Abstract

Overproduction of human light chains (LCs) and immunoglobulins can result in various forms of renal disease such as cast nephropathy, monoclonal immunoglobulin deposition disease, LC proximal tubulopathy, AL amyloidosis, and crystal storing histiocytosis. This is caused by cellular uptake of LCs and overwhelmed intracellular transport and degradation in patients with high urine LC concentrations. LC kappa and lambda purification was evaluated by sodium dodecyl sulfate gel electrophoresis. LC and myeloma protein binding to immobilized renal proteins was measured by enzyme-linked immunosorbent assay (ELISA). The human protein microarray (HuProt™) was screened with purified kappa and lambda LC. Identified LC partners were subsequently analyzed in silico for renal expression sites using protein databases, Human Protein Atlas, UniProt, and Bgee. Binding of urinary LCs and immunoglobulins to immobilized whole renal proteins from 22 patients with myeloma or plasma cell dyscrasia was shown by ELISA. Forty lambda and 23 kappa interaction partners were identified from HuProt™ array screens, of which 21 were shared interactors. Among the total of 42 interactors, 12 represented cell surface proteins. Lambda binding signals were approximately 40% higher than kappa signals. LC interaction with renal cells and disease-causing pathologies are more complex than previously thought. It involves an extended spectrum of proteins expressed throughout the nephron, and their identification has been enabled by recently developed methods of protein analysis such as protein microarray screening. Further biochemical studies on interacting proteins are warranted to elucidate their clinical relevance.

Highlights

  • The most frequent multiple myeloma–associated renal lesion is cast nephropathy [1, 2]

  • Cast nephropathy can be associated with other renal lesions such as monoclonal immunoglobulin deposition disease, light chains (LCs) proximal tubulopathy, AL amyloidosis, and crystal storing histiocytosis [2]

  • LC, light chain; λ, lambda light chain; κ, kappa light chain; FGN, monotypic fibrillary glomerulonephritis; LCPT, light-chain proximal tubulopathy; MGRS, monoclonal gammopathy with renal significance; MGUS, monoclonal gammopathy with undefined significance; MM, multiple myeloma; n.a., not available; PGNMID, proliferative glomerulonephritis and monoclonal immunoglobulin deposits; U[P/C], urinary protein/creatinine ratio given in mg/g; sCr, serum creatinine given in mg/dL after 1-year follow-up

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Summary

INTRODUCTION

The most frequent multiple myeloma–associated renal lesion is cast nephropathy [1, 2]. To obtain more detailed data on specific binding partners, we purified urinary monoclonal LC kappa and lambda and sought for ways to investigate their interaction potential with renal tubular cell proteins. For this purpose, protein microarrays with 23,000 proteins originating from 16,000 human genes were screened with either purified kappa or lambda LCs. In addition, protein databases, the Human Protein Atlas, UniProt, and Bgee were studied to verify the primary structure and to identify the site and extent of expression in the renal tissue and nephron

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