Immunoglobulin Free Light Chains in Severe Asthma Patient: could they be
a new biomarker?
Abstract
Background: Increasing evidence are 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,
disease severity and also an alternative approach to the treatment.
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, 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 disease severity.