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Intrathecal kappa free light chains as markers for multiple sclerosis.

D Vecchio^1,2, G Bellomo³, R Serino⁴

¹Department of Translational Medicine, Neurology Unit, University of Piemonte Orientale, Corso Mazzini 18, 28100, Novara, Italy. domizia.vecchio@gmail.com.

Scientific Reports

|November 24, 2020

Summary

The cerebrospinal fluid kappa free light chain (KFLC) index accurately diagnoses multiple sclerosis (MS) and predicts disease progression in early syndromes. A "kappa-oriented" response is characteristic of MS.

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Area of Science:

Neurology
Immunology
Biochemistry

Background:

Intrathecal IgG synthesis is crucial for diagnosing multiple sclerosis (MS).
The cerebrospinal fluid (CSF) kappa free light chain (KFLC) index is a potential marker for this synthesis.
Different interpretation methods for KFLC require comparison for optimal diagnostic and prognostic use.

Purpose of the Study:

To compare the diagnostic efficiency of KFLC using various interpretation approaches in MS.
To assess the prognostic value of KFLC in radiologically and clinically isolated syndromes (RIS-CIS).

Main Methods:

Analyzed CSF and serum samples from 133 MS patients and 240 with other neurological diseases.
Measured albumin, lambda free light chain (LFLC), and KFLC using nephelometry.
Calculated KFLC index, LFLC index, IgG index, and CSF ratios (KFLC/LFLC, KFLC/IgG, LFLC/IgG).

Main Results:

KFLC levels were significantly higher in MS patients compared to controls.
KFLC index and CSF KFLC/IgG ratio demonstrated high sensitivity and moderate specificity for MS diagnosis.
Elevated KFLC index and CSF KFLC/IgG were observed in RIS-CIS patients who later converted to MS.

Conclusions:

KFLC markers, particularly the KFLC index and CSF KFLC/IgG ratio, are accurate in diagnosing MS.
These KFLC markers possess prognostic value in individuals with early MS syndromes (RIS-CIS).
A "kappa-oriented" response is a hallmark of MS and impacts prognosis in early disease stages.