Evidence map›Paper›PMID 41995461›Full record

ArticleEuropean journal of neurology2026

Kappa Free Light Chains Reflect Treatment Response and Progression Independent of Focal Inflammation in Multiple Sclerosis.

Igal Rosenstein, Markus Axelsson, Magnus Johnsson, Clas Malmeström, Hlin Kvartsberg, Henrik Zetterberg, Jan Lycke, Lenka Novakova

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

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.

Igal RosensteinDepartment of Clinical Neuroscience, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID https://orcid.org/0000-0002-5078-9690
Markus AxelssonDepartment of Clinical Neuroscience, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Magnus JohnssonDepartment of Clinical Neuroscience, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID https://orcid.org/0000-0001-7151-201X
Clas MalmeströmDepartment of Clinical Neuroscience, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID https://orcid.org/0000-0003-2477-0088
Hlin KvartsbergDepartment of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
Henrik ZetterbergDepartment of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
Jan LyckeDepartment of Clinical Neuroscience, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Lenka NovakovaDepartment of Clinical Neuroscience, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Funding

Edit Jacobson FoundationG #x00F6; teborgs L #x00E4; kares #x00E4; llskap GLS #x2010;1021566Research Foundation of the Multiple Sclerosis Society of GothenburgSwedish Foundation for MS ResearchSwedish Society of the Neurologically Disabled
6 · The paper itself

Abstract

backgroundCerebrospinal fluid (CSF) kappa free light chains (KFLC) is a sensitive marker of intrathecal immunoglobulin synthesis and is incorporated into the 2024 McDonald criteria for multiple sclerosis (MS). How disease-modifying therapies (DMTs) influence KFLC dynamics and their association with treatment response remains unclear.

objectiveTo determine whether intrathecal KFLC synthesis changes during DMT and whether these changes are associated with clinical outcomes.

methodsPatients with treatment-naïve relapsing-remitting MS were prospectively enrolled at the Sahlgrenska MS Center (Gothenburg, Sweden). Paired CSF and serum samples were collected at baseline and after 12 months of treatment with dimethyl fumarate (DMF) or natalizumab (NTZ). KFLC index was calculated as [(CSF KFLC/serum KFLC)/(CSF albumin/serum albumin)]. Treatment response was assessed using no evidence of disease activity-3 (NEDA-3) and progression independent of relapse and MRI activity (PIRMA

resultsForty-eight patients were included (DMF n = 26, NTZ n = 22). NTZ reduced KFLC index from a median 117.4 (63.6-171.9) at baseline to 78.8 (39.4-104.0) at 12 months (adjusted p = 0.003), corresponding to a median decline of -51.0 (IQR -82.1 to -24.7), whereas DMF produced no meaningful change. In NTZ-treated patients maintaining NEDA-3 or without PIRMA

conclusionsNatalizumab appears to reduce intrathecal KFLC synthesis, and a decline in KFLC index may reflect effective suppression of CNS humoral immunity. ΔKFLC index could serve as a sensitive biomarker of treatment response and disease stability in MS.

Indexed as

Dimethyl FumarateImmunoglobulin kappa-ChainsImmunologic FactorsMultiple Sclerosis, Relapsing-RemittingNatalizumabAdultBiomarkersDisease ProgressionFemaleHumansImmunosuppressive AgentsInflammationMaleMiddle AgedProspective StudiesTreatment OutcomeBiomarkersDimethyl FumarateImmunoglobulin kappa-ChainsImmunologic FactorsImmunosuppressive AgentsNatalizumabbiomarkersimmunologic factorsneurodegenerationneuroinflammationtreatment outcome

Identifiers

PMID41995461
PMCPMC13088974

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.