Department of Neurology, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.
Wien Med Wochenschr. 2022 Nov;172(15-16):337-345. doi: 10.1007/s10354-022-00912-7. Epub 2022 Feb 8.
Multiple sclerosis (MS) is a chronic immune-mediated disorder of the central nervous system that shows a high interindividual heterogeneity, which frequently poses challenges regarding diagnosis and prediction of disease activity. In this context, evidence of intrathecal inflammation provides an important information and might be captured by kappa free light chains (κ-FLC) in the cerebrospinal fluid (CSF). In this review, we provide an overview on what is currently known about κ‑FLC, its historical development, the available assays and current evidence on its diagnostic and prognostic value in MS. Briefly, intrathecal κ‑FLC synthesis reaches similar diagnostic accuracy compared to the well-established CSF-restricted oligoclonal bands (OCB) to identify patients with MS, and recent studies even depict its value for prediction of early MS disease activity. Furthermore, detection of κ‑FLC has significant methodological advantages in comparison to OCB detection.
多发性硬化症（MS）是一种中枢神经系统的慢性免疫介导性疾病，个体间异质性很高，这经常给疾病活动的诊断和预测带来挑战。在这种情况下，鞘内炎症的证据提供了重要的信息，并且可能通过脑脊液（CSF）中的κ-游离轻链（κ-FLC）来捕获。在这篇综述中，我们概述了目前关于 κ-FLC 的知识，包括其历史发展、现有的检测方法以及在 MS 中的诊断和预后价值的现有证据。简而言之，与成熟的 CSF 寡克隆带（OCB）相比，鞘内 κ-FLC 的合成在识别 MS 患者方面具有相似的诊断准确性，最近的研究甚至描绘了其在预测早期 MS 疾病活动方面的价值。此外，与 OCB 检测相比，κ-FLC 的检测具有显著的方法学优势。
