Kurashima C, Hirokawa K
Appl Pathol. 1985;3(1-2):39-54.
An autopsy case of multiple myeloma (IgA-lambda) with extensive amyloid arthropathy of the systemic joints was described. Heavy deposits of amyloid (amyloidoma) were observed in the articular cavities of the joints. Furthermore, numerous amyloid deposits were found in the walls of small blood vessels in the general organs. Incubation of the paraffin sections of amyloid with potassium permanganate produced little loss of Congo red affinity and apple-green birefringence under polarized light. A crude preparation of amyloid protein was isolated from a frozen intra-articular mass, which had been obtained at necropsy, and injected into the footpads of BALB/c mice with complete Freund's adjuvant. The immune spleen cells were fused with myeloma cells (P3 X 63-Ag8.653) under the presence of polyethylene glycol. Hybridoma cell lines, producing supernatants which reacted not only with amyloid substances but also with normal human tissues, were omitted from the subjects of recloning, and one hybridoma cell line (Am-1) producing a specific monoclonal antibody (MAb) against the immunized amyloid substance was finally obtained. Using the indirect immunoperoxidase method, the specificity of MAb Am-1 was confirmed in the cryostat sections as well as in the formalin-fixed paraffin sections of various organs of the case from which the crude amyloid protein was obtained and used for immunization. Amyloid deposits in 25 cases with amyloidosis or amyloid deposits were examined with MAb Am-1, and 2 cases showed positive reactivity with Am-1. These 2 cases presented primary amyloidosis and focal amyloid deposits in the oral cavity, respectively; Congo red staining of amyloid in these cases showed resistance to treatment with potassium permanganate, as observed in the amyloid of the original case used for immunization. Trypsin treatment of the sections resulted in a loss of positive reactivity with MAb Am-1 in all these cases. This result indicates that Am-1 recognizes a substance composed of protein molecules. Furthermore, the immunohistochemical distribution of Am-1 positive reaction was consistent with the histological distribution of substance which could be stained by Congo red and showed apple-green birefringence under polarized light. These results have suggested that Am-1 reacts with a portion of amyloid protein which is resistant to treatment with potassium permanganate followed by Congo red staining.
报告了一例多发性骨髓瘤(IgA-λ型)尸检病例,其全身关节存在广泛的淀粉样关节病。在关节的关节腔内观察到大量淀粉样物质沉积(淀粉样瘤)。此外,在全身各器官的小血管壁中发现了大量淀粉样沉积物。用高锰酸钾处理淀粉样石蜡切片后,刚果红亲和力和偏振光下的苹果绿双折射几乎没有损失。从尸检时获取的冷冻关节内肿块中分离出粗制的淀粉样蛋白制剂,并与完全弗氏佐剂一起注射到BALB/c小鼠的足垫中。在聚乙二醇存在下,将免疫脾细胞与骨髓瘤细胞(P3 X 63-Ag8.653)融合。产生的上清液不仅能与淀粉样物质反应,还能与正常人组织反应的杂交瘤细胞系被排除在再克隆对象之外,最终获得了一株产生针对免疫淀粉样物质的特异性单克隆抗体(MAb)的杂交瘤细胞系(Am-1)。使用间接免疫过氧化物酶法,在获得粗制淀粉样蛋白并用于免疫的该病例的各种器官的冷冻切片以及福尔马林固定石蜡切片中,证实了MAb Am-1的特异性。用MAb Am-1检测了25例淀粉样变性或有淀粉样沉积物的病例中的淀粉样沉积物,其中2例与Am-1呈阳性反应。这2例分别表现为原发性淀粉样变性和口腔局灶性淀粉样沉积物;这些病例中淀粉样物质的刚果红染色显示对高锰酸钾处理有抗性,如同用于免疫的原始病例的淀粉样物质。在所有这些病例中,用胰蛋白酶处理切片导致与MAb Am-1的阳性反应消失。该结果表明Am-1识别一种由蛋白质分子组成的物质。此外,Am-1阳性反应的免疫组织化学分布与可被刚果红染色并在偏振光下显示苹果绿双折射的物质的组织学分布一致。这些结果表明,Am-1与一部分对高锰酸钾处理后再进行刚果红染色有抗性的淀粉样蛋白发生反应。