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Kappa-Free Light Chains in CSF Predict Early Multiple Sclerosis Disease Activity.
Klaus Berek1, Gabriel Bsteh1, Michael Auer1
1From the Department of Neurology (K.B., M.A., F.D.P., A.Z., F.D., H.H.), Medical University of Innsbruck; Department of Neurology (G.B., T.B.), Medical University of Vienna; Department of Neuroradiology (A.G., P.P.), Medical University of Innsbruck; FH Campus Wien (D.M., C.S.), University of Applied Sciences, Vienna; Department of Neurology (S.W.), Medical University of Graz; and Department of Statistics (J.W.), Faculty of Economics and Statistics, University of Innsbruck, Austria.
High kappa-free light chain (κ-FLC) index predicts early multiple sclerosis (MS) disease activity. Patients with a high κ-FLC index face a significantly higher probability of a second clinical attack sooner than those with a low index.
Area of Science:
- Neurology
- Immunology
- Biomarker Research
Background:
- Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system.
- Predicting MS disease activity is crucial for timely intervention and management.
- Current prediction methods often rely on clinical and MRI data, but novel biomarkers are needed.
Purpose of the Study:
- To determine if the kappa-free light chain (κ-FLC) index can predict multiple sclerosis (MS) disease activity.
- To assess the κ-FLC index's predictive power independently of demographic, clinical, and MRI factors.
- To evaluate the κ-FLC index as a risk factor for early disease progression in MS.
Main Methods:
- Longitudinal study of 88 early MS patients followed for 4 years post-onset.
- Baseline assessment included demographics, clinical symptoms, MRI (T2L, CELs), and serum/CSF κ-FLC levels.
- κ-FLC index calculated as ([CSF κ-FLC/serum κ-FLC]/albumin quotient); multivariate Cox regression used for analysis.
Main Results:
- A high κ-FLC index (>100) at baseline independently predicted a second clinical attack in MS patients.
- Patients with high κ-FLC index had a 2x higher probability of a second attack within 12 months and 4x higher within 24 months.
- Median time to a second attack was significantly shorter for high κ-FLC index (11 months) vs. low κ-FLC index (36 months).
Conclusions:
- Elevated κ-FLC index is a significant independent predictor of early disease activity in multiple sclerosis.
- High κ-FLC index serves as a valuable biomarker for identifying MS patients at higher risk of rapid progression.
- This finding supports the use of κ-FLC index for risk stratification in early MS management.
