Intrathecal kappa free light chains as markers for multiple sclerosis

Abstract 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 e...

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Autores principales:	D. Vecchio, G. Bellomo, R. Serino, E. Virgilio, M. Lamonaca, U. Dianzani, R. Cantello, C. Comi, I. Crespi
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2020
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/27e1be2eb90a492e9f67a99363913987
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spelling	oai:doaj.org-article:27e1be2eb90a492e9f67a993639139872021-12-02T11:42:15ZIntrathecal kappa free light chains as markers for multiple sclerosis10.1038/s41598-020-77029-72045-2322https://doaj.org/article/27e1be2eb90a492e9f67a993639139872020-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-77029-7https://doaj.org/toc/2045-2322Abstract 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.D. VecchioG. BellomoR. SerinoE. VirgilioM. LamonacaU. DianzaniR. CantelloC. ComiI. CrespiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 10, Iss 1, Pp 1-6 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q D. Vecchio G. Bellomo R. Serino E. Virgilio M. Lamonaca U. Dianzani R. Cantello C. Comi I. Crespi Intrathecal kappa free light chains as markers for multiple sclerosis
description	Abstract 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.
format	article
author	D. Vecchio G. Bellomo R. Serino E. Virgilio M. Lamonaca U. Dianzani R. Cantello C. Comi I. Crespi
author_facet	D. Vecchio G. Bellomo R. Serino E. Virgilio M. Lamonaca U. Dianzani R. Cantello C. Comi I. Crespi
author_sort	D. Vecchio
title	Intrathecal kappa free light chains as markers for multiple sclerosis
title_short	Intrathecal kappa free light chains as markers for multiple sclerosis
title_full	Intrathecal kappa free light chains as markers for multiple sclerosis
title_fullStr	Intrathecal kappa free light chains as markers for multiple sclerosis
title_full_unstemmed	Intrathecal kappa free light chains as markers for multiple sclerosis
title_sort	intrathecal kappa free light chains as markers for multiple sclerosis
publisher	Nature Portfolio
publishDate	2020
url	https://doaj.org/article/27e1be2eb90a492e9f67a99363913987
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Intrathecal kappa free light chains as markers for multiple sclerosis

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