Allergy：慢性鼻窦炎患者体内游离轻链浓度增加

根据2012年7月5日在线发表在儿科期刊上的一项研究，患有慢性鼻窦炎(chronic rhinosinusitis, CRS)的病人拥有浓度增加的游离轻链(free light chain, FLC)，特别是对同时患有慢性鼻窦炎和鼻息肉(CRS with nasal polyps, CRSwNP)的病人而言，尤是如此。

荷兰乌得勒支大学研究员Tom Groot Kormelink和同事们分析了患有CRSwNP的病人和患有CRS但是未患上鼻息肉(CRS without nasal polyps, CRSsNP)的病人的鼻腔组织、鼻分泌物和血清以便确定FLC的存在。与此同时，研究人员也研究了不同治疗方法对FLC表达的影响。

研究人员发现患有CRS的病人在鼻分泌物和鼻粘膜组织匀浆液(nasal mucosal tissue homogenate)中FLC浓度增加，而在患有CRSwNP的病人组织中，这种浓度增加是最为显著的。利用免疫组织化学方法证实鼻息肉组织中FLC浓度增加。利用甲强龙(methylprednisolone)或白细胞介素5(interleukin-5, IL-5)抗体治疗患有CRSwNP的病人能够导致全身或局部FLC浓度下降。

论文作者们写到，“在CRSwNP和CRSsNP疾病中，FLC的存在意味着它可能在调节鼻旁窦(paranasal cavity)局部免疫反应发挥着作用。再者，利用IL-5抗体治疗之后，局部FLC浓度下降可能意味着IL-5创造环境来促进FLC产生。”

本文编译自Free light chains identified in chronic rhinosinusitis

doi: 10.1111/j.1398-9995.2012.02866.x
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Local free light chain expression is increased in chronic rhinosinusitis with nasal polyps

T. Groot Kormelink1,†, L. Calus2, N. de Ruyck2,†, G. Holtappels2, C. Bachert2, F. A. Redegeld1,‡,*, P. Gevaert

Background Free light chain (FLC) concentrations are demonstrated to be increased in different inflammatory disorders and are proposed to mediate mast cell–dependent immune responses. A role for mast cells is suggested in chronic rhinosinusitis with nasal polyposis (CRSwNP), which is characterized by a local Th2 inflammatory response. However, clear mast cell–activating factors are not always apparent. In this study, the presence of FLCs in CRS patients with or without nasal polyps (CRSw/sNP) was investigated and the effect of different treatments on FLC expression was analyzed. Methods Nasal tissue, nasal secretion, and serum of control patients, patients with CRSwNP, and CRSsNP were analyzed for the presence of kappa and lambda FLC. The expression of FLCs in nasal polyp tissue was investigated using immunohistochemistry. In addition, FLC was measured in serum and nasal secretion of nasal polyp patients treated with methylprednisolone, doxycycline, anti-IL-5, or placebo. Results Free light chain concentrations were increased in nasal secretion and mucosal tissue homogenates in patients with chronic rhinosinusitis, and this effect was most prominent in CRSwNP patients. Immunohistochemical analysis confirmed the increased FLC concentrations in nasal polyp tissue. In CRSwNP patients, treatment with methylprednisolone or anti-IL-5 resulted in the reduction in systemic or local FLC concentrations, respectively. Conclusion The presence of FLC in CRSwNP and CRSsNP suggests a possible role in mediating the local immune reaction in the paranasal cavities. Furthermore, the decrease in local FLCs after treatment with anti-IL-5 presumes that IL-5 creates an environment that favors FLC production.