High Levels of Cerebrospinal Fluid Kappa Free Light Chains Relate to IgM Intrathecal Synthesis and Might Have Prognostic Implications in Relapsing Multiple Sclerosis

• DOI: 10.3389/fimmu.2022.827738
• Publication Date: 2022-03-07T09:28:47Z
• Authors: Jéssica Castillo-...; Sara Gil-Perotín; Raquel Gasque-Rubio; Laura Cubas-Nuñez; Sara Carratalà-Boscà; Carmen Alcalá; Carlos Quintanill...; Francisco Pérez-M...; Cristina Ferrer; Antonio Cañada Ma...; Jordi Tortosa; Luís Solís-Tarazona; Luisa Campos; Alberto Leivas; Begoña Laíz Marro; Bonaventura Casanova
• Keywords: Kappa; Intrathecal; Neuromyelitis Optica

Cerebrospinal kappa free light chain (KFLC)-index is a marker of intrathecal immunoglobulin synthesis that aids in the diagnosis multiple sclerosis (MS). However, little evidence exists on its prognostic role. Our aim to analyze relationship between KFLC-index and other MS biomarkers explore This monocentric observational study cohort 52 people with relapsing (pwRMS) performed prospectively acquired clinical data retrospective evaluation biomarkers. We measured KFLC-index, synthesis, cerebrospinal fluid (CSF) chitinase 3-like 1 (CHI3L1), neurofilament protein (NFL) reviewed MRI detect leptomeningeal contrast enhancement (LMCE). compared time Expanded Disability Status Scale (EDSS) 3 initiation high-efficacy disease-modifying therapies (heDMTs) by multivariate Cox regression analysis. Median correlated IgG/IgM indexes ( p < 0.0001/ 0.05) IgG-oligoclonal bands (OCGBs) 0.001). Patients IgM-oligoclonal (OCMBs) had higher = 0.049). was patients LMCE 0.008) CHI3L1 0.007), but disease activity no effect value. Bivariate analyses confirmed > 58 as an independent risk factor for reaching EDSS (hazard ratio (HR) 12.4; 95% CI 1.1–147; 0.047) need treatment heDMTs (HR 3.0; 1.2–7.1; 0.0013). To conclude, our suggest potential role during course.