Kappa Free Light Chain Biomarkers Are Efficient for the Diagnosis of Multiple Sclerosis: A Large Multicenter Cohort Study.
Journal
Neurology(R) neuroimmunology & neuroinflammation
ISSN: 2332-7812
Titre abrégé: Neurol Neuroimmunol Neuroinflamm
Pays: United States
ID NLM: 101636388
Informations de publication
Date de publication:
01 2023
01 2023
Historique:
received:
07
04
2022
accepted:
07
09
2022
entrez:
14
11
2022
pubmed:
15
11
2022
medline:
18
11
2022
Statut:
epublish
Résumé
Kappa free light chains (KFLC) seem to efficiently diagnose MS. However, extensive cohort studies are lacking to establish consensus cut-offs, notably to rule out non-MS autoimmune CNS disorders. Our objectives were to (1) determine diagnostic performances of CSF KFLC, KFLC index, and KFLC intrathecal fraction (IF) threshold values that allow us to separate MS from different CNS disorder control populations and compare them with oligoclonal bands' (OCB) performances and (2) to identify independent factors associated with KFLC quantification in MS. We conducted a retrospective multicenter study involving 13 French MS centers. Patients were included if they had a noninfectious and nontumoral CNS disorder, eligible data concerning CSF and serum KFLC, albumin, and OCB. Patients were classified into 4 groups according to their diagnosis: MS, clinically isolated syndrome (CIS), other inflammatory CNS disorders (OIND), and noninflammatory CNS disorder controls (NINDC). One thousand six hundred twenty-one patients were analyzed (675 MS, 90 CIS, 297 OIND, and 559 NINDC). KFLC index and KFLC IF had similar performances in diagnosing MS from nonselected controls and OIND ( KFLC biomarkers are efficient tools to separate patients with MS from controls, even when compared with other patients with CNS autoimmune disorder. Given these results, we suggest using KFLC index or KFLC IF as a criterion to diagnose MS. This study provides Class III evidence that KFLC index or IF can be used to differentiate patients with MS from nonselected controls and from patients with other autoimmune CNS disorders.
Sections du résumé
BACKGROUND AND OBJECTIVES
Kappa free light chains (KFLC) seem to efficiently diagnose MS. However, extensive cohort studies are lacking to establish consensus cut-offs, notably to rule out non-MS autoimmune CNS disorders. Our objectives were to (1) determine diagnostic performances of CSF KFLC, KFLC index, and KFLC intrathecal fraction (IF) threshold values that allow us to separate MS from different CNS disorder control populations and compare them with oligoclonal bands' (OCB) performances and (2) to identify independent factors associated with KFLC quantification in MS.
METHODS
We conducted a retrospective multicenter study involving 13 French MS centers. Patients were included if they had a noninfectious and nontumoral CNS disorder, eligible data concerning CSF and serum KFLC, albumin, and OCB. Patients were classified into 4 groups according to their diagnosis: MS, clinically isolated syndrome (CIS), other inflammatory CNS disorders (OIND), and noninflammatory CNS disorder controls (NINDC).
RESULTS
One thousand six hundred twenty-one patients were analyzed (675 MS, 90 CIS, 297 OIND, and 559 NINDC). KFLC index and KFLC IF had similar performances in diagnosing MS from nonselected controls and OIND (
DISCUSSION
KFLC biomarkers are efficient tools to separate patients with MS from controls, even when compared with other patients with CNS autoimmune disorder. Given these results, we suggest using KFLC index or KFLC IF as a criterion to diagnose MS.
CLASSIFICATION OF EVIDENCE
This study provides Class III evidence that KFLC index or IF can be used to differentiate patients with MS from nonselected controls and from patients with other autoimmune CNS disorders.
Identifiants
pubmed: 36376096
pii: 10/1/e200049
doi: 10.1212/NXI.0000000000200049
pmc: PMC9663206
pii:
doi:
Substances chimiques
Immunoglobulin kappa-Chains
0
Oligoclonal Bands
0
Biomarkers
0
Types de publication
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.
Références
Eur J Neurol. 2020 Mar;27(3):461-467
pubmed: 31710409
Neurotherapeutics. 2021 Jan;18(1):364-377
pubmed: 33258072
PLoS One. 2014 Apr 02;9(4):e88680
pubmed: 24695382
Mult Scler. 2020 Jul;26(8):912-923
pubmed: 31066634
Ann Neurol. 2021 Jan;89(1):13-23
pubmed: 33091175
Lancet Neurol. 2018 Feb;17(2):162-173
pubmed: 29275977
Neurol Neuroimmunol Neuroinflamm. 2020 Sep 18;7(6):
pubmed: 32948648
Front Neurol. 2021 Aug 11;12:676527
pubmed: 34456842
Clin Chim Acta. 2019 Feb;489:109-116
pubmed: 30529605
Front Immunol. 2019 Mar 29;10:641
pubmed: 30984199
Clin Chim Acta. 2020 Aug;507:205-209
pubmed: 32353362
Clin Chim Acta. 2019 Oct;497:153-162
pubmed: 31351929
Clin Chem Lab Med. 2018 Jul 26;56(8):1383-1391
pubmed: 29648995
Mult Scler. 2016 Apr;22(4):502-10
pubmed: 26199348
Clin Chem Lab Med. 2019 Sep 25;57(10):1574-1586
pubmed: 31112501
Brain. 2018 Jul 1;141(7):2066-2082
pubmed: 29873694
Neurology. 2019 Jan 1;92(1):26-33
pubmed: 30381369
JCI Insight. 2019 Mar 21;4(6):
pubmed: 30747723
J Neurochem. 2021 Nov;159(3):618-628
pubmed: 34478561
Clin Chem Lab Med. 2011 Nov 23;50(3):489-95
pubmed: 22098433
Clin Chem. 2007 Aug;53(8):1557-8
pubmed: 17644797
J Neuroimmunol. 2020 Jun 12;346:577287
pubmed: 32599341
Autoimmun Rev. 2019 Jan;18(1):43-49
pubmed: 30408586
Clin Trials. 2006;3(3):272-9
pubmed: 16895044
J Neuroimmunol. 2020 Oct 15;347:577355
pubmed: 32795735
J Cent Nerv Syst Dis. 2021 Nov 19;13:11795735211042166
pubmed: 34840504
Int J Mol Sci. 2018 Nov 29;19(12):
pubmed: 30501024
Mult Scler J Exp Transl Clin. 2015 Dec 16;1:2055217315620935
pubmed: 28607709
Pathology. 2015 Oct;47(6):564-9
pubmed: 26352111
Am J Clin Pathol. 2017 Jun 01;147(6):611-622
pubmed: 28575180
Cells. 2021 Mar 11;10(3):
pubmed: 33799494
Diagnostics (Basel). 2020 Oct 21;10(10):
pubmed: 33096861
Neurol Neuroimmunol Neuroinflamm. 2021 May 28;8(4):
pubmed: 34049994
Nat Immunol. 2018 Jul;19(7):696-707
pubmed: 29925992
J Neuroimmunol. 2013 Oct 15;263(1-2):116-20
pubmed: 23916392
Arch Neurol. 2005 Jun;62(6):865-70
pubmed: 15956157
Front Immunol. 2022 Mar 25;13:864133
pubmed: 35401550
Mayo Clin Proc. 2022 Apr;97(4):738-751
pubmed: 34893322
J Neuroimmunol. 2020 Feb 15;339:577108
pubmed: 31743879
J Neurol Neurosurg Psychiatry. 2018 Oct;89(10):1044-1049
pubmed: 29743290
PLoS One. 2015 Nov 25;10(11):e0143375
pubmed: 26606531
J Neuroimmunol. 2020 Feb 15;339:577122
pubmed: 31837636
Brain. 2019 Jul 1;142(7):1858-1875
pubmed: 31209474
Brain. 2022 Jun 21;:
pubmed: 35727945
Mult Scler. 2013 Nov;19(13):1802-9
pubmed: 23695446