The relationship between high-sensitivity CRP and polyclonal free light chains as markers of inflammation in chronic disease

Int J Lab Hematol. 2014 Aug;36(4):415-24. doi: 10.1111/ijlh.12159. Epub 2013 Nov 5.


Introduction: Serum concentrations of polyclonal free light chains (FLC) represent the activity of the adaptive immune system. This study assessed the relationship between polyclonal FLC and the established marker of innate immunity, C-reactive protein (CRP), in chronic and acute disease.

Methods: We utilized four cross-sectional chronic disease patient cohorts: chronic kidney disease (CKD), diabetes, vasculitis and kidney transplantation; and a longitudinal intensive care case series to assess the kinetics of production in acute disease.

Results: There was a weak association between polyclonal FLC and high-sensitivity CRP (hs-CRP) in the study cohorts. A longitudinal assessment in acute disease showed a gradual increase in FLC concentrations over time, often when CRP levels were falling, demonstrating clear differences in the response kinetics of CRP and FLC in this setting.

Conclusion: Polyclonal FLC and hs-CRP provide independent information as to inflammatory status. Prospective studies are now required to assess the utility of hs-CRP and polyclonal FLC in combination for risk stratification in disease populations.

Keywords: C-reactive protein; inflammation; risk stratification; serum free light chains.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • C-Reactive Protein / metabolism*
  • Chronic Disease
  • Cross-Sectional Studies
  • Diabetes Mellitus / blood*
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / physiopathology
  • Female
  • Humans
  • Immunoglobulin Light Chains / blood*
  • Inflammation / blood
  • Inflammation / diagnosis
  • Inflammation / physiopathology
  • Kidney Transplantation*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Renal Insufficiency, Chronic / blood*
  • Renal Insufficiency, Chronic / diagnosis
  • Renal Insufficiency, Chronic / physiopathology
  • Systemic Vasculitis / blood*
  • Systemic Vasculitis / diagnosis
  • Systemic Vasculitis / physiopathology


  • Biomarkers
  • Immunoglobulin Light Chains
  • C-Reactive Protein