Prognostic Value of Lambda Free Light Chains in Early Multiple Sclerosis

IF 1.1 3区医学 Q2 CLINICAL NEUROLOGY

Acta Neurologica Scandinavica Pub Date : 2026-08-28 DOI:10.1155/ane/8187265

Kamila Zondra Revendova, David Zeman, Krystof Damian Svub, Pavla Hanzlikova, Aravind Ganesh, Pavlina Kusnierova

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Abstract

Background

Lambda free light chains (LFLC) measures in cerebrospinal fluid (CSF) may reflect early CNS inflammation, but their prognostic value in early relapsing–remitting multiple sclerosis (RRMS) remains unclear. This study evaluated whether baseline LFLC-related parameters are associated with risk of second relapse, MRI activity and progression to Expanded Disability Status Scale (EDSS) ≥ 4.

Methods

This single-centre retrospective study enrolled patients aged ≥ 18 years with RRMS who had experienced no more than one clinical relapse at lumbar puncture and had baseline paired CSF/serum FLC measurements. Baseline LFLC parameters, including CSF LFLC concentration, LFLC index, CSF LFLC/IgG ratio, CSF KFLC/LFLC ratio and oligoclonal LFLC bands, were analysed in relation to clinical and radiological outcomes using Cox proportional hazards models.

Results

The analyses included 91 RRMS patients: 65.9% female; median age at disease onset, 34.7 years (IQR 15.4) and median follow-up period, 36 months (IQR 25). Baseline LFLC-related measures were not associated with the risk of second relapse, MRI activity or progression to EDSS ≥ 4 in multivariable analyses. The number of CSF-restricted oligoclonal LFLC bands was associated with reaching EDSS ≥ 4 in univariable analysis (HR 1.09, 95% CI 1.01–1.17); however, this association was not confirmed after adjustment for baseline EDSS and treatment exposure.

Conclusions

LFLC-related measures were not independently associated with relapse risk, MRI activity or disability progression to EDSS ≥ 4 in early RRMS. These findings suggest limited prognostic value of LFLC biomarkers in early disease stages and support the need for further prospective multicentre studies.

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来源期刊

Acta Neurologica Scandinavica 医学-临床神经学

CiteScore

6.70

自引率

2.90%

发文量

161

审稿时长

4-8 weeks

期刊介绍： Acta Neurologica Scandinavica aims to publish manuscripts of a high scientific quality representing original clinical, diagnostic or experimental work in neuroscience. The journal''s scope is to act as an international forum for the dissemination of information advancing the science or practice of this subject area. Papers in English will be welcomed, especially those which bring new knowledge and observations from the application of therapies or techniques in the combating of a broad spectrum of neurological disease and neurodegenerative disorders. Relevant articles on the basic neurosciences will be published where they extend present understanding of such disorders. Priority will be given to review of topical subjects. Papers requiring rapid publication because of their significance and timeliness will be included as ''Clinical commentaries'' not exceeding two printed pages, as will ''Clinical commentaries'' of sufficient general interest. Debate within the speciality is encouraged in the form of ''Letters to the editor''. All submitted manuscripts falling within the overall scope of the journal will be assessed by suitably qualified referees.