{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T23:23:46Z","timestamp":1791156226022,"version":"4.1.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,9,19]],"date-time":"2023-09-19T00:00:00Z","timestamp":1695081600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The serum-free immunoglobulin light chain assay has been recommended as a screening test for monoclonal gammopathy. We evaluated the usefulness of urine free immunoglobulin light concentration for selection of specimens for immunofixation electrophoresis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Using kits from The Binding Site for Freelite \u00ae, we validated examination of urine for measuring free \u03ba and \u03bb light chains. The results of urine free light chain concentrations were evaluated to ascertain if the results could be used to reduce the number of specimens requiring urine protein immunofixation electrophoresis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In the 515 specimens examined, there was no evidence of monoclonal gammopathy or history of monoclonal gammopathy in 331. Monoclonal \u03ba or \u03bb light chains were detectable in 42 and 30 specimens, respectively. There was history of \u03ba or \u03bb chain associated monoclonal gammopathy in 62 and 50 patients, respectively. In the 38 monoclonal \u03ba positive urine specimens, with light chain data, \u03ba\/\u03bb ratio was &amp;gt;5.83 in all specimens. In 27 specimens positive for monoclonal \u03bb light chains, with light chain data, the urine \u03bb\/\u03ba ratio was &amp;gt; 0.17 in 24 of 27 specimens and &amp;gt; 0.041 in all specimens. In patients without monoclonal gammopathy all specimens had a \u03ba\/\u03bb ratio of &amp;gt;5.83 or \u03bb\/\u03ba ratio &amp;gt;0.17.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The Freelite \u00ae assay from The Binding Site is suitable for quantification of free light chains in urine. In patients with known history of monoclonal gammopathy, urine immunofixation electrophoresis may be omitted in specimens with \u03ba\/\u03bb ratio of &amp;lt;5.83 for \u03ba associated lesions and \u03bb\/\u03ba ratio of &amp;lt;0.041 for \u03bb associated lesions. However, the results do not support using this test for first-time urine testing for monoclonal light chains as it is not predictive of positive result, nor does it exclude a monoclonal light chain in urine.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jalm\/jfad055","type":"journal-article","created":{"date-parts":[[2023,9,19]],"date-time":"2023-09-19T22:21:30Z","timestamp":1695162090000},"page":"1101-1114","source":"Crossref","is-referenced-by-count":4,"title":["Quantification of Free Immunoglobulin Light Chains in Urine"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0621-7254","authenticated-orcid":false,"given":"Gurmukh","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Pathology, Medical College of Georgia at Augusta University , Augusta, GA , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Cotter","sequence":"additional","affiliation":[{"name":"Department of Pathology, Medical College of Georgia at Augusta University , Augusta, GA , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"May","family":"Ye Mon","sequence":"additional","affiliation":[{"name":"Department of Pathology, Medical College of Georgia at Augusta University , Augusta, GA , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyan","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, Medical College of Georgia at Augusta University , Augusta, GA , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roni J","family":"Bollag","sequence":"additional","affiliation":[{"name":"Department of Pathology, Medical College of Georgia at Augusta University , Augusta, GA , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,9,19]]},"reference":[{"key":"2023110702171468400_jfad055-B1","doi-asserted-by":"crossref","first-page":"520","DOI":"10.3389\/fimmu.2014.00520","article-title":"IgG subclasses and allotypes: from structure to effector functions","volume":"5","author":"Vidarsson","year":"2014","journal-title":"Front Immunol"},{"key":"2023110702171468400_jfad055-B2","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1038\/s41467-019-13992-8","article-title":"IgA subclasses have different effector functions associated with distinct glycosylation profiles","volume":"11","author":"Steffen","year":"2020","journal-title":"Nat Commun"},{"key":"2023110702171468400_jfad055-B3","doi-asserted-by":"crossref","first-page":"S41","DOI":"10.1016\/j.jaci.2009.09.046","article-title":"Structure and function of immunoglobulins","volume":"125","author":"Schroeder","year":"2010","journal-title":"J Allergy Clin Immunol"},{"key":"2023110702171468400_jfad055-B4","first-page":"303","article-title":"The Nobel lectures in immunology. 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Implications for protein electrophoresis and serum free light chain assay results","volume":"9","author":"Singh","year":"2017","journal-title":"J Clin Med Res"},{"key":"2023110702171468400_jfad055-B21","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1093\/ajcp\/aqw099","article-title":"Serum free light chain assay and \u03ba\/\u03bb ratio performance in patients without monoclonal gammopathies: high false-positive rate","volume":"146","author":"Singh","year":"2016","journal-title":"Am J Clin Pathol"},{"key":"2023110702171468400_jfad055-B22","doi-asserted-by":"crossref","first-page":"46","DOI":"10.14740\/jocmr2802w","article-title":"Serum free light chain assay and \u03ba\/\u03bb ratio: performance in patients with monoclonal gammopathy-high false negative rate for \u03ba\/\u03bb ratio","volume":"9","author":"Singh","year":"2017","journal-title":"J Clin Med Res"},{"key":"2023110702171468400_jfad055-B23","doi-asserted-by":"publisher","DOI":"10.1093\/labmed\/lmac155","article-title":"Urine protein immunofixation electrophoresis: free light chain urine immunofixation electrophoresis is more sensitive than conventional assays for detecting monoclonal light chains and could serve as a marker of minimal residual disease","author":"Singh","journal-title":"Lab Med"},{"key":"2023110702171468400_jfad055-B24","doi-asserted-by":"crossref","first-page":"284","DOI":"10.5045\/br.2022.2022187","article-title":"Comparison of serum and urine free light chain analysis in clinical diagnosis","volume":"57","author":"Cho","year":"2022","journal-title":"Blood Res"},{"key":"2023110702171468400_jfad055-B25","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1111\/cei.13611","article-title":"Serum and urine free light chains measurements in patients with systemic sclerosis: novel biomarkers for disease activity","volume":"205","author":"Gigante","year":"2021","journal-title":"Clin Exp Immunol"},{"key":"2023110702171468400_jfad055-B26","doi-asserted-by":"crossref","first-page":"25","DOI":"10.4097\/kja.21209","article-title":"Receiver operating characteristic curve: overview and practical use for clinicians","volume":"75","author":"Nahm","year":"2022","journal-title":"Korean J Anesthesiol"},{"key":"2023110702171468400_jfad055-B27","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1097\/JTO.0b013e3181ec173d","article-title":"Receiver operating characteristic curve in diagnostic test assessment","volume":"5","author":"Mandrekar","year":"2010","journal-title":"J Thorc Oncol"},{"key":"2023110702171468400_jfad055-B28","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1002\/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3","article-title":"Index for rating diagnostic tests","volume":"3","author":"Youden","year":"1950","journal-title":"Cancer"}],"container-title":["The Journal of Applied Laboratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jalm\/article-pdf\/8\/6\/1101\/52760138\/jfad055.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jalm\/article-pdf\/8\/6\/1101\/52760138\/jfad055.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T02:20:22Z","timestamp":1699323622000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jalm\/article\/8\/6\/1101\/7277362"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,19]]},"references-count":28,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,9,19]]},"published-print":{"date-parts":[[2023,11,2]]}},"URL":"https:\/\/doi.org\/10.1093\/jalm\/jfad055","relation":{},"ISSN":["2475-7241"],"issn-type":[{"value":"2475-7241","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,11]]},"published":{"date-parts":[[2023,9,19]]}}}