Scientific article
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Kappa free light chains is a valid tool in the diagnostics of MS: A large multicenter study

Published inMultiple sclerosis, vol. 26, no. 8, p. 912-923
Publication date2020-07
First online date2019-05-08
Abstract

Objective: To validate kappa free light chain (KFLC) and lambda free light chain (LFLC) indices as a diagnostic biomarker in multiple sclerosis (MS).

Methods: We performed a multicenter study including 745 patients from 18 centers (219 controls and 526 clinically isolated syndrome (CIS)/MS patients) with a known oligoclonal IgG band (OCB) status. KFLC and LFLC were measured in paired cerebrospinal fluid (CSF) and serum samples. Gaussian mixture modeling was used to define a cut-off for KFLC and LFLC indexes.

Results: The cut-off for the KFLC index was 6.6 (95% confidence interval (CI) = 5.2-138.1). The cut-off for the LFLC index was 6.9 (95% CI = 4.5-22.2). For CIS/MS patients, sensitivity of the KFLC index (0.88; 95% CI = 0.85-0.90) was higher than OCB (0.82; 95%CI = 0.79-0.85;p < 0.001), but specificity (0.83; 95% CI = 0.78-0.88) was lower (OCB = 0.92; 95% CI = 0.89-0.96;p < 0.001). Both sensitivity and specificity for the LFLC index were lower than OCB.

Conclusion: Compared with OCB, the KFLC index is more sensitive but less specific for diagnosing CIS/MS. Lacking an elevated KFLC index is more powerful for excluding MS compared with OCB but the latter is more important for ruling in a diagnosis of CIS/MS.

Keywords
  • CSF
  • KFLC
  • Multiple sclerosis
  • OCB
  • Biomarkers
  • Adult
  • Biomarkers / blood
  • Biomarkers / cerebrospinal fluid
  • Female
  • Humans
  • Immunoglobulin kappa-Chains / blood
  • Immunoglobulin kappa-Chains / cerebrospinal fluid
  • Immunoglobulin kappa-Chains / metabolism
  • Immunoglobulin lambda-Chains / blood
  • Immunoglobulin lambda-Chains / cerebrospinal fluid
  • Immunoglobulin lambda-Chains / metabolism
  • Male
  • Middle Aged
  • Multiple Sclerosis / diagnosis
  • Oligoclonal Bands / blood
  • Oligoclonal Bands / cerebrospinal fluid
  • Reproducibility of Results
  • Sensitivity and Specificity
Affiliation entities Not a UNIGE publication
Citation (ISO format)
LEURS, C E et al. Kappa free light chains is a valid tool in the diagnostics of MS: A large multicenter study. In: Multiple sclerosis, 2020, vol. 26, n° 8, p. 912–923. doi: 10.1177/1352458519845844
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Article (Published version)
Identifiers
ISSN of the journal1352-4585
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Technical informations

Creation12/16/2022 7:27:00 AM
First validation12/16/2022 7:27:00 AM
Update time03/16/2023 10:54:15 AM
Status update03/16/2023 10:54:15 AM
Last indexation11/01/2024 4:25:54 AM
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