重度哮喘患者中的免疫球蛋白游离轻链：它们可以成为一种新的生物标志物吗？
2024/03/26
摘要
背景：越来越多的证据表明，在特应性和非特应性炎症性疾病（包括重度哮喘）中，免疫球蛋白（Ig）游离轻链（FLC）的血清浓度升高，这为疾病提供了一种可能的新生物标志物。
方法：我们分析了79名哮喘受试者的临床和实验室数据，包括FLC，这些受试者被临床分为不同的GINA阶段。考虑了40名年龄匹配的健康供体（HD）作为对照组。特别是，根据没有单克隆成分（为了排除副蛋白血症）选择了HD，测试了总IgE（在正常范围内），并且对空气变应原特异性IgE呈阴性。此外，没有发现常见的炎症标志物（即红细胞沉降率和C反应蛋白）的异常。
结果：与对照组相比，哮喘人群的FLC-k水平显著升高。尽管FLC-λ水平没有统计学上的显著差异，但两组之间的FLC-k/FLC-λ比值显示出显着差异。发现FLC-κ和FLC-λ水平呈正相关。FLC-λ水平与FEV1值呈显着负相关。此外，FLC-κ/FLC-λ比值与SNOT-22评分呈负相关，FLC与金黄色葡萄球菌IgE肠毒素致敏之间呈正相关。
结论：我们的发现证实了FLC在哮喘中的作用，作为一种潜在的生物标志物，在以不同内型和表型为特征的炎性疾病中发挥作用。特别是，FLC-κ和FLC-k/FLC-λ比值可作为哮喘的定性指标，而FLC-λ水平可作为临床严重程度参数的定量指标。
Immunoglobulin free light chains in severe asthma patient: Could they be a new biomarker?
C Caruso, G Ciasca, I Baglivo, R Di Santo, A Gasbarrini, D Firinu, D Bagnasco, G Passalacqua, M Schiappoli, M Caminati, G W Canonica, E Heffler, C Crimi, R Intravaia, V Basile, M Marino, S Colantuono, S Del Giacco
Abstract
Background: Increasing evidence is available about the presence of increased serum concentration of immunoglobulin (Ig) free light chains (FLCs) in both atopic and non-atopic inflammatory diseases, including severe asthma, providing a possible new biomarker of disease.
Methods: We analyzed clinical and laboratory data, including FLCs, obtained from a cohort of 79 asthmatic subjects, clinically classified into different GINA steps. A control group of 40 age-matched healthy donors (HD) was considered. Particularly, HD have been selected according to the absence of monoclonal components (in order to exclude paraproteinemias), were tested for total IgE (that were in the normal ranges) and were negative for aeroallergens specific IgE. Moreover, no abnormality of common inflammatory markers (i.e., erythrocyte sedimentation rate and C-reactive protein) was detectable.
Results: FLC-k levels were significantly increased in the asthmatic population, compared to the control group. Despite the absence of statistically significant differences in FLC-λ levels, the FLC-k/FLC-λ ratio displayed remarkable differences between the two groups. A positive correlation between FLC-κ and FLC-λ levels was found. FLC- λ level displayed a significant negative correlation with the FEV1 value. Moreover, the FLC-κ /FLC- λ ratio was negatively correlated with the SNOT-22 score and a positive correlation was observed between FLCs and Staphylococcus Aureus IgE enterotoxins sensitization.
Conclusions: Our findings confirmed the role of FLCs in asthma as a potential biomarker in an inflammatory disease characterized by different endotypes and phenotypes. In particular, FLC-κ and FLC-k/FLC-λ ratio could be a qualitative indicator for asthma, while FLC-λ levels could be a quantitative indicator for clinical severity parameters.
背景：越来越多的证据表明，在特应性和非特应性炎症性疾病（包括重度哮喘）中，免疫球蛋白（Ig）游离轻链（FLC）的血清浓度升高，这为疾病提供了一种可能的新生物标志物。
方法：我们分析了79名哮喘受试者的临床和实验室数据，包括FLC，这些受试者被临床分为不同的GINA阶段。考虑了40名年龄匹配的健康供体（HD）作为对照组。特别是，根据没有单克隆成分（为了排除副蛋白血症）选择了HD，测试了总IgE（在正常范围内），并且对空气变应原特异性IgE呈阴性。此外，没有发现常见的炎症标志物（即红细胞沉降率和C反应蛋白）的异常。
结果：与对照组相比，哮喘人群的FLC-k水平显著升高。尽管FLC-λ水平没有统计学上的显著差异，但两组之间的FLC-k/FLC-λ比值显示出显着差异。发现FLC-κ和FLC-λ水平呈正相关。FLC-λ水平与FEV1值呈显着负相关。此外，FLC-κ/FLC-λ比值与SNOT-22评分呈负相关，FLC与金黄色葡萄球菌IgE肠毒素致敏之间呈正相关。
结论：我们的发现证实了FLC在哮喘中的作用，作为一种潜在的生物标志物，在以不同内型和表型为特征的炎性疾病中发挥作用。特别是，FLC-κ和FLC-k/FLC-λ比值可作为哮喘的定性指标，而FLC-λ水平可作为临床严重程度参数的定量指标。
(中日友好医院呼吸与危重症医学科 李红雯 摘译 林江涛 审校)
(Allergy. 2024 Feb 29. doi: 10.1111/all.16082.)
(Allergy. 2024 Feb 29. doi: 10.1111/all.16082.)
Immunoglobulin free light chains in severe asthma patient: Could they be a new biomarker?
C Caruso, G Ciasca, I Baglivo, R Di Santo, A Gasbarrini, D Firinu, D Bagnasco, G Passalacqua, M Schiappoli, M Caminati, G W Canonica, E Heffler, C Crimi, R Intravaia, V Basile, M Marino, S Colantuono, S Del Giacco
Abstract
Background: Increasing evidence is available about the presence of increased serum concentration of immunoglobulin (Ig) free light chains (FLCs) in both atopic and non-atopic inflammatory diseases, including severe asthma, providing a possible new biomarker of disease.
Methods: We analyzed clinical and laboratory data, including FLCs, obtained from a cohort of 79 asthmatic subjects, clinically classified into different GINA steps. A control group of 40 age-matched healthy donors (HD) was considered. Particularly, HD have been selected according to the absence of monoclonal components (in order to exclude paraproteinemias), were tested for total IgE (that were in the normal ranges) and were negative for aeroallergens specific IgE. Moreover, no abnormality of common inflammatory markers (i.e., erythrocyte sedimentation rate and C-reactive protein) was detectable.
Results: FLC-k levels were significantly increased in the asthmatic population, compared to the control group. Despite the absence of statistically significant differences in FLC-λ levels, the FLC-k/FLC-λ ratio displayed remarkable differences between the two groups. A positive correlation between FLC-κ and FLC-λ levels was found. FLC- λ level displayed a significant negative correlation with the FEV1 value. Moreover, the FLC-κ /FLC- λ ratio was negatively correlated with the SNOT-22 score and a positive correlation was observed between FLCs and Staphylococcus Aureus IgE enterotoxins sensitization.
Conclusions: Our findings confirmed the role of FLCs in asthma as a potential biomarker in an inflammatory disease characterized by different endotypes and phenotypes. In particular, FLC-κ and FLC-k/FLC-λ ratio could be a qualitative indicator for asthma, while FLC-λ levels could be a quantitative indicator for clinical severity parameters.
上一篇：
支气管扩张和哮喘：来自欧洲支气管扩张登记处（EMBARC）的数据
下一篇：
阿奇霉素诱导持续性未控制哮喘成年患者哮喘缓解：一项随机、双盲、安慰剂对照试验的二次分析
