Immune-system test may predict early death
June 4th, 2012
03:11 PM ET

Immune-system test may predict early death

A blood test that measures a marker of immune-system activity may help doctors identify people who are at risk of dying at an early age, a new study suggests.

Researchers at the Mayo Clinic measured levels of the immune-system molecules known as free light chains in 15,859 Minnesotans age 50 and up, and found that people whose levels were in the top 10% were four times more likely than the other study participants to die over the next 13 years.

Doctors commonly test for free light chains to diagnose and manage blood disorders and blood-related cancers, such as multiple myeloma or lymphoma. This study, which was published this week in the journal Mayo Clinic Proceedings, is the first to link high levels of free light chains with earlier death in a group of people without any known blood disorders.

Normally, light chains bind with so-called heavy chains to form infection-fighting antibodies. The presence of unattached "free" light chains has long been recognized as a signal that the immune system has gone awry, either due to inflammation, infection, or both, says lead author Vincent Rajkumar, M.D., a hematologist at the Mayo Clinic, in Rochester, Minnesota.

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Elevated free light chain levels have been observed in people with kidney dysfunction, and are also seen in autoimmune disorders such as rheumatoid arthritis and lupus. Even after the researchers took into account the kidney function, age and gender of the participants, however, those with the highest free light chain levels were still twice as likely as their peers to die during the study.

Free light chain levels appeared to be equally effective at predicting death from many different causes, including cancer, heart disease, lung disease and diabetes.

It's not clear from the findings why, exactly, free light chains are linked to a higher risk of early death. High levels could be a marker of inflammation, which is associated with heart disease and numerous other health problems. But it's also possible they're a sign of normal, age-related deterioration of the immune system, the study notes.

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And it's still unclear how this test might be useful in generally healthy people. For now, Rajkumar and his colleagues urge doctors not to use the test as a screening instrument, as that will simply serve to alarm patients.

On the other hand, Rajkumar says, if doctors order the test for a specific reason and it comes back high, they may want to use that information to test for additional problems that could then be treated.

"It might be telling you something you might be missing," he says.

Dr. Neil Blumberg, a professor of pathology and laboratory medicine at the University of Rochester Medical Center, in Rochester, New York, says he's skeptical that free light chain tests are more powerful than existing tests that measure immune-system function or markers of inflammation, such as C-reactive protein.

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The study authors didn't compare the free light chain test with these other tests, Blumberg points out, and it "may not measure anything that we don't get with white cell count or C-reactive protein or 15 other tests which are cheaper and easier to do."

Besides, Blumberg says, if a person's test results were to come back sky-high, the advice for preventing an early death would likely be what patients hear from their doctors already. "We really don't need any more tests to tell us we ought to lose weight, exercise, [and] eat a less pro-inflammatory diet," he says.

Copyright Health Magazine 2011

soundoff (41 Responses)
  1. krk


    June 4, 2012 at 15:26 | Report abuse | Reply
    • Charli

      Posted on You could stuff him with or roll him in catnip and give him to a freind/relatives cat. I'm sure a cat wouldn't care if he didn't look purrfect:)Rogue Rylla’s last blog post..

      September 12, 2012 at 03:16 | Report abuse |
  2. krk

    Thats heavy

    June 4, 2012 at 15:54 | Report abuse | Reply
  3. Noel

    Interesting but kinda scary knowing when you are going to die!

    June 4, 2012 at 15:56 | Report abuse | Reply
  4. Elizabeth

    I've been denied medicine by my insurance company because I do not have markers for lupus, rheumatoid arthritis, diabetes, high cholesterol, or low immune system. But I have a high sedimentation rate and C-reactive protein (which this article does not mention; those are indicators of high inflammation, and usually rheumatoid arthritis at the level I have these). I want to know a whole lot more about this. So far, all my doctor wants to do is to turn down the immune system, which is standard treatment for rheumatoid arthritis (but I don't have the markers). Methotrexate gives me a splitting headache. I want more proof that I am not at risk for cancer, and the mononucleosis marker indicates that I at least "once" had mono, but I could be harboring it, although the insurance company does not believe it. I am very frustrated as a patient. My husband has cancer; maybe we will pass away together, but is that the best that medical science can do? We are in our 50s.

    June 4, 2012 at 17:24 | Report abuse | Reply
    • D

      Um, C-reactive protein IS mentioned in the article.

      June 4, 2012 at 20:42 | Report abuse |
    • Been There

      Ask your doctor about trying Leflunomide (generic for Arava). You may tolerate it better.

      June 4, 2012 at 21:56 | Report abuse |
    • mr. nurse

      after 40 years as a nurse, i can tell you this: Half the doctors practicing today graduated in the lower 50% of their class. If you are dissatisfied with your doctor, get a new doctor. If you think your doctor may have injured or harmed you in any way, report this to your state medical board. Then follow up with calls and letters/emails to insurt your complaint is investigated. Doctors regulate themselves nation wide. Good luck.

      June 4, 2012 at 22:16 | Report abuse |
    • eva68

      Yowsa..pretty sure I wouldn't want the insurance company (if I had one) to know about my blood work if that was found. Better be sure that you are requesting it NOT be done at this stage. I see those companies using the information to drop you like a hot potato or your rate will sky rocket.

      June 5, 2012 at 06:46 | Report abuse |
    • Leo

      I went through similar issues, although with me, my ANA and lupus anticoagulant test were positive, and I had a rheumatoid nodule confirmed by biopsy, but my CRP and sed-rate were normal. The doctor seemed to think that it was impossible to have a normal sed rate if I had "real" inflammation. My joints were swollen, and he didn't care. The blood test didn't confirm it, as far as he was concerned. It wasn't until I had a confirmed case of pericarditis with fluid buildup around my heart that the rheumatologist was willing to prescribe ANYTHING. The plaquenil (hydroxychloroquine) made my ANA go negative (yay!) but now the rheumatologist says, "Your ANA is negative, so I don't see any problem with you aside from occasional joint aches." Suffice to say, I fired him. My GP monitors me now, and with the plaquenil, I've got it under control.

      Talk to your doctor about plaquenil. It's a medication that's been used for decades, and if you tolerate it well, it can he a real help. It's not expensive (generics available), and it gave me my life back.

      June 5, 2012 at 10:46 | Report abuse |
    • Jesus

      Being denied health insurance coverage for not having acceptable markers, or the procedure is claimed to be experimental, or the insurer claims a pre-existing related condition (e.g. the leading case of cancer traetment denied bexcause to a prior ance condition) is commonplace. Insurers make their money by collecting premiums, not by paying out benefits. We've got a broken system. Obama tried to fix it, but the health insurance companies and Romney are trying to kill the law and give no hope that these wrongdoings will ever end.

      June 5, 2012 at 11:50 | Report abuse |
    • Frank

      Knowledge is power. First thing to do is get your vitamin D levels checked. DO NOT accept "okay" as a level. Get the number. Supplement to get your number between 50 and 80 if well, up to 100 if unwell. Check out vitaminDcouncil.org.

      June 5, 2012 at 11:57 | Report abuse |
    • Christy

      I'd suggest making an appointment with a naturopath. I am uninsured and pay $99 for each appointment, during which my naturopath talks to me and listens for 45 mins to an hour. NDs can be primary caregivers and offer affordable services – often preventative – at rates that can be cheaper than visiting a busy, distracted MD.

      June 5, 2012 at 12:26 | Report abuse |
    • queenbee10

      Methotrexate is an anti cancer drug that can cause cancer–WHY are you taking this? Most anticancer drugs (5-flourouracil, vincristine, vinblastine, etc) are also mutagens that can cause cancer I would seek out another dr and NOT a referral from your present dr. I would like to know why you are specifically on a methotrexate protocol unless you are treating an agressive cancer. That is some nasty stuff.

      June 5, 2012 at 13:19 | Report abuse |
    • Sara

      Take a look at your diet. Are you eating too many omega 6's? They are pro-inflammatory chemicals when not in proper balance with omega 3's. If you don't take omega 3's you should talk to your doctor and start ASAP. Auto-immune disorders are common in people with too much omega 6 in their diet. Look up the anti-inflammatory diet and try it for one month and see if your symptoms get better. I bet they will. Our food supply is chalk full of omega 6 and void of natural omega 3's. This is due to the fact that omega 3's cause food to spoil quickly. It's up to you to make sure your getting crucial GOOD QUALITY omega 3's through fish oil or algae if your vegetarian.

      June 6, 2012 at 11:06 | Report abuse |
    • Victoria

      Elizabeth, please get tested for lyme disease. Use Igenex Laboratory in CA and get both the IgM and IgG western blot. What you are describing sounds like lyme disease.

      June 7, 2012 at 10:58 | Report abuse |
    • ankylosing spondylitis

      Before taking any Meds, please look at the side effects. My doc put me on Leflunomide (generic for Arava) in 2009. In January 2011 I noticed all the pain (bone pain, joint pain and flu like symptoms) associated because of this med. I thought it was due to the arthritis. I stopped the med and it cleared up and I feel 100 times better. Just be careful.

      June 25, 2012 at 23:22 | Report abuse |
  5. taskmaster

    Ay 75 years old I don't Think I'll get the test.

    June 4, 2012 at 17:29 | Report abuse | Reply
  6. ddg000

    Just another way to be denied health insurance and life insurance.

    June 4, 2012 at 18:12 | Report abuse | Reply
    • Jesus

      So true! I work in the health insurance industry. They give bonuses for DENYING benefits regardless of the veracity of the denial. The slogan used in the industry is , "Delay and deny and hope they die".

      June 5, 2012 at 11:54 | Report abuse |
  7. Phillygal

    I have advanced Psoriatic Arthritis, and I take immuno-supressive drugs to help control it. I already know I can expect to shorten my life by 20 years because of it. A test is just a test folks.

    June 4, 2012 at 18:37 | Report abuse | Reply
  8. Ralph in Orange Park, FL

    I am 66. What if I get the test and it tells me I should have died 10 years ago?

    June 4, 2012 at 20:50 | Report abuse | Reply
    • mr. nurse

      buy a lottery ticket.

      June 4, 2012 at 22:17 | Report abuse |
    • momo0828

      Go fishing.

      June 5, 2012 at 07:51 | Report abuse |
    • Jesus

      You may be a zombie...the walking dead!

      June 5, 2012 at 11:54 | Report abuse |
  9. amac

    Would you rather take the test, know you're in the top 10 percent and live your life accordingly, or would you rather not take the test and die tomorrow not having attempted to live as fulfilling a life as possible in the time you had left?

    June 4, 2012 at 21:24 | Report abuse | Reply
    • Katherine

      Shouldn't you be living your life as fulfilling as possible anyway? What are you waiting for? To find out you're dying before you start living?

      June 4, 2012 at 22:06 | Report abuse |
  10. Mike

    Amazing story! Check out Protandim @ STOPYOURCLOCK.COM and see how this supplement could help you with inflammation(diseases!!) Feel free to email me at blkhillsguy@gmail.com after reading the above story if I can be of any assistance. This is an amazing product! Watch the video!

    June 5, 2012 at 02:05 | Report abuse | Reply
  11. stevenbeto

    Epitaph for our species: Died under the constellation Benzene with Mercury rising.

    June 5, 2012 at 09:56 | Report abuse | Reply
    • Elizabeth

      And dioxin and other poly vinyl chlorides, and radioactive fish, now found throughout the Pacific...

      September 6, 2012 at 17:04 | Report abuse |
  12. anna

    Do you really want to know when your are going to die? I dont think so.

    June 5, 2012 at 13:30 | Report abuse | Reply
  13. Marielaina Perrone DDS

    Amazing story but not so sure I would want to know if it cannot be fixed. Definitely a moral dilemma.

    Marielaina Perrone DDS

    June 5, 2012 at 16:05 | Report abuse | Reply
  14. life is now

    Most people are so worried about dying they forget to live. Life is RIGHT NOW, not tomorrow, not when you retire, not when you finish school. Put down that mfing smart phone and start contributing/participating!

    We will all die. Get over it and actually experience every moment of each day and then you will have lived.

    June 27, 2012 at 12:36 | Report abuse | Reply
  15. mani

    Insurance companies frequently ask little more than your stated income in
    the insurance applications.

    August 31, 2012 at 02:26 | Report abuse | Reply
  16. Katherine

    I'm in my early 20s and am going in for this test soon. My doctor thinks it's a good idea from my multiple abnormal blood chemistry's over the last year. Kind of worried now!

    September 6, 2012 at 15:43 | Report abuse | Reply
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