Myara I, Quenum G, Storogenko M, Tenenhaus D, Guillemain R, Moatti N
Laboratoire de Biochimie, Hôpital Broussais, Paris, France.
Clin Chem. 1991 Aug;37(8):1334-7.
Immunoglobulin abnormalities in serum from 76 heart-transplant recipients were examined by cellulose acetate and agarose gel electrophoresis. Monoclonal components were typed by immunofixation. IgG, IgA, and IgM and total kappa and lambda light chains were quantified by immunonephelometry. We confirm that both monoclonal and oligoclonal immunoglobulin banding are common in serum from these patients. Of the 149 serum samples examined, 21 (15%) had one monoclonal component and 53 (35%) had two or more. These monoclonal immunoglobulins were generally present at a low concentration and were transient. The class of immunoglobulins most commonly involved was IgG (about sevenfold more numerous than IgM); monoclonal IgA components and free light chains were not detected. The nephelometric kappa/lambda and heavy chain/light chain ratios were poor indicators of these abnormalities. Immunoglobulin abnormalities were not correlated with the sex and age of recipients, the pre-existing cardiopathy, the time since transplantation, or plasma concentrations of cyclosporine, but did correlate with plasma immunoglobulin concentration, biopsy findings, and viral infections, especially cytomegalovirus (CMV). A monoclonal IgG purified from a patient with a high titer of anti-CMV antibodies did not react with CMV antigens. The origin of these immunoglobulin abnormalities is unclear. Our data suggest that the presence of monoclonal or oligoclonal banding in heart-transplant recipients is of limited prognostic significance.
通过醋酸纤维素和琼脂糖凝胶电泳检测了76例心脏移植受者血清中的免疫球蛋白异常情况。通过免疫固定法对单克隆成分进行分型。采用免疫比浊法对IgG、IgA、IgM以及总的κ和λ轻链进行定量分析。我们证实单克隆和寡克隆免疫球蛋白条带在这些患者的血清中很常见。在所检测的149份血清样本中，21份（15%）有一个单克隆成分，53份（35%）有两个或更多。这些单克隆免疫球蛋白通常浓度较低且呈一过性。最常涉及的免疫球蛋白类别是IgG（比IgM多约7倍）；未检测到单克隆IgA成分和游离轻链。比浊法检测的κ/λ和重链/轻链比值并不能很好地指示这些异常情况。免疫球蛋白异常与受者的性别、年龄、原有心脏病、移植后的时间或环孢素的血浆浓度无关，但与血浆免疫球蛋白浓度、活检结果以及病毒感染，尤其是巨细胞病毒（CMV）感染相关。从一名抗CMV抗体滴度高的患者纯化得到的单克隆IgG与CMV抗原不发生反应。这些免疫球蛋白异常的来源尚不清楚。我们的数据表明心脏移植受者中存在单克隆或寡克隆条带的预后意义有限。
