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Serum immunoglobulin free light chain levels in systemic autoimmune rheumatic diseases.

  • Gulli, F1
  • Napodano, C2, 3
  • Marino, M4, 5
  • Ciasca, G5, 6
  • Pocino, K2, 3
  • Basile, V7
  • Visentini, M8
  • Stefanile, A9
  • Todi, L4, 5
  • De Spirito, M5, 6
  • Rapaccini, G L2, 3
  • Basile, U9
  • 1 Dipartimento di Medicina di Laboratorio, Ospedale Madre Giuseppina Vannini, Rome, Italy. , (Italy)
  • 2 Istituto di Medicina Interna, Università Cattolica del Sacro Cuore, Rome, Italy. , (Italy)
  • 3 Area di Gastroenterologia e Oncologia medica, Fondazione Policlinico Universitario 'A. Gemelli' - I.R.C.C.S, Rome, Italy. , (Italy)
  • 4 Istituto di Patologia Generale, Università Cattolica del Sacro Cuore, Rome, Italy. , (Italy)
  • 5 Fondazione Policlinico Universitario 'A. Gemelli' - I.R.C.C.S, Rome, Italy. , (Italy)
  • 6 Istituto di Fisica, Università Cattolica del Sacro Cuore, Rome, Italy. , (Italy)
  • 7 Dipartimento di Medicina di Laboratorio, Università di Tor Vergata, Rome, Italy. , (Italy)
  • 8 Dipartimento di Medicina Traslazionale e di Precisione, Università di Roma La Sapienza, Rome, Italy. , (Italy)
  • 9 Area Diagnostica di Laboratorio, Fondazione Policlinico Universitario 'A. Gemelli', IRCCS, Rome, Italy. , (Italy)
Published Article
Clinical & Experimental Immunology
Wiley (Blackwell Publishing)
Publication Date
Oct 16, 2019
DOI: 10.1111/cei.13385
PMID: 31618438


Several reports have highlighted the abnormal increments of serum immunoglobulin free light chains (FLCs) in the course of systemic autoimmune rheumatic diseases (SARD), but a comparative analysis among different conditions is still lacking. A strong association between elevated FLC and hepatitis C virus (HCV)-related mixed cryoglobulinaemia (HCVMC) has been well established. Here, we aimed to analyse serum FLC levels in patients with four different SARD in comparison with HCVMC. Using a turbidimetric assay, free κ and λ chains were quantified in sera from 198 SARD patients (37 rheumatoid arthritis, RA; 47 systemic lupus erythematosus, SLE; 52 anti-phospholipid syndrome, APS; 62 primary Sjogren's syndrome, pSS), 62 HCVMC and 50 healthy blood donors (HD). All patient groups showed increased κ levels when compared to HD: 33·5 ± 2·6 mg/l in HCVMC, 26·7 ± 2·3 mg/l in RA, 29·7 ± 1·9 mg/l in SLE, 23·8 ± 1·1 mg/l in APS, 24·2 ± 1·1 mg/l in pSS; 10·1 ± 0·6 mg/l in HD. Free λ levels displayed a significant increase only for HCVMC (20·4 ± 1·4 mg/l) and SLE (18·4 ± 1·0 mg/l) compared to HD (13·6 ± 0·9 mg/l). The increase of κ compared to λ takes into account a κ /λ ratio of 1·6 for all groups. Our results substantially analyse and strengthen the association between FLC and SARD focusing the questions regarding their role in the pathogenesis and diagnosis of human diseases. Unfortunately, the biochemical differences distinguishing normal from pathological FLC have not been identified. Production of different isotypes is probably connected to still-unknown pathways. © 2019 British Society for Immunology.

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