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Increased free light chains in the urine from patients with multiple sclerosis
P D Mehta1, S D Cook, R A Troiano
1New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY 10314.
Neurology
|April 1, 1991
Summary
Researchers measured free light chains in urine to monitor multiple sclerosis (MS) activity. Elevated levels of urinary free lambda light chains indicate MS, and changes in the kappa/creatinine ratio may track disease progression.
Area of Science:
- Neurology
- Immunology
- Biochemistry
Background:
- Multiple sclerosis (MS) is a chronic neurological disease.
- Current methods for monitoring MS activity can be invasive or costly.
- Biomarkers for non-invasively assessing MS progression are needed.
Purpose of the Study:
- To investigate the utility of free kappa (kappa) and lambda (L) light chains in urine as potential biomarkers for multiple sclerosis (MS).
- To assess the correlation between urinary free light chain levels and MS disease activity or clinical status.
Main Methods:
- Quantification of free kappa and lambda light chains in coded urine specimens from MS patients (N=56), other neurologic diseases (OND) patients (N=30), and normal controls (N=28).
- Analysis of the ratio of kappa light chains to creatinine.
- Comparison of urinary free light chain levels across different patient groups and correlation with clinical status (relapsing-remitting vs. stable MS).
- Serial urine sample analysis during periods of clinical worsening and recovery in a subset of MS patients.
Main Results:
- Urine from MS patients exhibited statistically significant increases in free L chains compared to OND patients and normal controls, with some overlap between MS and OND groups.
- The ratio of kappa/creatinine was significantly higher in the relapsing-remitting MS group compared to clinically stable MS, OND, and normal control groups.
- Elevated free L chains were generally independent of urinary albumin and beta 2-microglobulin levels.
- Serial studies revealed elevated urinary free kappa/creatinine ratios during clinical worsening in 7/8 MS patients, with subsequent decreases during clinical recovery.
Conclusions:
- Urinary free light chains, particularly lambda light chains, show potential as biomarkers for distinguishing multiple sclerosis (MS) from other neurologic diseases.
- The urinary kappa/creatinine ratio may serve as a valuable indicator of disease activity in relapsing-remitting MS.
- Monitoring urinary free light chains at intervals could be a useful, non-invasive method for tracking disease activity in MS patients.