The Role of Immunoglobulin Free Kappa Light Chains (FLCs) in Liver Cirrhosis

Articles in Press

Document Type : Review Articles

Authors

1 Theodor Bilharz Research Institute

2 Clinical Pathology, Faculty of Medicine, Zagazig University

3 Hepatology, Faculty of Medicine, Zagazig University

Abstract

Background:

Liver cirrhosis represents the end-stage of chronic liver disease, characterized by progressive fibrosis, architectural distortion, and declining hepatic function. Traditional biomarkers primarily assess synthetic capacity, but growing evidence underscores the pivotal role of immune dysregulation in disease progression. Immunoglobulin free light chains (FLCs), particularly kappa (κ) chains, have gained attention as novel biomarkers that reflect both systemic immune activation and impaired hepatic clearance mechanisms. Elevated FLC levels correlate with inflammatory pathways and endothelial dysfunction, offering insights into cirrhosis pathophysiology beyond conventional liver function tests.



Conclusion:

This review consolidates current evidence on FLCs in cirrhosis, highlighting their strong diagnostic accuracy (AUC 0.82) and prognostic utility, with significant associations to MELD/Child-Pugh scores and complications like ascites and hepatic encephalopathy. We evaluate their clinical potential for risk stratification and early decompensation prediction, while addressing limitations such as renal confounding and assay variability. Future research should explore standardized cutoffs, longitudinal dynamics, and integration into multimodal prognostic models to optimize cirrhosis management.

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Zagazig University Medical Journal

Articles in Press, Accepted Manuscript
Available Online from 03 June 2025

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