Аннотация
Background: Intrathecal activation of B-cell is a major pathological finding in multiple sclerosis (MS) that is characterized by increased intrathecal synthesis and oligoclonal banding of immunoglobulins in cerebrospinal fluid (CSF). Free light chains (FLC) are fragments of immunoglobulins that are produced in parallel with OCB.
Objective: To define prognostic significance of FLC
Patients and Methods/Material and Methods: 381 patients with MS participated in this study. We reviewed two patient groups: long term prognosis (LTP) (n=284) and short term prognosis (STP) (n=97). STP and LTP were also divided on subgroups with high FLC concentration and low FLC concentration. FLC were measured using ELISA. In LTP Multiple Sclerosis Severity Score (MSSS) and Expanded Disability Status Scale (EDSS) were measured at the date of the last follow-up. EDSS at the moment of the first relapse and after 2 years was measured in STP.
Results: In LTP positive correlations were detected between EDSS and kappa-FLC in CSF (r=0,181; р=0,002), MSSS and kappa-FLC in CSF (r=0,121; р=0,044). Survival analysis revealed an increased risk for long-term progression of disability (EDSS=6.0) for high kappa-FLC in CSF (HR=2.055, p=0.026). In STP positive correlation was detected between EDSS after 2 years and kappa-FLC in CSF (r=0,377; р=0,00019). EDSS in all subgroups of STP significantly decreased after 2 years, except for subgroup with high kappa-FLC in CSF where EDSS level at the moment of the first relapse and EDSS after 2 years didn’t change significantly after 2 years (p=0,1844).
Conclusion: Kappa-FLC in CSF possess prognostic value for longterm and short-term disability progression.
Процитировать:
Nazarov, V. & Makshakov, Gleb & Lapin, Sergey & Evdoshenko, Evgeniy & Surkova, Elena. (2017). Prognostic significance of free light chains for long-term and short term disability progression in multiple sclerosis. Journal of the Neurological Sciences. 381. 789. 10.1016/j.jns.2017.08.2228.