Evidence map›Paper›PMID 40643211›Full record

ArticleEuropean journal of neurology2025

Kappa Free Light Chain Index Correlates With Prognostic Biomarkers in Multiple Sclerosis and Decreases Slowly Following Treatment.

Frida Duell, Klara Asplund Högelin, Benjamin Vlad, Stephan Neidhart, Mohsen Khademi, Ilijas Jelcic, Magnus Hansson, Faiez Al Nimer

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Article in European journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Frida DuellDepartment of Neurobiology, Care Sciences and Society, Karolinska Institutet and Department of Clinical Chemistry, Karolinska University Hospital, Stockholm, Sweden.ORCID 0000-0002-0503-5929
Klara Asplund HögelinDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-3696-355X
Benjamin VladNeuroimmunology and Multiple Sclerosis Research Section, Department of Neurology, University of Zurich and University Hospital Zurich, Zurich, Switzerland.ORCID 0009-0002-8830-0173
Stephan NeidhartNeuroimmunology and Multiple Sclerosis Research Section, Department of Neurology, University of Zurich and University Hospital Zurich, Zurich, Switzerland.
Mohsen KhademiDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Ilijas JelcicNeuroimmunology and Multiple Sclerosis Research Section, Department of Neurology, University of Zurich and University Hospital Zurich, Zurich, Switzerland.
Magnus HanssonDepartment of Laboratory Medicine, Karolinska Institutet, and Department of Clinical Chemistry, Karolinska University Hospital, Stockholm, Sweden.
Faiez Al NimerDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.

Funding

Stockholm läns landsting
6 · The paper itself

Abstract

objectiveTo investigate the relation between intrathecal antibody production, as reflected by kappa free light chain (KFLC) metrics, and multiple sclerosis (MS) prognosis-related markers and study its modulation following MS treatment.

methodsThis study comprised matched plasma and cerebrospinal fluid (CSF) samples from a total of 130 persons with MS (pwMS), 99 of whom were untreated at baseline. Paired samples from 73 pwMS (18 on dimethyl fumarate (DMF), 10 on fingolimod, 6 on natalizumab, 25 on rituximab (RTX) and 14 after autologous hematopoietic stem cell transplantation (HSCT)) were used to analyze treatment effects on KFLC metrics. KFLC was measured by nephelometry while clinical and paraclinical data were collected from the patient charts. HLA typing was performed with SNP genotyping.

resultsThe KFLC local concentration (KFLC loc) and index was higher in HLA-DRB1*15:01 carriers and correlated with the number of CSF mononuclear cells, IgG index, and CSF levels of CXCL13 and neurofilament light chain, the latter particularly during remission (r = 0.27, p = 0.045). With regard to treatment effects, we found that treatment with DMF, RTX, and HSCT resulted in a decrease of CSF-KFLC levels and/or KFLC loc and index. Interestingly, the rate of decrease in KFLC index correlated with time since first treatment (r = -0.41, p = 0.045).

conclusionThese findings support an involvement of intrathecal antibodies in non-relapsing MS pathology and inform on the effect of current treatments. The slow rate of decrease in KFLC index following B cell depletion stresses the need for early treatment start.

Indexed as

Immunoglobulin kappa-ChainsMultiple SclerosisAdultBiomarkersChemokine CXCL13Dimethyl FumarateFemaleFingolimod HydrochlorideHematopoietic Stem Cell TransplantationHumansImmunologic FactorsImmunosuppressive AgentsMaleMiddle AgedNatalizumabNeurofilament ProteinsBiomarkersChemokine CXCL13Dimethyl FumarateFingolimod HydrochlorideImmunoglobulin kappa-ChainsImmunologic FactorsImmunosuppressive AgentsNatalizumabNeurofilament ProteinsRituximabbiomarkerscerebrospinal fluiddimethyl fumaratehematopoietic stem cell transplantationHLA‐DRB1*15:01kappa free light chainsmultiple sclerosisrituximab

Identifiers

PMID40643211
PMCPMC12247182

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