Evidence for the involvement of free light chain immunoglobulins in allergic and nonallergic rhinitis.
BACKGROUND
Allergic rhinitis is characterized by mast cell degranulation induced by antigen cross-linking of IgE. It has been proposed that some patients with rhinitis show nasal allergy in the absence of systemic markers of atopy, termed entopy. Recent murine studies suggest the existence of an IgE-independent hypersensitivity response involving antigen-induced mast cell activation, mediated by immunoglobulin free light chains (FLCs).


OBJECTIVE
To determine whether FLC is associated with mast cell-mediated nasal hypersensitivity and its relationship with eosinophilic activity in allergic and nonatopic rhinitis.


METHODS
Patients with allergy and nonallergic rhinitis with eosinophilia syndrome (NARES) had levels of soluble FLC measured in nasal secretions and serum. In addition, levels of the nasal inflammatory mediators mast cell tryptase and eosinophil cationic protein were quantified. Cellular expression of kappa and lambda FLC was characterized in the nasal mucosa of allergic and nonatopic idiopathic rhinitis and control subjects by using immunohistochemistry. Immunopositive cells were phenotyped by using laser microdissection and PCR.


RESULTS
Free light chain was significantly increased in nasal secretions of subjects with allergy and NARES, and in serum of patients with NARES. Nonatopic patients with allergy showed significantly increased nasal mast cell tryptase and eosinophil cationic protein. FLC-positive cells were significantly increased in allergic and nonatopic mucosa, and were shown to be mast cells and plasma cells.


CONCLUSIONS
Nasal FLC is significantly increased in allergic and nonatopic rhinitis nasal mucosa, suggesting a role in nasal hypersensitivity. Further studies are needed to identify which allergens trigger FLC-mediated responses in nonatopic rhinitis.
Powe
Desmond G
DG
Department of Histopathology, Surgical and Medical Sciences, Queen's Medical Centre, Nottingham University Hospitals Trust, Nottingham NG7 2UH, United Kingdom. des.powe@nottingham.ac.uk
Groot Kormelink
Tom
T
Sisson
Melanie
M
Blokhuis
Bart J
BJ
Kramer
Matthias F
MF
Jones
Nicholas S
NS
Redegeld
Frank A
FA
D000328:Adult; D004802:Eosinophilia / Q000276:immunology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000097:blood / Q000276:immunology / Q000378:metabolism; D008297:Male; D008407:Mast Cells / Q000276:immunology; D008875:Middle Aged; D009297:Nasal Mucosa / Q000276:immunology* / Q000503:physiopathology; D012220:Rhinitis / Q000276:immunology / Q000503:physiopathology; D012221:Rhinitis, Allergic, Perennial / Q000276:immunology / Q000503:physiopathology; D006255:Rhinitis, Allergic, Seasonal / Q000276:immunology / Q000503:physiopathology; D013577:Syndrome
D007147:Immunoglobulin Light Chains