Multiple sclerosis and related disorders · 2026
Increased kappa free light chain index in patients with late onset multiple sclerosis.
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Serrazina Filipa, Mendes Alexandra Sofia, Fonseca Isabel Ribeiro, Krupka Danna, Costa José Blazer, Salavisa Manuel
Аннотация
INTRODUCTION: Intrathecal immunoglobulin-G synthesis is a pathological hallmark of multiple sclerosis (MS). Cerebrospinal fluid (CSF) kappa-free light chain (κFLC) detection has emerged as a new biomarker in MS, but little is known about its expression and variance across distinct patient subgroups.
OBJECTIVE: To assess and compare intrathecal synthesis through kFLC index between patients with early and late onset MS.
METHODS: An exploratory retrospective single-center cohort study including consecutively diagnosed MS patients was conducted. Nephelometric kFLC measurements of paired serum/CSF samples collected at MS diagnosis were obtained. A cut-off for increased κFLC index was established at ≥6.1 as per previous published reports. Two groups were defined: early onset (EO) patients (first MS symptoms < 50 years) and late onset (LO) patients (first MS symptoms ≥ 50 years).
RESULTS: Sixty (60) patients were included, 42(70 %) female, with a mean age of 48.3 years (±14.3; min18-max79) and a mean disease duration of 5.2 years (± 4.8; min 0.5-máx 23). 25 (41.7 %) LO patients were included. Groups did not differ in demographic or clinical variables. Although the prevalence of CSF-restricted OCB was similar between groups (EO n = 31, 88.6 %; LO n = 22, 88,0 %, p = 1.000), the prevalence of a kFLC index >6.1 was significantly higher in LO MS patients (n = 22, 88.0 % vs EO n = 22, 62,9 % p = 0.040).
CONCLUSION: In this cohort, a higher prevalence of increased kFLC index was found among patients with late-onset MS. This may reflect a longer period of intrathecal dysimune reactions connected to MS pathological onset, even if not clinically expressed until later stages.
OBJECTIVE: To assess and compare intrathecal synthesis through kFLC index between patients with early and late onset MS.
METHODS: An exploratory retrospective single-center cohort study including consecutively diagnosed MS patients was conducted. Nephelometric kFLC measurements of paired serum/CSF samples collected at MS diagnosis were obtained. A cut-off for increased κFLC index was established at ≥6.1 as per previous published reports. Two groups were defined: early onset (EO) patients (first MS symptoms < 50 years) and late onset (LO) patients (first MS symptoms ≥ 50 years).
RESULTS: Sixty (60) patients were included, 42(70 %) female, with a mean age of 48.3 years (±14.3; min18-max79) and a mean disease duration of 5.2 years (± 4.8; min 0.5-máx 23). 25 (41.7 %) LO patients were included. Groups did not differ in demographic or clinical variables. Although the prevalence of CSF-restricted OCB was similar between groups (EO n = 31, 88.6 %; LO n = 22, 88,0 %, p = 1.000), the prevalence of a kFLC index >6.1 was significantly higher in LO MS patients (n = 22, 88.0 % vs EO n = 22, 62,9 % p = 0.040).
CONCLUSION: In this cohort, a higher prevalence of increased kFLC index was found among patients with late-onset MS. This may reflect a longer period of intrathecal dysimune reactions connected to MS pathological onset, even if not clinically expressed until later stages.