli Canada
Sergio Bernardini Italy
Marcello Ciaccio Italy
Eleftherios Diamandis Canada
Philippe Gillery France
Kjell Grankvist Sweden
Hans Jacobs The Netherlands
Eric Kilpatrick UK
Magdalena Krintus Poland
Giuseppe Lippi Italy
Mario Plebani Italy
Sverre Sandberg Norway
Ana-Maria Simundic Croatia
Tommaso Trenti Italy
Cas Weykamp The Netherlands
Maria Willrich USA
Paul Yip Canada
Publisher
Biomedia srl
Via L. Temolo 4, 20126 Milano
Responsible Editor
Giuseppe Agosta
Editorial Secretary
Chiara Riva
Biomedia srl
Via L. Temolo 4, 20126 Milano
Tel. 0245498282
email: biochimica.clinica@sibioc.it
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ISSN print: 0393 – 0564
ISSN digital: 0392- 7091
BC: Articoli scritti da D. Scribano
La misura delle catene leggere libere nel liquor nella diagnosi della sclerosi multipla
Cerebrospinal fluid kappa and lambda free light chains for the diagnosis of multiple sclerosis
<p>Presently, oligoclonal band (OCB) detection is considered the gold standard for Multiple Sclerosis (MS) diagnosis. The technique is however cumbersome and requires interpretative expertise for the evaluation of dubious OCB patterns. Recently, the kappa and lambda free light chains (FLCs) measurement in cerebrospinal fluid (CSF) has been suggested as potential diagnostic tool. We describe here two case reports where the FLCs determination contributed importantly to the diagnosis. A 43 years old female with left homonym hemianopia and frontal headache showed a negative OCBs pattern showing only a single monoclonal band. CSF and serum FLCs were within the reference range while kFLC index was positive. Visual evoked potentials and magnetic resonance investigation (MRI) were suggestive of clinically isolated syndrome. A 55 year old female with visual left homonym hemianopia and mild retroorbital pain showed very similar findings with a negative pattern for OCBs, and a single monoclonal band. CSF FLCs were slightly above the upper value of the reference range and kFLC index was positive. Evoked potentials and MRI were suggestive for MS diagnosis. In conclusion, the FLCs quantification in CSF could be a valid tool to support MS diagnosis especially in the presence of unclear OCB results.</p>
Biochimica Clinica ; 42(2) e22-e25 Casi clinici - Case report
Is there a role for serum cystatin C as a biomarker of multiple sclerosis?
<p>Multiple sclerosis (MS) is the most common chronic demyelinating disorder of the central nervous system (CNS). No single clinical feature or diagnostic test is sufficient for the diagnosis of MS and the clinical assessment is very difficult, mainly at the early disease stages. Considering MS as a disorder confined to CNS compartment and related to CNS specific pathogenetic pathways, several studies selectively investigated cerebrospinal fluid (CSF) components to detect predictive/prognostic MS markers. Several molecules, such as CSF 14-3-3 protein, tau protein and cystatin C, have been found dysregulated, even though with discordant results. We analyzed serum and CSF cystatin C concentrations of MS patients, comparing them with results obtained from individuals affected by other neurological diseases. We found no statistical differences between groups in CSF cystatin C, cystatin C difference (<span style="font-family:symbol">D</span><sub>CystC</sub> = CSF - serum cystatin C) and ratio (CystC<sub>ratio</sub> = CSF/serum cystatin C). Interestingly, serum cystatin C concentrations of MS patients resulted significantly lower than in control population [0.71 (interquartile range, 0.64-0.84) mg/L vs. 0.80 (0.67-0.93) mg/L, P=0.008], with no gender-related differences. The pathophysiologic explanation of this finding is unclear, although it cannot be excluded that pathologic mechanisms that lead to MS may involve not only the CNS compartment, but also systemic pathogenetic pathways.</p>
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