{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T10:02:06Z","timestamp":1791021726275,"version":"4.1.0"},"reference-count":50,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T00:00:00Z","timestamp":1752192000000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011727","name":"Stockholm l\u00e4ns landsting","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011727","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the relation between intrathecal antibody production, as reflected by kappa free light chain (KFLC) metrics, and multiple sclerosis (MS) prognosis\u2010related markers and study its modulation following MS treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study comprised matched plasma and cerebrospinal fluid (CSF) samples from a total of 130 persons with MS (pwMS), 99 of whom were untreated at baseline. Paired samples from 73 pwMS (18 on dimethyl fumarate (DMF), 10 on fingolimod, 6 on natalizumab, 25 on rituximab (RTX) and 14 after autologous hematopoietic stem cell transplantation (HSCT)) were used to analyze treatment effects on KFLC metrics. KFLC was measured by nephelometry while clinical and paraclinical data were collected from the patient charts. HLA typing was performed with SNP genotyping.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The KFLC local concentration (KFLC loc) and index was higher in HLA\u2010DRB1*15:01 carriers and correlated with the number of CSF mononuclear cells, IgG index, and CSF levels of CXCL13 and neurofilament light chain, the latter particularly during remission (<jats:italic>r<\/jats:italic>\u2009=\u20090.27, <jats:italic>p<\/jats:italic>\u2009=\u20090.045). With regard to treatment effects, we found that treatment with DMF, RTX, and HSCT resulted in a decrease of CSF\u2010KFLC levels and\/or KFLC loc and index. Interestingly, the rate of decrease in KFLC index correlated with time since first treatment (<jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.41, <jats:italic>p<\/jats:italic>\u2009=\u20090.045).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These findings support an involvement of intrathecal antibodies in non\u2010relapsing MS pathology and inform on the effect of current treatments. The slow rate of decrease in KFLC index following B cell depletion stresses the need for early treatment start.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.70291","type":"journal-article","created":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T12:49:22Z","timestamp":1752238162000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Kappa Free Light Chain Index Correlates With Prognostic Biomarkers in Multiple Sclerosis and Decreases Slowly Following Treatment"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0503-5929","authenticated-orcid":false,"given":"Frida","family":"Duell","sequence":"first","affiliation":[{"name":"Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Department of Clinical Chemistry Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3696-355X","authenticated-orcid":false,"given":"Klara Asplund","family":"H\u00f6gelin","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8830-0173","authenticated-orcid":false,"given":"Benjamin","family":"Vlad","sequence":"additional","affiliation":[{"name":"Neuroimmunology and Multiple Sclerosis Research Section, Department of Neurology University of Zurich and University Hospital Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Neidhart","sequence":"additional","affiliation":[{"name":"Neuroimmunology and Multiple Sclerosis Research Section, Department of Neurology University of Zurich and University Hospital Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohsen","family":"Khademi","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilijas","family":"Jelcic","sequence":"additional","affiliation":[{"name":"Neuroimmunology and Multiple Sclerosis Research Section, Department of Neurology University of Zurich and University Hospital Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Hansson","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Karolinska Institutet, and Department of Clinical Chemistry Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faiez","family":"Al Nimer","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,11]]},"reference":[{"issue":"2","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1056\/NEJMra1401483","article-title":"Multiple Sclerosis","volume":"378","author":"Reich D. 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