Groot Kormelink T, Thio M, Blokhuis B R, Nijkamp F P, Redegeld F A
Division of Pharmacology and Pathophysiology, Department of Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands.
Clin Exp Allergy. 2009 Jan;39(1):33-42. doi: 10.1111/j.1365-2222.2008.03135.x. Epub 2008 Nov 17.
Allergic diseases have become a serious global health problem in the developed world. IgE interacting with its high-affinitiy receptor FcepsilonRI is considered a major contributing factor to most types of allergies, but depending on the type of allergy, however, a subgroup of patients displays common symptoms and yet lack elevated levels of total serum IgE and/or antigen-specific IgE. Novel therapeutic strategies such as anti-IgE therapy may therefore not be applicable to these patients. It is clear, however, that these patients do display activation of mast cells. In several patients suffering from immunological disorders, an increase in free immunoglobulin (IG) light chain levels can be detected. Previously, we have described the capability of free light chains to elicit immediate hypersensitivity responses. In this Opinion article, we will discuss the role of IgE- and non-IgE-mediated mechanisms in allergic disorders and point out a possible role of free IG light chains in the pathogenesis of the non-atopic types of these allergies.
在发达国家，过敏性疾病已成为一个严重的全球健康问题。免疫球蛋白E（IgE）与其高亲和力受体FcepsilonRI相互作用被认为是大多数类型过敏的主要促成因素，但根据过敏类型的不同，有一部分患者表现出常见症状，然而血清总IgE和/或抗原特异性IgE水平并未升高。因此，诸如抗IgE治疗等新型治疗策略可能不适用于这些患者。然而，很明显这些患者确实表现出肥大细胞的激活。在一些患有免疫紊乱的患者中，可以检测到游离免疫球蛋白（IG）轻链水平的升高。此前，我们已经描述了游离轻链引发速发型超敏反应的能力。在这篇观点文章中，我们将讨论IgE介导和非IgE介导的机制在过敏性疾病中的作用，并指出游离IG轻链在这些非特应性过敏类型发病机制中的可能作用。
