Prognostic value of kappa free light chain index in patients with primary progressive multiple sclerosis Article Swipe
Martin Schmidauer
,
Klaus Berek
,
Michael Auer
,
Gabriel Bsteh
,
Paola Cavalla
,
Franziska Di Pauli
,
Massimiliano Di Filippo
,
Janette Walde
,
Andreja Emeršič
,
Fabian Föttinger
,
Lorenzo Gaetani
,
Michaela Hassler
,
Nik Krajnc
,
Dejan Milosavljevic
,
Markus Ponleitner
,
Thor Petersen
,
Stefan Presslauer
,
Igal Rosenstein
,
Uroš Rot
,
Caroline Winther Tørring
,
Domizia Vecchio
,
Marco Vercellino
,
Tobias Zrzavy
,
Anne Zinganell
,
Harald Hegen
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.3389/fimmu.2025.1658182
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.3389/fimmu.2025.1658182
Background The kappa free light chain (κ-FLC) index is a well-established biomarker in multiple sclerosis (MS). While the prognostic value of the κ-FLC index has been demonstrated in early relapsing–remitting MS, its prognostic value in primary progressive MS (PPMS) has not yet been investigated. Methods In this multicenter, retrospective cohort study, patients diagnosed with PPMS with diagnostic lumbar puncture and clinical follow-up of at least 12 months were recruited from nine MS centers across five countries. At baseline, age, sex, disease duration, and the number of T2 hyperintense (T2L) and contrast-enhancing T1 lesions (CEL) on MRI were determined. κ-FLC was measured using nephelometry/turbidimetry, and the κ-FLC index was calculated as (CSF κ-FLC/serum κ-FLC)/albumin quotient. At follow-up, the occurrence of disability progression and the administration of disease-modifying treatment (DMT) were registered. The primary endpoint was time to disability progression. Results A total of 121 PPMS patients were included with a median age of 53 years (25th–75th percentile: 46–59) and a balanced sex distribution (48.8% female). Multivariable Cox regression analysis revealed no significant association between the κ-FLC index and disability progression [hazard ratio (HR) 1.0, p = 0.950]. Prior use of DMT (HR 0.60, p = 0.023) and brain T2L > 9 at baseline (HR 2.22, p = 0.026) were significantly associated with disability progression. The remaining covariates, including age, sex, disease duration, and CEL, showed no significant associations. Conclusion The κ-FLC index does not predict disability progression in PPMS, contrasting its growing role as a prognostic biomarker in relapsing MS. This highlights phenotypic differences in MS pathophysiology and underscores the need for prognostic biomarkers in PPMS.
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- Type
- article
- Language
- en
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- https://doi.org/10.3389/fimmu.2025.1658182
- https://public-pages-files-2025.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2025.1658182/pdf
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Prognostic value of kappa free light chain index in patients with primary progressive multiple sclerosisWork title
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articleOpenAlex work type
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enPrimary language
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2025Year of publication
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2025-11-07Full publication date if available
- Authors
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Martin Schmidauer, Klaus Berek, Michael Auer, Gabriel Bsteh, Paola Cavalla, Franziska Di Pauli, Massimiliano Di Filippo, Janette Walde, Andreja Emeršič, Fabian Föttinger, Lorenzo Gaetani, Michaela Hassler, Nik Krajnc, Dejan Milosavljevic, Markus Ponleitner, Thor Petersen, Stefan Presslauer, Igal Rosenstein, Uroš Rot, Caroline Winther Tørring, Domizia Vecchio, Marco Vercellino, Tobias Zrzavy, Anne Zinganell, Harald HegenList of authors in order
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https://doi.org/10.3389/fimmu.2025.1658182Publisher landing page
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https://public-pages-files-2025.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2025.1658182/pdfDirect link to full text PDF
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goldOpen access status per OpenAlex
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https://public-pages-files-2025.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2025.1658182/pdfDirect OA link when available
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0Total citation count in OpenAlex
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| abstract_inverted_index.PPMS | 54, 143 |
| abstract_inverted_index.This | 249 |
| abstract_inverted_index.age, | 78, 217 |
| abstract_inverted_index.been | 25, 42 |
| abstract_inverted_index.does | 231 |
| abstract_inverted_index.five | 74 |
| abstract_inverted_index.free | 3 |
| abstract_inverted_index.from | 69 |
| abstract_inverted_index.need | 259 |
| abstract_inverted_index.nine | 70 |
| abstract_inverted_index.role | 241 |
| abstract_inverted_index.sex, | 79, 218 |
| abstract_inverted_index.this | 46 |
| abstract_inverted_index.time | 134 |
| abstract_inverted_index.were | 67, 96, 128, 145, 207 |
| abstract_inverted_index.with | 53, 55, 147, 210 |
| abstract_inverted_index.(CEL) | 93 |
| abstract_inverted_index.(DMT) | 127 |
| abstract_inverted_index.(MS). | 15 |
| abstract_inverted_index.(T2L) | 88 |
| abstract_inverted_index.0.60, | 191 |
| abstract_inverted_index.2.22, | 203 |
| abstract_inverted_index.PPMS, | 237 |
| abstract_inverted_index.PPMS. | 264 |
| abstract_inverted_index.Prior | 186 |
| abstract_inverted_index.While | 16 |
| abstract_inverted_index.brain | 196 |
| abstract_inverted_index.chain | 5 |
| abstract_inverted_index.early | 28 |
| abstract_inverted_index.index | 7, 23, 106, 175, 230 |
| abstract_inverted_index.kappa | 2 |
| abstract_inverted_index.least | 64 |
| abstract_inverted_index.light | 4 |
| abstract_inverted_index.ratio | 180 |
| abstract_inverted_index.total | 140 |
| abstract_inverted_index.using | 101 |
| abstract_inverted_index.value | 19, 33 |
| abstract_inverted_index.years | 153 |
| abstract_inverted_index.(48.8% | 162 |
| abstract_inverted_index.(PPMS) | 38 |
| abstract_inverted_index.0.023) | 194 |
| abstract_inverted_index.0.026) | 206 |
| abstract_inverted_index.across | 73 |
| abstract_inverted_index.cohort | 49 |
| abstract_inverted_index.lumbar | 57 |
| abstract_inverted_index.median | 149 |
| abstract_inverted_index.months | 66 |
| abstract_inverted_index.number | 84 |
| abstract_inverted_index.showed | 223 |
| abstract_inverted_index.study, | 50 |
| abstract_inverted_index.κ-FLC | 22, 98, 105, 174, 229 |
| abstract_inverted_index.0.950]. | 185 |
| abstract_inverted_index.Methods | 44 |
| abstract_inverted_index.Results | 138 |
| abstract_inverted_index.[hazard | 179 |
| abstract_inverted_index.between | 172 |
| abstract_inverted_index.centers | 72 |
| abstract_inverted_index.disease | 80, 219 |
| abstract_inverted_index.growing | 240 |
| abstract_inverted_index.lesions | 92 |
| abstract_inverted_index.predict | 233 |
| abstract_inverted_index.primary | 35, 131 |
| abstract_inverted_index.> | 198 |
| abstract_inverted_index.(κ-FLC) | 6 |
| abstract_inverted_index.46–59) | 156 |
| abstract_inverted_index.analysis | 167 |
| abstract_inverted_index.balanced | 159 |
| abstract_inverted_index.baseline | 201 |
| abstract_inverted_index.clinical | 60 |
| abstract_inverted_index.endpoint | 132 |
| abstract_inverted_index.female). | 163 |
| abstract_inverted_index.included | 146 |
| abstract_inverted_index.measured | 100 |
| abstract_inverted_index.multiple | 13 |
| abstract_inverted_index.patients | 51, 144 |
| abstract_inverted_index.puncture | 58 |
| abstract_inverted_index.revealed | 168 |
| abstract_inverted_index.baseline, | 77 |
| abstract_inverted_index.biomarker | 11, 245 |
| abstract_inverted_index.diagnosed | 52 |
| abstract_inverted_index.duration, | 81, 220 |
| abstract_inverted_index.follow-up | 61 |
| abstract_inverted_index.including | 216 |
| abstract_inverted_index.quotient. | 113 |
| abstract_inverted_index.recruited | 68 |
| abstract_inverted_index.relapsing | 247 |
| abstract_inverted_index.remaining | 214 |
| abstract_inverted_index.sclerosis | 14 |
| abstract_inverted_index.treatment | 126 |
| abstract_inverted_index.Background | 0 |
| abstract_inverted_index.Conclusion | 227 |
| abstract_inverted_index.associated | 209 |
| abstract_inverted_index.biomarkers | 262 |
| abstract_inverted_index.calculated | 108 |
| abstract_inverted_index.countries. | 75 |
| abstract_inverted_index.diagnostic | 56 |
| abstract_inverted_index.disability | 119, 136, 177, 211, 234 |
| abstract_inverted_index.follow-up, | 115 |
| abstract_inverted_index.highlights | 250 |
| abstract_inverted_index.occurrence | 117 |
| abstract_inverted_index.phenotypic | 251 |
| abstract_inverted_index.prognostic | 18, 32, 244, 261 |
| abstract_inverted_index.regression | 166 |
| abstract_inverted_index.association | 171 |
| abstract_inverted_index.contrasting | 238 |
| abstract_inverted_index.covariates, | 215 |
| abstract_inverted_index.determined. | 97 |
| abstract_inverted_index.differences | 252 |
| abstract_inverted_index.percentile: | 155 |
| abstract_inverted_index.progression | 120, 178, 235 |
| abstract_inverted_index.progressive | 36 |
| abstract_inverted_index.registered. | 129 |
| abstract_inverted_index.significant | 170, 225 |
| abstract_inverted_index.underscores | 257 |
| abstract_inverted_index.(25th–75th | 154 |
| abstract_inverted_index.demonstrated | 26 |
| abstract_inverted_index.distribution | 161 |
| abstract_inverted_index.hyperintense | 87 |
| abstract_inverted_index.multicenter, | 47 |
| abstract_inverted_index.progression. | 137, 212 |
| abstract_inverted_index.κ-FLC/serum | 111 |
| abstract_inverted_index.Multivariable | 164 |
| abstract_inverted_index.associations. | 226 |
| abstract_inverted_index.investigated. | 43 |
| abstract_inverted_index.retrospective | 48 |
| abstract_inverted_index.significantly | 208 |
| abstract_inverted_index.administration | 123 |
| abstract_inverted_index.pathophysiology | 255 |
| abstract_inverted_index.κ-FLC)/albumin | 112 |
| abstract_inverted_index.well-established | 10 |
| abstract_inverted_index.disease-modifying | 125 |
| abstract_inverted_index.contrast-enhancing | 90 |
| abstract_inverted_index.relapsing–remitting | 29 |
| abstract_inverted_index.nephelometry/turbidimetry, | 102 |
| cited_by_percentile_year | |
| countries_distinct_count | 0 |
| institutions_distinct_count | 25 |
| citation_normalized_percentile |