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Internal Grant Competition DGC





Detection of monoclonal free light chains by immunofixation electrophoresis and isoelectric focusing - comparison with the quantitative method of determination and kappa/lambda ratio
Project IdSGS06/LF/2018-2019
Main solverdoc. RNDr. Pavlína Kušnierová, Ph.D.
Period1/2018 - 12/2019
ProviderSpecifický VŠ výzkum
Statefinished
AnotationThe aim of the project is determination of the frequency of finding monoclonal free light chain (fLC) in patients with abnormal kappa free/lambda free ratio (fKLC/fLLC) and at the same time an increased concentration of the predominant type of serum fLC. Consecutive series of such specimens will be examined by immunofixation electrophoresis and all these samples with negative immunofixation electrophoresis (absence of monoclonal fLC) will be examined by isoelectric focusing followed by affinity immunoblotting (IEF/AIB). The current classification of monoclonal gammopathies (MG) defines the monoclonal gammapatie of free light chain by an abnormal fKLC/fLLC ratio (99% reference interval 0.26-1.65) at increased concentration of the relevant fLC type. In our previous neuroimmunological studies involving neurological patients without other signs indicating MG, such a result was found in 10.6% (n=254) and 12.8% (n=78) of patients. Only in one case it was associated with the finding of monoclonal fLC in IEF/AIB detection (this method, on the other hand, captured serum monoclonal fKLC in 1 patient with normal fKLC and normal fKLC/fLLC). We believe that the reference intervals for fKLC and fLC and especially for the fKLC/fLLC ratio need to be revised. We also believe that the current MG classification of free light chains leads to a significant percentage of false positive findings and it needs to be clarified. In case of confirmation of our hypothesis in a prospective study, we will propose the introduction of IEF/AIB as a "decision making" method in case of a negative finding of immunofixation electrophoresis in routine practice. An established fLC detection procedure will be used using the IEF/AIB method. In addition to chromogenic detection, chemiluminescence detection will be tested in collaboration with the Department of Physics, Faculty of Science, where the required device is available. All other necessary devices are available at the ÚLD FN Ostrava.