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...

Full description

Saved in:
Bibliographic Details
Main Authors: Raffaella Candeloro, Maila Galloppa, Laura Lombardo, Michele Laudisi, Sara Ghisellini, Giovanna Negri, Caterina Ferri, Carla Marcialis, Tiziana Bellini, Maura Pugliatti, Massimiliano Castellazzi
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Diagnostics
Subjects:
Online Access:https://www.mdpi.com/2075-4418/14/24/2798
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850241977287704576
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
collection DOAJ
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
record_format Article
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
work_keys_str_mv AT raffaellacandeloro kappafreelightchainsinmultiplesclerosisasamarkerofintrathecalhumoralresponseasexdisaggregatedstudy
AT mailagalloppa kappafreelightchainsinmultiplesclerosisasamarkerofintrathecalhumoralresponseasexdisaggregatedstudy
AT lauralombardo kappafreelightchainsinmultiplesclerosisasamarkerofintrathecalhumoralresponseasexdisaggregatedstudy
AT michelelaudisi kappafreelightchainsinmultiplesclerosisasamarkerofintrathecalhumoralresponseasexdisaggregatedstudy
AT saraghisellini kappafreelightchainsinmultiplesclerosisasamarkerofintrathecalhumoralresponseasexdisaggregatedstudy
AT giovannanegri kappafreelightchainsinmultiplesclerosisasamarkerofintrathecalhumoralresponseasexdisaggregatedstudy
AT caterinaferri kappafreelightchainsinmultiplesclerosisasamarkerofintrathecalhumoralresponseasexdisaggregatedstudy
AT carlamarcialis kappafreelightchainsinmultiplesclerosisasamarkerofintrathecalhumoralresponseasexdisaggregatedstudy
AT tizianabellini kappafreelightchainsinmultiplesclerosisasamarkerofintrathecalhumoralresponseasexdisaggregatedstudy
AT maurapugliatti kappafreelightchainsinmultiplesclerosisasamarkerofintrathecalhumoralresponseasexdisaggregatedstudy
AT massimilianocastellazzi kappafreelightchainsinmultiplesclerosisasamarkerofintrathecalhumoralresponseasexdisaggregatedstudy