Immunoglobulin Free Light Chains in Severe Asthma Patient: could they be
a new biomarker?
Caruso C.1*, Ciasca G.2, Baglivo
I.3, Di Santo R.2, Gasbarrini
A.3, Firinu D.4, Bagnasco
D.5, Passalacqua G.5, Schiappoli
M.6, Caminati M.7, Canonica
G.W.8-9, Heffler E. 8-9, Crimi
C.10, Intravaia R. 11, Basile
V.12, Marino M.13, Colantuono
S.1° and Del Giacco S4°.
° Senior authors
* Corresponding author
- UOSD DH Internal Medicine and Gastroenterology, Department of Medical
and Surgical Sciences, Fondazione Policlinico Universitario ”A.
Gemelli” IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
- Dipartimento di Neuroscienze, Sezione di Fisica, Università Cattolica
del Sacro Cuore, Fondazione Policlinico Universitario ”A. Gemelli”
IRCCS, 00168 Rome, Italy.
- CEMAD Digestive Diseases Center, Fondazione Policlinico Universitario
”A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
- Department of Medical Sciences and Public Health, University of
Cagliari, Cagliari, Italy.
- Allergy and Respiratory Diseases, IRCCS Policlinico San Martino,
University of Genoa, 16132 Genoa, Italy.
- Allergy and Asthma Unit, Verona University Hospital, Verona, Italy.
- Department of Medicine, Asthma, Allergy and Clinical Immunology
Section, University of Verona, Verona, Italy.
- Personalized Medicine, Asthma and Allergy-IRCCS Humanitas Research
Hospital, Via Alessandro Manzoni, 56, 20089 Rozzano, Italy.
- Department of Biomedical Sciences, Humanitas University, 20090 Pieve
Emanuele, Italy.
- Respiratory Medicine Unit, Policlinico ”G. Rodolico-San Marco”
University Hospital, Catania, Italy.
- Unit of Cardiology, University Hospital Paolo Giaccone, University of
Palermo.
- Clinical Pathology Unit and Cancer Biobank, Department of research and
Advanced Technologies, IRCCS Regina Elena National Cancer Institute,
Rome , Italy
- Sezione di Patologia Generale, Dipartimento di Medicina e Chirurugia
Traslazionale, Università Cattolica del Sacro Cuore, Fondazione
Policlinico Universitario ”A. Gemelli” IRCCS, Rome, Italy.
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.
Keywords: biomarker, free light chains, severe asthma, type 2
inflammation.