{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T16:40:08Z","timestamp":1789663208811,"version":"4.0.1"},"reference-count":36,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,6,28]],"date-time":"2025-06-28T00:00:00Z","timestamp":1751068800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The kappa\u2010free light chain (\u03ba\u2010FLC) index is known to be highly sensitive and specific for diagnosing multiple sclerosis (MS), while little is understood about lambda (\u03bb)\u2010FLC. This study assessed the \u03ba\u2010FLC and \u03bb\u2010FLC indices in autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter study compares \u03ba\u2010FLC and \u03bb\u2010FLC indexes among patients with autoimmune GFAP astrocytopathy and sex\u2010 and age\u2010matched MS (positive control group) as well as symptomatic controls (headaches and small cerebral vessel disease, as the negative control group). We describe the correlation of both indexes with clinical variables and outcomes in the GFAP astrocytopathy cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 93 patients were included (31 in each group). The median \u03ba\u2010FLC index was higher in the MS group (65.5 [35.7; 118.3]) compared to the GFAP astrocytopathy group (26.1 [11.4; 78.4],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.062). With a \u03ba\u2010FLC index threshold of 6.1, the proportion of patients with a positive \u03ba\u2010FLC index was similar between the MS (94%) and GFAP\u2010astrocytopathy groups (84%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.425). The median \u03bb\u2010FLC index was higher in the GFAP astrocytopathy group (45.5 [28.4; 96.9]) than in the MS group (10.6 [2.2; 29.1],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                    <jats:p>\n                      In the GFAP\u2010astrocytopathy group, both CSF \u03bb\u2010FLC and the \u03bb\u2010FLC index at baseline were correlated with the last follow\u2010up mRS (\n                      <jats:italic>\u2374<\/jats:italic>\n                      \u2009=\u20090.46,\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.088,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014, and\n                      <jats:italic>\u2374<\/jats:italic>\n                      \u2009=\u20090.32,\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.12,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.101, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The \u03ba\u2010FLC index alone cannot distinguish between autoimmune GFAP astrocytopathy and MS. We indicate a potential diagnostic and prognostic role of the \u03bb\u2010FLC index in GFAP astrocytopathy that needs confirmation in independent cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.70103","type":"journal-article","created":{"date-parts":[[2025,6,29]],"date-time":"2025-06-29T02:40:26Z","timestamp":1751164826000},"page":"1785-1793","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Relevance of Kappa and Lambda Free Light Chains in Autoimmune Astrocytopathy Associated With Anti\u2010\n                    <scp>GFAP<\/scp>\n                    Antibodies"],"prefix":"10.1002","volume":"12","author":[{"given":"Michael","family":"Levraut","sequence":"first","affiliation":[{"name":"UR2CA\u2010URRIS, Unit\u00e9 de Recherche Clinique C\u00f4te d'Azur Universit\u00e9 Nice Cote d'Azur, Centre Hospitalier Universitaire de Nice  Nice France"},{"name":"Laboratoire d'Immunologie Centre Hospitalier Universitaire de Nice  Nice France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5967-2800","authenticated-orcid":false,"given":"Romain","family":"Marignier","sequence":"additional","affiliation":[{"name":"Service de Neurologie, CRC\u2010SEP, and Centre de R\u00e9f\u00e9rence des Maladies Inflammatoires Rares du Cerveau et de la Moelle H\u00f4pital Neurologique Pierre Wertheimer  Bron France"},{"name":"Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR5292  Lyon France"},{"name":"Universit\u00e9 Claude Bernard Lyon 1  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3985-1297","authenticated-orcid":false,"given":"Mikael","family":"Cohen","sequence":"additional","affiliation":[{"name":"UR2CA\u2010URRIS, Unit\u00e9 de Recherche Clinique C\u00f4te d'Azur Universit\u00e9 Nice Cote d'Azur, Centre Hospitalier Universitaire de Nice  Nice 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