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Title: Low serum free light chain is associated with risk of COPD exacerbation
Authors: Tanimura, Kazuya
Sato, Susumu  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0002-9626-1090 (unconfirmed)
Sato, Atsuyasu  kyouindb  KAKEN_id
Tanabe, Naoya  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0002-7481-0212 (unconfirmed)
Hasegawa, Koichi
Uemasu, Kiyoshi
Hamakawa, Yoko
Hirai, Toyohiro  kyouindb  KAKEN_id
Muro, Shigeo
Author's alias: 谷村, 和哉
佐藤, 晋
佐藤, 篤靖
田辺, 直也
長谷川, 浩一
上桝, 潔
濱川, 瑶子
平井, 豊博
室, 繁郎
Issue Date: 1-Apr-2020
Publisher: European Respiratory Society (ERS)
Journal title: ERJ Open Research
Volume: 6
Issue: 2
Thesis number: 00288-2019
Abstract: Background: Most exacerbations of chronic obstructive pulmonary disease (COPD) are triggered by respiratory tract infections. Adaptive immunity via antibody production is important in preventing infections. Impaired antibody production is reported to be associated with an increased risk of exacerbations of COPD. In the present study, we elucidated whether reduced free light chains (FLCs), which are excessive amounts of light chains produced during antibody synthesis and can be used to estimate systemic antibody production, may be a promising biomarker to predict the risk of exacerbations of COPD. Methods: We enrolled stable male patients with COPD and prospectively observed them for 2 years. At baseline, serum combined FLC (cFLC; sum of kappa and lambda values) and pulmonary function were evaluated. Exacerbation was defined as a worsening of symptoms requiring treatments with antibiotics, corticosteroids or both. Results: 63 patients with stable COPD were enrolled (72.8±8.1 years, GOLD A/B/C/D=24/28/6/5), and 51 patients completed the 2-year follow-up. Serum cFLC was 31.1 mg·L−1 on average and ranged widely (1.4 to 89.9 mg·L−1). The patients with low cFLC (below the mean−sd, n=6) experienced a significantly shorter time to the first exacerbation of COPD (p<0.0001 by the log-rank test). A multivariate Cox proportional hazard model, including the COPD assessment test score, % predicted forced expiratory volume in 1 s (FEV1 % pred), and number of previous exacerbations demonstrated that low cFLC and low FEV1 % pred were independently and significantly correlated with the risk for exacerbations of COPD. Conclusion: Low cFLC may be a B-cell-associated novel biomarker associated with risk of COPD exacerbation.
Rights: © ERS 2020. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.
URI: http://hdl.handle.net/2433/255619
DOI(Published Version): 10.1183/23120541.00288-2019
PubMed ID: 32665945
Appears in Collections:Journal Articles

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