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Intrathecal kappa free light chains as markers for multiple sclerosis
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Intrathecal kappa free light chains as markers for multiple sclerosis
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Journal Article
Intrathecal kappa free light chains as markers for multiple sclerosis
2020
Overview
Cerebrospinal fluid (CSF) kappa free light chain (KFLC) index has been described as a reliable marker of intrathecal IgG synthesis to diagnose multiple sclerosis (MS). Our aims were: (1) to compare the efficiency of KFLC through different interpretation approaches in diagnosing MS. (2) to evaluate the prognostic value of KFLC in radiologically and clinically isolated syndromes (RIS-CIS). We enrolled 133 MS patients and 240 with other neurological diseases (93 inflammatory including 18 RIS-CIS, 147 non-inflammatory). Albumin, lambda free light chain (LFLC) and KFLC were measured in the CSF and serum by nephelometry. We included two groups of markers: (a) corrected for blood-CSF barrier permeability: immunoglobulin G (IgG), KFLC and LFLC indexes. (b) CSF ratios (not including albumin and serum-correction): CSF KFLC/LFLC, CSF KFLC/IgG, CSF LFLC/IgG. KFLC were significantly higher in MS patients compared to those with other diseases (both inflammatory or not). KFLC index and CSF KFLC/IgG ratio showed high sensitivity (93% and 86.5%) and moderate specificity (85% and 88%) in diagnosing MS. RIS-CIS patients who converted to MS showed greater KFLC index and CSF KFLC/IgG. Despite OB are confirmed to be the gold-standard to detect intrathecal IgG synthesis, the KFLC confirmed their accuracy in MS diagnosis. A “kappa-oriented” response characterizes MS and has a prognostic impact in the RIS-CIS population.
Publisher
Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
Subject
/ 692/617
/ Adult
/ Aged
/ Albumin
/ Biomarkers - cerebrospinal fluid
/ Female
/ Humanities and Social Sciences
/ Humans
/ Immunoglobulin G - cerebrospinal fluid
/ Immunoglobulin kappa-Chains - blood
/ Immunoglobulin kappa-Chains - cerebrospinal fluid
/ Immunoglobulin lambda-Chains - blood
/ Immunoglobulin lambda-Chains - cerebrospinal fluid
/ Male
/ Multiple Sclerosis - cerebrospinal fluid
/ Multiple Sclerosis - diagnosis
/ Multiple Sclerosis - epidemiology
/ Nephelometry and Turbidimetry
/ Science
