Elevated CSF free kappa light chains correlate with disability prognosis in multiple sclerosis.

Area of Science:

• Neurology
• Immunology
• Biochemistry

Background:

• Multiple sclerosis (MS) is a chronic neurological disease.
• Disability progression in MS varies significantly among patients.
• Biomarkers are needed to predict MS disability.

Purpose of the Study:

• To investigate the predictive value of cerebrospinal fluid free kappa light chains (FKLCs) for disability progression in MS.
• To establish a threshold for CSF FKLCs indicative of future ambulatory assistance needs.

Main Methods:

• Retrospective review of 57 MS patient records.
• Median follow-up of 15 years.
• Correlation analysis between CSF FKLC levels and disability milestones.

Main Results:

• Elevated CSF FKLC levels (≥1.53 microg/mL) predicted the need for ambulatory assistance.
• High specificity (87.5%) and positive predictive value (88.9%) were observed for predicting need for assistance during follow-up.
• Significant predictive value was also found for need within 10 years (PPV 66.7%).

Conclusions:

• CSF FKLCs are a potential prognostic biomarker in MS.
• A CSF FKLC level of ≥1.53 microg/mL is associated with increased risk of mobility impairment in MS patients.