Diagnostic value of kappa free light chain index in patients with primary progressive multiple sclerosis - a multicentre study

Harald Hegen; Klaus Berek; Paola Cavalla; Mikael Christiansen; Andreja Emeršič; Massimiliano Di Filippo; Lorenzo Gaetani; Michaela Hassler; Cyra Leurs; Dejan Milosavljevic; Vincent van Pesch; Thor Petersen; Stefan Presslauer; Igal Rosenstein; Uroš Rot; Christine Schnabl; Charlotte Teunissen; Domizia Vecchio; Marco Vercellino; Florian Deisenhammer

doi:10.3389/fimmu.2023.1327947

Diagnostic value of kappa free light chain index in patients with primary progressive multiple sclerosis - a multicentre study

Front Immunol. 2023 Dec 19:14:1327947. doi: 10.3389/fimmu.2023.1327947. eCollection 2023.

Authors

Harald Hegen¹, Klaus Berek¹, Paola Cavalla², Mikael Christiansen³, Andreja Emeršič⁴, Massimiliano Di Filippo⁵, Lorenzo Gaetani⁵, Michaela Hassler⁶, Cyra Leurs⁷, Dejan Milosavljevic⁶, Vincent van Pesch⁸, Thor Petersen⁹, Stefan Presslauer¹⁰, Igal Rosenstein¹¹, Uroš Rot^{4

12}, Christine Schnabl⁶, Charlotte Teunissen¹³, Domizia Vecchio¹⁴, Marco Vercellino², Florian Deisenhammer¹

Affiliations

¹ Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
² Multiple Sclerosis Center and Neurologia I U, Department of Neuroscience and Mental Health, AOU Città della Salute e della Scienza di Torino, Torino, Italy.
³ Department of Clinical Biochemistry, Regional Hospital in Horsens, Horsens, Denmark.
⁴ Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
⁵ Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
⁶ FH Campus Wien, University of Applied Sciences, Vienna, Austria.
⁷ Department of Neurology and Neurophysiology, Amsterdam Neuroscience, Amsterdam UMC, Location VUMC, Amsterdam, Netherlands.
⁸ Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium.
⁹ Sygehus Sønderjylland, Department of Regional Health Research, University Hospital of Southern Denmark, Hadersleben, Denmark.
¹⁰ Department of Neurology, Klinikum Ottakring, Vienna, Austria.
¹¹ Department of Clinical Neuroscience, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
¹² Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
¹³ Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam UMC, Location Vrije Universiteit, Amsterdam Neuroscience, Amsterdam, Netherlands.
¹⁴ Neurology Unit Department of Translational Medicine, Maggiore della Carità University Hospital, Novara, Italy.

Abstract

Background: Kappa free light chains (κ-FLC) in the cerebrospinal fluid (CSF) are an emerging biomarker in multiple sclerosis (MS).

Objective: To investigate whether κ-FLC index has similar diagnostic value in patients with primary progressive multiple sclerosis (PPMS) compared to oligoclonal bands (OCB).

Methods: Patients with PPMS were recruited through 11 MS centres across 7 countries. κ-FLC were measured by immunonephelometry/-turbidimetry. OCB were determined by isoelectric focusing and immunofixation.

Results: A total of 174 patients (mean age of 52±11 years, 51% males) were included. κ-FLC index using a cut-off of 6.1 was positive in 161 (93%) and OCB in 153 (88%) patients.

Conclusion: κ-FLC index shows similar diagnostic sensitivity than OCB in PPMS.

Keywords: cerebrospinal fluid; diagnosis; kappa free light chain; multiple sclerosis; primary progressive; sensitivity.

Copyright © 2023 Hegen, Berek, Cavalla, Christiansen, Emeršič, Di Filippo, Gaetani, Hassler, Leurs, Milosavljevic, van Pesch, Petersen, Presslauer, Rosenstein, Rot, Schnabl, Teunissen, Vecchio, Vercellino and Deisenhammer.

Publication types

Multicenter Study

MeSH terms

Adult
Biomarkers / cerebrospinal fluid
Female
Humans
Immunoglobulin Light Chains
Immunoglobulin kappa-Chains / cerebrospinal fluid
Male
Middle Aged
Multiple Sclerosis* / cerebrospinal fluid
Multiple Sclerosis* / diagnosis
Multiple Sclerosis, Chronic Progressive* / diagnosis
Oligoclonal Bands / cerebrospinal fluid

Substances

Immunoglobulin Light Chains
Immunoglobulin kappa-Chains
Biomarkers
Oligoclonal Bands

Grants and funding

The authors declare no financial support was received for the research, authorship, and/or publication of this article.