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[慢性阻塞性肺疾病患者血清及肺组织中免疫球蛋白游离轻链的表达及意义]

[Expression and significance of immunoglobulin free light chains in serum and lung tissues from patients with chronic obstructive pulmonary disease].

作者信息

Zhang Miao, Tao Hong-chen, Li Yue-qiu, Pei Hou-shuang, Zhu Shu-yang, Chen Bi, Zhou Rui-juan, Zhang Mao-wei

机构信息

Department of Respiratory Medicine, Affiliated Hospital of Xuzhou Medical College, Xuzhou 221002, China.

Department of Respiratory Medicine,Affiliated Hospital of Xuzhou Medical College, Xuzhou 221002, China. Email:

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2013 Dec;36(12):945-9.

Abstract

OBJECTIVE

To study the association of free immunoglobulin light chain (FLC) with clinical manifestations and lung inflammation in smokers with normal lung function and chronic obstructive pulmonary disease (COPD) patients.

METHODS

Thirty-two patients with peripheral lung cancer undergoing surgical resection were enrolled from the Department of Thoracic Surgery,Affiliated Hospital of Xuzhou Medical College. They were divided into non-smoking with normal lung function group (non-smoking group, 10 cases), smoking with normal lung function group (smoking group, 12 cases) and smoking with stable COPD group (COPD group, 10 cases). Their preoperative fasting serum and lung tissues away from cancer were used in the study.Enzyme-linked immunesorbent assays (ELISA) were used to detect the levels of FLC-λ and FLC-κ in serum and lung tissue homogenates. The expression of FLC-λ and FLC-κ in the airway epithelium, alveolar wall and blood vessel wall was detected by immunohistochemistry. The correlation between FLC levels and pulmonary functions were analyzed.

RESULTS

The serum levels of FLC-λ and FLC-κ in COPD group and smoking group were (35 ± 11),(38 ± 12) and (26 ± 9),(26 ± 8) mg/L, respectively. They were all significantly increased compared with the non-smoking group [(16 ± 7),(16 ± 5) mg/L]. The differences were all statistically significant (q = 3.590-7.482, P < 0.01), and those of the COPD group were significantly higher than those of the smoking group (q = 3.209-4.198, P < 0.05 and P < 0.01). The concentrations of FLC-λ and FLC-κ in lung tissue homogenates of the COPD group and the smoking group were (1.29 ± 0.31),(1.32 ± 0.30) and (0.86 ± 0.42),(0.85 ± 0.37) µg/mg, respectively. They were all significantly increased compared with those of the non-smoking group [(0.45 ± 0.18),(0.42 ± 0.13) µg/mg],(q = 4.178- 9.795, P < 0.05 and P < 0.01). The levels of FLC-λ and FLC-κ in the lung tissue homogenates from the COPD group were significantly higher than those from the smoking group (q = 4.269-4.349, all P < 0.05). The expression of FLC-λ and FLC-κ was detected in airway epithelium, alveolar wall and blood vessel wall. The levels of FLC-λ and FLC-κ in serum and lung tissue homogenates showed a negative correlation with FEV1 percentage of predicted value (r = -0.476 to -0.591, all P < 0.01).

CONCLUSIONS

Expressions of FLC were increased in the serum and the lung tissues of COPD patients and smokers with normal lung function, and closely correlated with airflow limitation. The results suggest that FLC plays a proinflammatory role in the pathogenesis of COPD.

摘要

目的

研究游离免疫球蛋白轻链(FLC)与肺功能正常的吸烟者及慢性阻塞性肺疾病(COPD)患者的临床表现及肺部炎症的相关性。

方法

选取徐州医科大学附属医院胸外科32例行手术切除的周围型肺癌患者。将其分为肺功能正常的非吸烟组(非吸烟组,10例)、肺功能正常的吸烟组(吸烟组,12例)和稳定期COPD吸烟组(COPD组,10例)。研究采用其术前空腹血清及癌旁肺组织。采用酶联免疫吸附测定(ELISA)法检测血清及肺组织匀浆中FLC-λ和FLC-κ水平。采用免疫组织化学法检测气道上皮、肺泡壁及血管壁中FLC-λ和FLC-κ的表达。分析FLC水平与肺功能的相关性。

结果

COPD组和吸烟组血清中FLC-λ和FLC-κ水平分别为(35±11)、(38±12)mg/L和(26±9)、(26±8)mg/L。与非吸烟组[(16±7)、(16±5)mg/L]相比,均显著升高。差异均有统计学意义(q=3.590-7.482,P<0.01),且COPD组显著高于吸烟组(q=3.209-4.198,P<0.05和P<0.01)。COPD组和吸烟组肺组织匀浆中FLC-λ和FLC-κ浓度分别为(1.29±0.31)、(1.32±0.30)μg/mg和(0.86±0.42)、(0.85±0.37)μg/mg。与非吸烟组[(0.45±0.18)、(0.42±0.13)μg/mg]相比,均显著升高(q=4.178-9.795,P<0.05和P<0.01)。COPD组肺组织匀浆中FLC-λ和FLC-κ水平显著高于吸烟组(q=4.269-4.349,均P<0.05)。在气道上皮、肺泡壁及血管壁中检测到FLC-λ和FLC-κ的表达。血清及肺组织匀浆中FLC-λ和FLC-κ水平与预测值的FEV1百分比呈负相关(r=-0.476至-0.591,均P<0.01)。

结论

COPD患者及肺功能正常的吸烟者血清及肺组织中FLC表达增加,且与气流受限密切相关。结果提示FLC在COPD发病机制中起促炎作用。

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