Shimojima Yasuhiro, Matsuda Masayuki, Gono Takahisa, Ishii Wataru, Fushimi Tomohisa, Hoshii Yoshinobu, Yamada Toshiyuki, Ikeda Shu-Ichi
Third Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Amyloid. 2005 Mar;12(1):33-40. doi: 10.1080/02772240500032515.
To investigate whether there is a correlation between subtypes of plasma cells in the bone marrow and the production of M-protein, flow cytometry and serum free light chain (FLC) analyses were carried out in 17 patients with primary systemic AL amyloidosis (mean age, 59.9+/-8.8 years) and controls with M-protein (MGUS controls, n=6) and without it (negative controls, n=9). The patients showed a significantly higher value in the serum predominant FLC:serum creatinine ratio (43.8+/-63.2) and CD38++ CD19- CD56+ subpopulation (monoclonal plasma cells) (2.57+/-5.35%) than either the negative (p<0.0005 and p<0.001, respectively) or MGUS controls (p<0.05). With respect to maturation of plasma cells in the bone marrow, the intermediate (MPC-1+ CD45- CD49e-) and mature (MPC-1+ CD45+ CD49e-) subtypes were significantly higher (49.2+/-23.2%, p<0.005) and lower (27.6+/-21.3%, p<0.005) in the patients than in the negative controls, respectively. The serum predominant FLC:serum creatinine ratio was elevated in parallel with an increase in CD38++ CD19- CD56+ and MPC-1+ CD45- CD49e- cells and a decrease in mature subtypes (MPC-1+ CD45+ CD49e- and MPC-1+ CD45+ CD49e+ cells), There was a significantly positive correlation between the serum predominant FLC:serum creatinine ratio and either CD38++ CD19- CD56+ (r=0.510, p<0.05) or MPC-1+ CD45- CD49e- cells (r=0.481, p<0.05). In primary AL amyloidosis M-protein is probably produced by increased monoclonal plasma cells in the bone marrow, particularly by the intermediate subpopulation with a phenotype of MPC-1+ CD45- CD49e-.
为了研究骨髓中浆细胞亚型与M蛋白产生之间是否存在相关性，对17例原发性系统性AL淀粉样变性患者（平均年龄59.9±8.8岁）以及伴有M蛋白的对照者（MGUS对照，n = 6）和不伴有M蛋白的对照者（阴性对照，n = 9）进行了流式细胞术和血清游离轻链（FLC）分析。患者血清中优势FLC与血清肌酐比值（43.8±63.2）以及CD38++ CD19- CD56+亚群（单克隆浆细胞）（2.57±5.35%）的值显著高于阴性对照（分别为p<0.0005和p<0.001）或MGUS对照（p<0.05）。关于骨髓中浆细胞的成熟情况，与阴性对照相比，患者的中间型（MPC-1+ CD45- CD49e-）和成熟型（MPC-1+ CD45+ CD49e-）亚型分别显著升高（49.2±23.2%，p<0.005）和降低（27.6±21.3%，p<0.005）。血清中优势FLC与血清肌酐比值随着CD38++ CD19- CD56+和MPC-1+ CD45- CD49e-细胞的增加以及成熟亚型（MPC-1+ CD45+ CD49e-和MPC-1+ CD45+ CD49e+细胞）的减少而升高。血清中优势FLC与血清肌酐比值与CD38++ CD19- CD56+（r = 0.510，p<0.05）或MPC-1+ CD45- CD49e-细胞（r = 0.481，p<0.05）之间存在显著正相关。在原发性AL淀粉样变性中，M蛋白可能由骨髓中增加的单克隆浆细胞产生，特别是具有MPC-1+ CD45- CD49e-表型的中间亚群。
