[Immunonephelometric analysis of immunoglobulin light chains: agreement between the theoretical and experimental model. Assessment of the reference values of the kappa/lambda ratio and the heavy to light chain ratio]. / Dosage immunonéphélémétrique des chaînes légères d'immunoglobulines: concordance du modèle théorique et du modèle expérimental. Détermination des valeurs de référence des rapports kappa/lambda et chaînes lourdes/chaînes légères.

Since the introduction of fully automated nephelometric systems simultaneous measurements of immunoglobulin light chains kappa (kappa) and lambda (lambda) and IgG, IgA and IgM have become increasingly used for the routine assessment of humoral immunity. From these data two ratios were calculated, the kappa/lambda ratio and the heavy chains to light chains ratio. As changes in these ratios might have some predictive clinical value besides reflecting a monoclonal component, it is necessary to know mean and reference limits of these ratios. On account of differences in the calibration method of the light chains measurements (either free light chains or light chains bound to a complete molecule) and of differences in the calculation method of the heavy chains to light chains ratio we were led to conduct our own investigation. IgG, IgA and IgM and kappa and lambda light chains were immunonephelometrically measured in the sera of 84 blood donors. For each sample theoretical values for kappa + lambda, kappa and lambda, and kappa/lambda were calculated using the existing relation between the concentration of a given immunoglobulin and the concentration of bound light chains. Using the Valtec Protocole and the t test we were able to evidence highly significant differences (p < 10(-4) between theoretical and experimental values of kappa, lambda and kappa + lambda; those differences could be proved to be directly linked to the nephelometric technique itself. However the experimental kappa/lambda ratio did not appear to differ from the theoretical one nor the standardization method to have an effect on the reference values of this ratio, our values (mean and reference limits, 1.81, 1.29-2.53) being very similar to previously published results. Concerning the so called heavy chains to light chains ratio two methods were used to express it, one consisting in the ratio of the theoretical kappa + lambda value to the experimental one with the following results, 1.05 and 0.93-1.18 for the mean and reference limits and the other one using the raw data. The results were as follows: mean 3.50, reference limits 3.11-3.94.