Kappa free light chain index as a diagnostic biomarker in multiple sclerosis: A real-world investigation.
Adult
Biomarkers
Demyelinating Diseases
/ diagnosis
Diagnosis, Differential
Disease Progression
Female
Humans
Immunoglobulin G
/ analysis
Immunoglobulin Light Chains
/ analysis
Inflammation
/ diagnosis
Magnetic Resonance Imaging
Male
Multiple Sclerosis
/ diagnosis
Reproducibility of Results
Sensitivity and Specificity
Spinal Cord
/ chemistry
Kappa free light chain index
biomarkers
cerebrospinal fluid
diagnosis
multiple sclerosis
Journal
Journal of neurochemistry
ISSN: 1471-4159
Titre abrégé: J Neurochem
Pays: England
ID NLM: 2985190R
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
received:
02
07
2021
accepted:
23
08
2021
pubmed:
4
9
2021
medline:
20
11
2021
entrez:
3
9
2021
Statut:
ppublish
Résumé
Kappa free light chain (KFLC) index, a measure for intrathecal production of free kappa chains, has been increasingly recognized for its diagnostic potential in multiple sclerosis (MS) as a quantitative alternative to IgG oligoclonal bands (OCBs). Our objective was to investigate the sensitivity, specificity, and overall diagnostic accuracy of KFLC index in MS. KFLC index was prospectively determined as part of the diagnostic workup in patients with suspected MS (n = 327) between May 2013 and February 2020. Patients with clinically isolated syndrome (CIS), radiologically isolated syndrome (RIS), and MS had markedly higher KFLC index (44.6, IQR 16-128) compared with subjects with other neuro-inflammatory disorders (ONID) and symptomatic controls (SC) (2.19, IQR 1.68-2.98, p < 0.001). KFLC index had a sensitivity of 0.93 (95% CI 0.88-0.95) and specificity of 0.87 (95% CI 0.8-0.92) to discriminate CIS/RIS/MS from ONID and SC (AUC 0.94, 95% CI 0.91-0.97, p < 0.001). KFLC index and intrathecal fraction (IF) KFLC had similar accuracies to detect MS. Treatment with disease-modifying therapy (DMT) did not influence the level of KFLC index and it was not affected by demographic factors or associated with degenerative or inflammatory biomarkers in cerebrospinal fluid (CSF). KFLC index in MS diagnostics has methodological advantages compared to OCB and is independent to subjective interpretation. Moreover, it is an attractive diagnostic tool since the diagnostic specificity and sensitivity of KFLC index are similar with that of OCBs and KFLC
Substances chimiques
Biomarkers
0
Immunoglobulin G
0
Immunoglobulin Light Chains
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
618-628Informations de copyright
© 2021 The Authors. Journal of Neurochemistry published by John Wiley & Sons Ltd on behalf of International Society for Neurochemistry.
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