The Use of Kappa Free Light Chains to Diagnose Multiple Sclerosis

Abstract

Background: The positive implications of using free light chains in diagnosing multiple sclerosis have increasingly gained considerable interest in medical research and the scientific community. It is often presumed that free light chains, particularly kappa and lambda free light chains, are of practical use and are associated with a higher probability of obtaining positive results compared to oligoclonal bands. The primary purpose of the current paper was to conduct a systematic review to assess the up-to-date methods for diagnosing multiple sclerosis using kappa and lambda free light chains. Method: An organized literature search was performed across four electronic sources, including Google Scholar, Web of Science, Embase, and MEDLINE. The sources analyzed in this systematic review and meta-analysis comprise randomized clinical trials, prospective cohort studies, retrospective studies, controlled clinical trials, and systematic reviews. Results: The review contains 116 reports that includes 1204 participants. The final selection includes a vast array of preexisting literature concerning the study topic: 35 randomized clinical trials, 21 prospective cohort studies, 19 retrospective studies, 22 controlled clinical trials, and 13 systematic reviews. Discussion: The incorporated literature sources provided integral insights into the benefits of free light chain diagnostics for multiple sclerosis. It was also evident that the use of free light chains in the diagnosis of clinically isolated syndrome (CIS) and multiple sclerosis is relatively fast and inexpensive in comparison to other conventional state-of-the-art diagnostic methods, e.g., using oligoclonal bands (OCBs).

Serum Neurofilament and Free Light Chain Levels in Patients Undergoing Treatment for Chronic Inflammatory Demyelinating Polyneuropathy

“…One possible explanation for these findings can be derived from considering the different structures of kappa and lambda, with the former being a monomer, while the latter tends to dimerize. Concerning MS, Arneth et al hypothesized that λ FLC dimers may have a reduced propensity to cross the blood-CSF barrier compared to monomeric k FLC [10]. If this same mechanism was confirmed in our case, it could potentially explain the observed behavior in Table 2 and Figure 3: the more severe the inflammation in the peripheral nervous system (PNS), the higher the levels of both of these markers in the CSF.…”

“…Aside from NfL, other circulating and cerebrospinal fluid markers are starting to attract attention for a more in-depth characterization of neuroinflammatory diseases. For instance, in multiple sclerosis (MS), altered levels of free light chains (FLCs) have also been identified in both blood and CSF [10,11]. Notably, a recent meta-analysis by Arneth et al has suggested the potential benefits of utilizing FLCs for the diagnosis of MS and clinically isolated syndrome (CIS) due to the efficiency and cost-effectiveness of their isolation and analysis [10].…”

“…For instance, in multiple sclerosis (MS), altered levels of free light chains (FLCs) have also been identified in both blood and CSF [10,11]. Notably, a recent meta-analysis by Arneth et al has suggested the potential benefits of utilizing FLCs for the diagnosis of MS and clinically isolated syndrome (CIS) due to the efficiency and cost-effectiveness of their isolation and analysis [10]. Similarly, a consensus statement indicates that FLCs accumulate in the CSF in cases of chronic inflammatory diseases of the central nervous system [11].…”

Predictive value of brain atrophy, serum biomarkers and information processing speed for early disease progression in multiple sclerosis

“…The presence of oligoclonal bands (OCBs) in the cerebrospinal fluid (CSF) is a diagnostic marker ( 3 ) and a negative predictor of MS evolution, indicating a greater progression in OCB-positive patients ( 4 ). Moreover, a measure of intrathecal production of kappa-free light chains is gaining interest as a quantitative alternative to OCB which is also a valuable diagnostic tool ( 5 , 6 ) and predicts early activity of the disease ( 7 ). Currently, one of the most promising biomarkers is neurofilaments, which are cytoskeletal proteins released from damaged axons into the CSF and the blood.…”

Concentration of immunoglobulin free light chains in cerebrospinal fluid in the diagnosis of multiple sclerosis

“…В последние годы содержание свободных легких цепей иммуноглобулинов в ЦСЖ рассматривается как потенциальный маркер РС, а также как возможный предиктор воспалительной активности заболевания [12].…”