Kappa Free Light Chains in Multiple Sclerosis as a Marker of Intrathecal Humoral Response: A Sex-Disaggregated Study
Background: Kappa free light chains (KFLCs) are emerging as promising biomarkers for intrathecal B cell activity for diagnosing multiple sclerosis (MS) through cerebrospinal fluid (CSF) analysis. In this study, we evaluated the ability of KFLC formulas to identify the presence of MS and their agreem...
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MDPI AG
2024-12-01
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| Online Access: | https://www.mdpi.com/2075-4418/14/24/2798 |
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| author | Raffaella Candeloro Maila Galloppa Laura Lombardo Michele Laudisi Sara Ghisellini Giovanna Negri Caterina Ferri Carla Marcialis Tiziana Bellini Maura Pugliatti Massimiliano Castellazzi |
| author_facet | Raffaella Candeloro Maila Galloppa Laura Lombardo Michele Laudisi Sara Ghisellini Giovanna Negri Caterina Ferri Carla Marcialis Tiziana Bellini Maura Pugliatti Massimiliano Castellazzi |
| author_sort | Raffaella Candeloro |
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| description | Background: Kappa free light chains (KFLCs) are emerging as promising biomarkers for intrathecal B cell activity for diagnosing multiple sclerosis (MS) through cerebrospinal fluid (CSF) analysis. In this study, we evaluated the ability of KFLC formulas to identify the presence of MS and their agreement with the ‘gold standard’ of CSF IgG oligoclonal bands (OCBs). Methods: A total of 233 patients were included in this study: 149, comprising 43 males and 106 females, had MS, and the remainder, 40 males and 44 females, had other neurological diseases (ONDs). We evaluated the potential of KFLCs in terms of sensitivity, specificity, and accordance. All analyses were conducted using a sex-disaggregated approach. Results: KFLCs showed a high sensitivity for both sexes with respect to the diagnosis of MS, with values between 74.42% and 93.03%. The specificity of the various formulas was much lower for females when compared to males, with values between 45.45% and 59.09%, with a significant difference between the two sexes for the K Index > 5.9 (<i>p</i> = 0.0451). Cohen’s kappa showed substantial agreement for men and moderate agreement for women between the KFLC indices and OCB. Conclusions: This study highlights the potential of KFLCs as a biomarker for MS but emphasises the need for sex-specific thresholds to improve diagnostic accuracy. |
| format | Article |
| id | doaj-art-aeb9727d0e58468c8db6ee677d7e22fa |
| institution | OA Journals |
| issn | 2075-4418 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
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| series | Diagnostics |
| spelling | doaj-art-aeb9727d0e58468c8db6ee677d7e22fa2025-08-20T02:00:26ZengMDPI AGDiagnostics2075-44182024-12-011424279810.3390/diagnostics14242798Kappa Free Light Chains in Multiple Sclerosis as a Marker of Intrathecal Humoral Response: A Sex-Disaggregated StudyRaffaella Candeloro0Maila Galloppa1Laura Lombardo2Michele Laudisi3Sara Ghisellini4Giovanna Negri5Caterina Ferri6Carla Marcialis7Tiziana Bellini8Maura Pugliatti9Massimiliano Castellazzi10Department of Neurosciences and Rehabilitation, University of Ferrara, 44121 Ferrara, ItalyDepartment of Neurosciences and Rehabilitation, University of Ferrara, 44121 Ferrara, ItalyDepartment of Neurosciences and Rehabilitation, University of Ferrara, 44121 Ferrara, ItalyDepartment of Neuroscience, “S. Anna” University Hospital, 44124 Ferrara, ItalyClinical Pathology Unit, “S. Anna” University Hospital, 44124 Ferrara, ItalyClinical Pathology Unit, “S. Anna” University Hospital, 44124 Ferrara, ItalyDepartment of Neuroscience, “S. Anna” University Hospital, 44124 Ferrara, ItalyDepartment of Neurosciences and Rehabilitation, University of Ferrara, 44121 Ferrara, ItalyDepartment of Neurosciences and Rehabilitation, University of Ferrara, 44121 Ferrara, ItalyDepartment of Neurosciences and Rehabilitation, University of Ferrara, 44121 Ferrara, ItalyDepartment of Neurosciences and Rehabilitation, University of Ferrara, 44121 Ferrara, ItalyBackground: Kappa free light chains (KFLCs) are emerging as promising biomarkers for intrathecal B cell activity for diagnosing multiple sclerosis (MS) through cerebrospinal fluid (CSF) analysis. In this study, we evaluated the ability of KFLC formulas to identify the presence of MS and their agreement with the ‘gold standard’ of CSF IgG oligoclonal bands (OCBs). Methods: A total of 233 patients were included in this study: 149, comprising 43 males and 106 females, had MS, and the remainder, 40 males and 44 females, had other neurological diseases (ONDs). We evaluated the potential of KFLCs in terms of sensitivity, specificity, and accordance. All analyses were conducted using a sex-disaggregated approach. Results: KFLCs showed a high sensitivity for both sexes with respect to the diagnosis of MS, with values between 74.42% and 93.03%. The specificity of the various formulas was much lower for females when compared to males, with values between 45.45% and 59.09%, with a significant difference between the two sexes for the K Index > 5.9 (<i>p</i> = 0.0451). Cohen’s kappa showed substantial agreement for men and moderate agreement for women between the KFLC indices and OCB. Conclusions: This study highlights the potential of KFLCs as a biomarker for MS but emphasises the need for sex-specific thresholds to improve diagnostic accuracy.https://www.mdpi.com/2075-4418/14/24/2798multiple sclerosiscerebrospinal fluidintrathecal synthesiskappa free light chainssex differences |
| spellingShingle | Raffaella Candeloro Maila Galloppa Laura Lombardo Michele Laudisi Sara Ghisellini Giovanna Negri Caterina Ferri Carla Marcialis Tiziana Bellini Maura Pugliatti Massimiliano Castellazzi Kappa Free Light Chains in Multiple Sclerosis as a Marker of Intrathecal Humoral Response: A Sex-Disaggregated Study Diagnostics multiple sclerosis cerebrospinal fluid intrathecal synthesis kappa free light chains sex differences |
| title | Kappa Free Light Chains in Multiple Sclerosis as a Marker of Intrathecal Humoral Response: A Sex-Disaggregated Study |
| title_full | Kappa Free Light Chains in Multiple Sclerosis as a Marker of Intrathecal Humoral Response: A Sex-Disaggregated Study |
| title_fullStr | Kappa Free Light Chains in Multiple Sclerosis as a Marker of Intrathecal Humoral Response: A Sex-Disaggregated Study |
| title_full_unstemmed | Kappa Free Light Chains in Multiple Sclerosis as a Marker of Intrathecal Humoral Response: A Sex-Disaggregated Study |
| title_short | Kappa Free Light Chains in Multiple Sclerosis as a Marker of Intrathecal Humoral Response: A Sex-Disaggregated Study |
| title_sort | kappa free light chains in multiple sclerosis as a marker of intrathecal humoral response a sex disaggregated study |
| topic | multiple sclerosis cerebrospinal fluid intrathecal synthesis kappa free light chains sex differences |
| url | https://www.mdpi.com/2075-4418/14/24/2798 |
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