Hampson Judith A, Stockley Robert A, Turner Alice M
Centre for Translational Inflammation Research, University of Birmingham, Birmingham, B15 2WB, UK.
ADAPT Project, University Hospital Birmingham, Birmingham, B15 2WB, UK.
Respir Res. 2016 Mar 31;17:34. doi: 10.1186/s12931-016-0348-1.
Circulating free light chains (FLCs) can alter neutrophil migration, apoptosis and activation and may be a biomarker of autoimmune disease and adaptive immune system activation. These pathogenic roles could be relevant to lung disease in alpha 1 antitrypsin deficiency (A1ATD) and chronic obstructive pulmonary disease (COPD).
Total combined (c)FLCs were measured using the FreeLite® assay in 547 patients with A1ATD and 327 patients with usual COPD in the stable state, and assessed for association with clinical phenotype, disease severity, airway bacterial colonisation and mortality. Univariate and multivariate analyses were undertaken.
Circulating cFLCs were static in the stable state when measured on 4 occasions in A1ATD and twice in usual COPD. Levels were inversely related to renal function (A1ATD and COPD p = <0.01), and higher in patients with chronic bronchitis (p = 0.019) and airway bacterial colonisation (p = 0.008). After adjusting for renal function and age the relationship between cFLCs and lung function was weak. Kaplan Meier curves showed that cFLC > normal (43.3 mg/L) significantly associated with mortality in both cohorts (A1ATD p = 0.001, COPD p = 0.013).
cFLCs may be a promising biomarker for risk stratification in A1ATD and COPD.
循环游离轻链（FLC）可改变中性粒细胞迁移、凋亡和激活，可能是自身免疫性疾病和适应性免疫系统激活的生物标志物。这些致病作用可能与α1抗胰蛋白酶缺乏症（A1ATD）和慢性阻塞性肺疾病（COPD）中的肺部疾病有关。
使用FreeLite®检测法测量了547例A1ATD患者和327例稳定期普通COPD患者的总组合（c）FLC，并评估其与临床表型、疾病严重程度、气道细菌定植和死亡率的相关性。进行了单因素和多因素分析。
在A1ATD患者中测量4次、在普通COPD患者中测量2次时，稳定期循环cFLC保持稳定。其水平与肾功能呈负相关（A1ATD和COPD，p＜0.01），在慢性支气管炎患者（p = 0.019）和气道细菌定植患者中更高（p = 0.008）。在调整肾功能和年龄后，cFLC与肺功能之间的关系较弱。Kaplan Meier曲线显示，cFLC＞正常水平（43.3 mg/L）与两个队列的死亡率显著相关（A1ATD，p = 0.001；COPD，p = 0.013）。
cFLC可能是A1ATD和COPD风险分层的一个有前景的生物标志物。
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