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

John R Rinker1, Kathryn Trinkaus, Anne H Cross

  • 1Department of Neurology and Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA. rinkerj@neuro.wustl.edu

Neurology
|October 13, 2006
PubMed

Insights

Elevated cerebrospinal fluid free kappa light chains (FKLCs) can predict future disability in multiple sclerosis (MS). Levels of 1.53 microg/mL or higher indicated a high likelihood of needing walking assistance.

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.

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