Abstract
Previous studies demonstrated that antigranulocyte colony-stimulating factor autoantibody (GMAb) was consistently present in patients with autoimmune pulmonary alveolar proteinosis (aPAP), and, thus, represented candidature as a reliable diagnostic marker. However, our large cohort study suggested that the concentration of this antibody was not correlated with disease severity in patients. We found that the κ/λ ratio of GMAb was significantly correlated with the degree of hypoxemia. The proportion of λ-type GMAb per total λ-type IgG was significantly higher in severely affected patients than those in mildly affected patients, but the proportion of κ-type was unchanged. The κ/λ ratio was significantly correlated with both KL-6 and SP-D, which have been previously reported as disease severity markers. Thus, the light chain isotype usage of GMAb may not only be associated with the severity of aPAP, but may also represent a useful disease severity marker.
Keywords:
Anti-GM-CSF autoantibody; Light chain ratio; Pulmonary alveolar proteinosis.
© 2013. Published by Elsevier Inc. All rights reserved.
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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Adolescent
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Adult
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Aged
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Aged, 80 and over
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Autoantibodies / blood*
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Autoimmune Diseases / blood
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Autoimmune Diseases / diagnosis
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Autoimmune Diseases / immunology*
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Autoimmune Diseases / pathology
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Biomarkers / blood
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Female
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Granulocyte-Macrophage Colony-Stimulating Factor / antagonists & inhibitors
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Granulocyte-Macrophage Colony-Stimulating Factor / blood
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Granulocyte-Macrophage Colony-Stimulating Factor / immunology*
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Humans
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Immunoglobulin kappa-Chains / blood*
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Immunoglobulin kappa-Chains / immunology
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Immunoglobulin lambda-Chains / blood*
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Immunoglobulin lambda-Chains / immunology
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Male
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Middle Aged
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Mucin-1 / blood
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Pulmonary Alveolar Proteinosis / blood
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Pulmonary Alveolar Proteinosis / diagnosis
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Pulmonary Alveolar Proteinosis / immunology*
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Pulmonary Alveolar Proteinosis / pathology
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Pulmonary Surfactant-Associated Protein D / blood
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Severity of Illness Index
Substances
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Autoantibodies
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Biomarkers
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Immunoglobulin kappa-Chains
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Immunoglobulin lambda-Chains
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MUC1 protein, human
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Mucin-1
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Pulmonary Surfactant-Associated Protein D
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Granulocyte-Macrophage Colony-Stimulating Factor
Supplementary concepts
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Pulmonary Alveolar Proteinosis, Acquired