ASSOCIATION BETWEEN KAPPA FREE LIGHT CHAINS, DISABILITY, AND MRI FINDINGS IN PREDICTING THE COURSE OF MULTIPLE SCLEROSIS
Keywords:
MRI diagnostics, paramagnetic rim lesions, prognosis, multiple sclerosis.Abstract
The search for reliable biomarkers reflecting intrathecal immunoglobulin synthesis and predicting the course of multiple sclerosis (MS) remains one of the priority tasks of modern neuroimmunology. Kappa free light chains (κ-FLC) in the cerebrospinal fluid are considered a sensitive quantitative marker of B-cell activity and an alternative to oligoclonal bands. Their potential association with the level of disability and neuroimaging characteristics of the disease requires further clarification.
References
1. Якимовски Д., Биттнер С., Живадинов Р. и др. Рассеянный склероз. Lancet 2024; 403: 183–202.
2. Weinshenker BG, Bass B, Rice GP и др. Естественное течение рассеянного склероза: географическое исследование. I. Клиническое течение и инвалидность. Brain 1989; 112(Pt. 1): 133–146.
3. Онтанеда Д., Таллантир Э., Калинчик Т. и др. Ранние высокоэффективные и эскалационные подходы к лечению рецидивирующего рассеянного склероза. Lancet Neurol 2019; 18(10): 973–980.
4. Luchetti S, Fransen NL, van Eden CG, et al. Progressive multiple sclerosis patients show substantial lesion activity that correlates with clinical disease severity and sex: A retrospective autopsy cohort analysis. Acta Neuropathol 2018; 135(4): 511–528.
5. Frischer JM, Weigand SD, Guo Y, et al. Clinical and pathological insights into the dynamic nature of the white matter multiple sclerosis plaque. Ann Neurol 2015; 78(5): 710–721.
6. Bagnato F, Hametner S, Yao B, et al. Tracking iron in multiple sclerosis: A combined imaging and histopathological study at 7 tesla. Brain 2011; 134(Pt. 12): 3602–3615.
7. Popescu BF, Frischer JM, Webb SM, et al. Pathogenic implications of distinct patterns of iron and zinc in chronic MS lesions. Acta Neuropathol 2017; 134(1): 45–64.
8. Yao B, Ikonomidou VN, Cantor FK, et al. Heterogeneity of multiple sclerosis white matter lesions detected with T2*-weighted imaging at 7.0 tesla. J Neuroimaging 2015; 25(5): 799–806.
9. Clarke MA, Pareto D, Pessini-Ferreira L, et al. Value of 3T susceptibility-weighted imaging in the diagnosis of multiple sclerosis. AJNR Am J Neuroradiol 2020; 41(6): 1001–1008.
10. Zhang Y, Gauthier SA, Gupta A, et al. Quantitative susceptibility mapping and R2* measured changes during white matter lesion development in multiple sclerosis: Myelin breakdown, myelin debris degradation and removal, and iron accumulation. AJNR Am J Neuroradiol 2016; 37(9): 1629–1635.
11. Dal-Bianco A, Grabner G, Kronnerwetter C, et al. Slow expansion of multiple sclerosis iron rim lesions: Pathology and 7 T magnetic resonance imaging. Acta Neuropathol 2017; 133(1): 25–42.
12. Dal-Bianco A, Grabner G, Kronnerwetter C, et al. Long-term evolution of multiple sclerosis iron rim lesions in 7 T MRI. Brain 2021; 144(3): 833–847.
13. Ng Kee Kwong KC, Mollison D, Meijboom R, et al. The prevalence of paramagnetic rim lesions in multiple sclerosis: A systematic review and meta-analysis. PLoS ONE 2021; 16: e0256845.
14. Meaton I, Altokhis A, Allen CM, et al. Paramagnetic rims are a promising diagnostic imaging biomarker in multiple sclerosis. Mult Scler J. Epub ahead of print 26 August 2022.
15. Absinta M, Sati P, Masuzzo F, et al. Association of chronic active multiple sclerosis lesions with disability in vivo. JAMA Neurol 2019; 76: 1474–1483.
16. Mehta V, Pei W, Yang G, et al. Iron is a sensitive biomarker for inflammation in multiple sclerosis lesions. PLoS ONE 2013; 8(3): e57573.
17. Harrison DM, Li X, Liu H, et al. Lesion heterogeneity on high-field susceptibility MRI is associated with multiple sclerosis severity. AJNR Am J Neuroradiol 2016; 37(8): 1447–1453.
18. Elliott C, Wolinsky JS, Hauser SL, et al. Slowly expanding/evolving lesions as a magnetic resonance imaging marker of chronic active multiple sclerosis lesions. Mult Scler 2019; 25(14): 1915–1925.
19. Preziosa P, Pagani E, Meani A, et al. Slowly expanding lesions predict 9-year multiple sclerosis disease progression. Neurol Neuroimmunol Neuroinflamm 2022; 9(2): e1139.
20. Elliott C, Belachew S, Wolinsky JS, et al. Chronic white matter lesion activity predicts clinical progression in primary progressive multiple sclerosis. Brain 2019; 142(9): 2787–2799.
21. Calvi A, Carrasco FP, Tur C, et al. Association of slowly expanding lesions on MRI with disability in people with secondary progressive multiple sclerosis. Neurology 2022; 98(17): e1783–e1793.
22. Beynon V, George IC, Elliott C, et al. Chronic lesion activity and disability progression in secondary progressive multiple sclerosis. BMJ Neurol Open 2022; 4(1): e000240.
23. Elliott C, Belachew S, Fisher E, et al. MRI characteristics of chronic MS lesions by phase rim detection and/or slowly expanding properties (4101). Neurology 2021; 96(15 Suppl.): 4101.
24. Klistorner S, Barnett MH, Yiannikas C, et al. Expansion of chronic lesions is linked to disease progression in relapsing–remitting multiple sclerosis patients. Mult Scler 2021; 27(10): 1533–1542.
25. Calvi A, Tur C, Chard D, et al. Slowly expanding lesions relate to persisting black-holes and clinical outcomes in relapse-onset multiple sclerosis. Neuroimage Clin 2022; 35: 103048.
26. 23.Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol 2018; 17(2): 162–173.
27. U. Abdullazizova, Y. Musayeva, S. Saidaliyev, F. Nigmatova, CLIPPERS syndrom is a recently defined inflammatory central nervous system disorder, prominently involving the brainstem and in particular the pons.,Parkinsonism & Related Disorders,Volume134,2025,107433,ISSN13538020,https://doi.org/10.1016/j.parkreldis.2025.107433.(https://www.sciencedirect.com/science/article/pii/S1353802025001749)





