ArticleJournal of neurology, neurosurgery, and psychiatry2018
Cerebrospinal fluid immunoglobulin light chain ratios predict disease progression in multiple sclerosis.
Article in Journal of neurology, neurosurgery, and psychiatry, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- The Use of Kappa Free Light Chains to Diagnose Multiple Sclerosis.Medicina (Kaunas, Lithuania) · 2022Pooled it
- KFLC to Total CSF Protein Ratio Is an Alternative to KFLC Index to Diagnose Multiple Sclerosis: A Retrospective Study of 814 Cases.Neurology(R) neuroimmunology & neuroinflammation · 2025Article
- Validation of ELISA assays for the calculation of FLC indices for the diagnosis of intrathecal immunoglobulin synthesis.Clinical chemistry and laboratory medicine · 2023Article
- Analysis of cerebrospinal fluid cells by flow cytometry: Comparison to conventional cytology.Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia · 2023Article
- Kappa Free Light Chain Biomarkers Are Efficient for the Diagnosis of Multiple Sclerosis: A Large Multicenter Cohort Study.Neurology(R) neuroimmunology & neuroinflammation · 2023Article
- Kappa free light chains index in multiple sclerosis very long-term prognosis.Frontiers in immunology · 2023Observational
- [Usefulness of the kappa index in the diagnosis of multiple sclerosis and validation of reference values in the Community of Aragon].Revista de neurologia · 2022Observational
- Intrathecal B cell-related markers for an optimized biological investigation of multiple sclerosis patients.Scientific reports · 2022Article
- A Scoping Review on Body Fluid Biomarkers for Prognosis and Disease Activity in Patients with Multiple Sclerosis.Journal of personalized medicine · 2022Article
- Diagnostic Cerebrospinal Fluid Biomarker in Early and Late Onset Multiple Sclerosis.Biomedicines · 2022Article
- Review
- Methods to investigate intrathecal adaptive immunity in neurodegeneration.Molecular neurodegeneration · 2021Article
- Depression and anxiety disorders in patients with multiple sclerosis: association with neurodegeneration and neurofilaments.Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica · 2021Article
- Does CSF pleocytosis have a predictive value for disease course in MS?Neurology(R) neuroimmunology & neuroinflammation · 2019Article
- Free Light Chains as a Novel Diagnostic Biomarker of Immune System Abnormalities in Multiple Sclerosis and HIV Infection.BioMed research international · 2019Review
- A challenging case of concurrent multiple sclerosis and anaplastic astrocytoma.Surgical neurology international · 2019Article
- The Persisting Significance of Oligoclonal Bands in the Dawning Era of Kappa Free Light Chains for the Diagnosis of Multiple Sclerosis.International journal of molecular sciences · 2018Article
- New biomarker predicts disability in MS.Nature reviews. Neurology · 2018Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo determine whether the ratio of cerebrospinal fluid (CSF) immunoglobulin kappa to lambda light chains at time of multiple sclerosis (MS) diagnosis predicts disease progression and whether this was intrinsic to CSF plasmablasts.
methodsCSF and peripheral blood were obtained from patients undergoing elective diagnostic lumbar puncture and included clinically isolated syndrome (CIS) (n=43), relapsing remitting MS (RRMS; n=50), primary progressive MS (PPMS; n=20) and other neurological disease controls, both inflammatory (ONID; n=23) and non-inflammatory (OND; n=114). CSF samples were assayed for free and immunoglobulin-associated light chains and on B cells and plasmablasts. Clinical follow-up data were collected during a 5-year follow-up period where available.
resultsThere was an increased median CSF κ:λ free light chain (FLC) in all MS groups (CIS: 18.2, 95% CI 6.8 to 30.3; RRMS: 4.4, 95% CI 2.7 to 11.4; PPMS: 12.0, 95% CI 3.6 to 37.1) but not controls (OND: 1.61, 95% CI 1.4 to 1.9; ONID: 1.7, 95% CI 1.3 to 2.2; p<0.001). This ratio predicted Expanded Disability Status Scores (EDSS) progression at 5 years, with a lower median EDSS in the group with high (>10) CSF κ:λ FLC (0.0, 95% CI 0 to 2.5 vs 2.5, 95% CI 0 to 4, high vs low; p=0.049). CSF κ:λ FLC correlated with CSF IgG1 κ:λ (r=0.776; p<0.0001) and was intrinsic to CSF plasmablasts (r=0.65; p=0.026).
conclusionsThese data demonstrate that CSF immunoglobulin κ:λ ratios, determined at the time of diagnostic lumbar puncture, predict MS disease progression and may therefore be useful prognostic markers for early therapeutic stratification.
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