IgG Type Research Articles

Efectos del belimumab en pacientes colombianos con lupus eritematoso sistémico, un estudio prospectivo observacional

IntroductionBelimumab, a monoclonal type Ig G1 antibody that binds and inhibits the soluble form of the Blys (B lymphocyte stimulator) has shown to be effective in the management of systemic lupus erythematosus (SLE). However, its effectiveness is unknown in an ethnically variable population, such as in Colombia. MethodsA prospective observational study was conducted between February 2015 and February 2016 on patients with active SLE disease despite being on standard treatment and who were treated with Belimumab. ResultsBelimumab showed a significant improvement in joint, cutaneous and haematological involvement, with an increase in complement levels, a decrease in lupus crises and hospital admissions. After 3 months there was lower activity, calculated by SLEDAI, with stability for 9 months. ConclusionsIn a real-life patient setting, it was observed that belimumab was useful in Colombian patients with SLE and refractory to standard therapy, especially in the joint, haematological, and cutaneous manifestations.

Effects of belimumab in Colombian patients with systemic lupus erythematosus; a prospective observational study

Abstract Introduction Belimumab, a monoclonal type Ig G1 antibody that binds and inhibits the soluble form of the Blys (B lymphocyte stimulator) has shown to be effective in the management of systemic lupus erythematosus (SLE). However, its effectiveness is unknown in an ethnically variable population, such as in Colombia. Methods A prospective observational study was conducted between February 2015 and February 2016 on patients with active SLE disease despite being on standard treatment and who were treated with Belimumab. Results Belimumab showed a significant improvement in joint, cutaneous and hematological involvement, with an increase in complement levels, a decrease in lupus crises and hospital admissions. After 3 months there was lower activity, calculated by SLEDAI, with stability for 9 months. Conclusions In a real-life patient setting, it was observed that belimumab was useful in Colombian patients with SLE and refractory to standard therapy, especially in the joint, hematological, and cutaneous manifestations.

Antigliadin Antibodies (AGA IgG) Are Related to Neurochemistry in Schizophrenia.

Inflammation may play a role in schizophrenia; however, subgroups with immune regulation dysfunction may serve as distinct illness phenotypes with potential different treatment and prevention strategies. Emerging data show that about 30% of people with schizophrenia have elevated antigliadin antibodies of the IgG type, representing a possible subgroup of schizophrenia patients with immune involvement. Also, recent data have shown a high correlation of IgG-mediated antibodies between the periphery and cerebral spinal fluid in schizophrenia but not healthy controls, particularly AGA IgG suggesting that these antibodies may be crossing the blood–brain barrier with resulting neuroinflammation. Proton magnetic resonance spectroscopy (MRS) is a non-invasive technique that allows the quantification of certain neurochemicals in vivo that may proxy inflammation in the brain such as myoinositol and choline-containing compounds (glycerophosphorylcholine and phosphorylcholine). The objective of this exploratory study was to examine the relationship between serum AGA IgG levels and MRS neurochemical levels. We hypothesized that higher AGA IgG levels would be associated with higher levels of myoinositol and choline-containing compounds (glycerophosphorylcholine plus phosphorylcholine; GPC + PC) in the anterior cingulate cortex. Thirty-three participants with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder had blood drawn and underwent neuroimaging using MRS within 9 months. We found that 10/33 (30%) had positive AGA IgG (≥20 U) similar to previous findings. While there were no significant differences in myoinositol and GPC + PC levels between patients with and without AGA IgG positivity, there were significant relationships between both myoinositol (r = 0.475, p = 0.007) and GPC + PC (r = 0.36, p = 0.045) with AGA IgG levels. This study shows a possible connection of AGA IgG antibodies to putative brain inflammation as measured by MRS in schizophrenia.

Clinical Value of Serum Fructosamine Measurement in IgA Type Multiple Myeloma

To investigate the value of serum fructosamine (FMN) measurement in clinical typing and staging of multiple myeloma(MM) as well as evaluation of curative efficacy and prognosis of IgA type MM. The levels of FMN were detected by nitro-blue-tetrazolium colorimetric method in 62 IgA type MM patients, 65 IgG type MM patients, 24 IgM type MM patients. The difference between the serum FMN levels and different MM types and its relationship with IgA type MM, patients' stages, efficacy and as well as, the effect of FMN level on overall survival (OS) time of IgA type MM patients were analyzed. FMN level of IgA type patients was obviously higher than that of IgG type and IgM type patients. Patients of DS stage III had higher FMN level than that of stage II, and patients of DS stage II had higher FMN level than that of stage I, the differences were statistical significant(P<0.05). Patients of ISS stage III also had higher FMN level than that of stage II, and patients of ISS stage II also had higher FMN level than that of stage I, the differences were statistical significant(P<0.05). After treatment, FMN level of patients obtained complete remission (CR) or very good partial remission(VGPR) obviously decreased, FMN level of patients obtained partial remission(PR) decreased, FMN level of patients obtained less than PR increased. Patients with normal FMN level had longer OS time, while patients with high FMN level had obviously short OS time. Serum FMN is obviously elevated in the IgA type MM, there is a certain association between staging and serum FMN level, the IgA type MM patients with FMN normalization after treatment have better prognosis.

The clinical development of obinutuzumab for the treatment of follicular lymphoma.

Impressive progress has been made in recent decades for advanced-stage follicular lymphoma with the availability of anti-CD20 monoclonal antibodies, initially rituximab and more recently obinutuzumab. Obinutuzumab is a unique, third-generation, fully humanized glycoengineered IgG1 type II anti-CD20 monoclonal antibody. It has been shown to have increased antitumor activity compared to rituximab in preclinical studies, including whole-blood B-cell depletion assays, xenograft models, and primate models. This has spurred on the development of obinutuzumab through Phase I/II trials as monotherapy and in combination with chemotherapeutic agents and other targeted therapies. Its efficacy compared to rituximab and in rituximab-refractory disease has led to its continued development and eventual approval for the treatment of follicular lymphoma. Here in this review, we highlight the design and development of obinutuzumab in the treatment of advanced stage grade 1–3A follicular lymphoma and its future directions.

Clinical significance of serum sialic acid in diagnosis and treatment of IgA type multiple myeloma

Objective To investigate the clinical significance of serum sialic acid (SA) in the diagnosis and treatment of IgA type multiple myeloma (MM). Methods The level of serum SA in 50 healthy subjects and 70 patients with MM were determined. Results In MM group, there were 25 cases of IgA type, 51 cases of other than IgA type (40 cases of IgG type, 7 cases of light chain type MM, 4 cases of non-secreting type MM). In healthy subjects, patients with IgA, IgG, light chain, non-secreting types and other than IgA type, the serum SA levels were (570.33 ± 67.72) mg/L, (1 289.24 ± 325.42) mg/L, (585.88 ± 159.12) mg/L, (600.77 ± 126.90) mg/L, (590.50 ± 100.86) mg/L, and (588.39 ± 150.90) mg/L. The serum SA level of IgA type patients was higher than those of healthy subjects and other types (all P 0.05). The serum SA level of IgA type patients had positive correlations with serum IgA, globulin, bone marrow smear myeloma cell population and ESR (r values were 0.699, 0.753, 0.504, and 0.732, all P 0.05). The level of serum SA in IgA type patients decreased with the improvement of the condition, and increased with the severity of the disease. Conclusions In MM patients, serum SA level in IgA type is high. The serum SA is an index for reflecting the tumor load capacity, and can evaluate the therapeutic efficiency of IgA type MM patients. Key words: Multiple myeloma; Sialic acids; Immunoglobulin A

Treatment of B-cell disorder improves renal outcome of patients with monoclonal gammopathy–associated C3 glomerulopathy

AbstractThe high frequency of monoclonal gammopathy in adult patients with C3 glomerulopathy (C3G) emphasizes the role of monoclonal immunoglobulin (MIg) in the occurrence of renal disease and raises the issue of the therapeutic management. The aim of the study was to evaluate the effect of chemotherapy in a large cohort of patients with MIg-associated C3G. Fifty adult patients with MIg and biopsy-proven C3G were extracted from the French national database of C3G. We retrospectively compared renal outcomes in patients who either received or did not receive chemotherapy targeting the underlying B-cell clone. At diagnosis, renal disease was severe, with nephrotic-range proteinuria in 20/46 (43%) patients and chronic kidney disease stage 3 or above in 42/49 (86%) patients. Monoclonal gammopathy was of IgG type in 47 (94%) patients. Hematological diagnosis was monoclonal gammopathy of renal significance in 30 (60%), multiple myeloma in 17 (34%), and chronic lymphocytic leukemia in 3 (6%) patients. Complement studies showed low C3 level in 22/50 (43%) and elevated soluble C5b-9 level in 27/34 (79%) patients. Twenty-nine patients received chemotherapy (including bortezomib in 22), whereas 8 and 13 patients received various immunosuppressive drugs or symptomatic measures alone, respectively. Patients who achieved hematological response after chemotherapy had higher renal response rates (P = .0001) and median renal survival (hazard ratio, 0.22; 95% confidence interval, 0.05-0.92; P = .009) than those receiving conservative/immunosuppressive therapy. In conclusion, our results suggest that chemotherapy adapted to the B-cell clone may constitute an efficient strategy for C3G in the setting of MIg, as rapid achievement of hematological response appears to result in improved renal survival.

Microtubule-associated protein 1B: Novel paraneoplastic biomarker.

To report the identification of microtubule-associated protein (MAP) 1B as the antigen of the previously described Purkinje cell cytoplasmic antibody type 2 (PCA-2) antibody, its frequency, and clinical, oncological, and serological associations. Archival serum or cerebrospinal fluid (CSF) specimens were available from 96 of 118 consecutive PCA-2-IgG-seropositive patients identified during 1993-2016. The autoantigen, defined in mouse brain lysate by Western blot and mass spectrometry, was confirmed by dual immunohistochemical staining using commercial antibodies. The major antigenic region was defined by Western blot using recombinant protein fragments. IgG in 95 of 96 patients' serum or CSF (but in none of 98 healthy or disease control subjects' serum specimens) bound to recombinant MAP1B. A minority (17.5%) of patients' IgG also bound to MAP1A. PCA-2 was often accompanied by additional neural autoantibody markers of small-cell carcinoma, including collapsin response-mediated protein 5 (CRMP5) IgG (26%) or antineuronal nuclear antibody type 1 (ANNA-1) IgG (also known as anti-Hu; 13%). Neurological manifestations in 95 patients were (in decreasing frequency): peripheral neuropathy, 53%; cerebellar ataxia, dysmetria, or dysarthria, 38%; and encephalopathy, 27%. Cancer (majority small-cell lung carcinoma [SCLC]) was detected in 66 of 84 evaluated patients (79%). The MAP1B (PCA-2) autoantibody detection rate, among approximately 70,000 patients undergoing service neural autoantibody evaluation in 2015, was 0.024%, equaling amphiphysin IgG (0.026%) and more common than ANNA-2 (also known as anti-Ri; 0.016%) and PCA-Tr (also known as delta/notch-like epidermal growth factor-related receptor [DNER]; 0.006%). MAP1B, the PCA-2 autoantigen, represents a novel target in paraneoplastic neurological disorders and has high predictive value for SCLC. Its relatively high prevalence, compared with other recognized paraneoplastic neural autoantibodies, justifies its testing in comprehensive paraneoplastic neural autoantibody evaluation. Ann Neurol 2017;81:266-277.

A Rare Occurrence of Plasma Cell Myeloma with Biclonal Gammopathy

Plasma cell myeloma is known to cause expansion of a single clone of immunoglobulin (Ig) which results in the secretion of a unique homogeneous monoclonal protein (M component). However, there are cases which reported that it can also cause production of two different clones of these monoclonal M proteins. Although it is relatively very rare as the prevalence is only 2% of all plasma cell myeloma cases, the clinical features are said to be similar to monoclonal gammopathy. It is suggested that these biclonal gammopathy results from either one monoclonal cell clone in monoclonal gammopathy or two different monoclonal cell clones. Whichever the mechanism of the disease be, the response to treatment seems to be similar as compared to the monoclonal cases although some reports shows chemoresistant. Here, we report a rare case of plasma cell myeloma with IgG (lambda) and IgA (lambda) type of biclonal gammopathy, the clinical presentation, the haematological and biochemical markers as well as the response to the treatment.

A study of the chikungunya virus in humans in Turkey

Background/aim: The chikungunya virus (CHIKV) is a mosquito-borne disease and has recently been causing explosive outbreaks. The CHIKV has spread throughout all continents. Although the first chikungunya case imported from India to Turkey was reported in 2012, there is no detailed epidemiologic study in Turkey yet. The aim of this study was to investigate the seroprevalence of the CHIKV in Turkey. Materials and methods: ELISA was used to screen 500 random serum samples of healthy people collected from Kırıkkale, which is located in central Anatolia in Turkey. The results were verified by indirect immunofluorescence test (IIFT). Results: The results showed that 0.4% samples were positive for CHIKV. In the verification study with IIFT, CHIKV IgG type antibodies were defined as negative. To the best of our knowledge, this is the first serological study on the CHIKV in Turkey. Conclusion: Further studies are needed to elucidate the epidemiological situation in patients that have fever and arthritis.

Mechanism of protective effects of tumor necrosis factor receptor associated protein 1 on hypoxic cardiomyocytes of rats

Mechanism of protective effects of tumor necrosis factor receptor associated protein 1 on hypoxic cardiomyocytes of rats

Type I CD20 Antibodies Recruit the B Cell Receptor for Complement-Dependent Lysis of Malignant B Cells.

Human IgG1 type I CD20 Abs, such as rituximab and ofatumumab (OFA), efficiently induce complement-dependent cytotoxicity (CDC) of CD20+ B cells by binding of C1 to hexamerized Fc domains. Unexpectedly, we found that type I CD20 Ab F(ab')2 fragments, as well as C1q-binding-deficient IgG mutants, retained an ability to induce CDC, albeit with lower efficiency than for whole or unmodified IgG. Experiments using human serum depleted of specific complement components demonstrated that the observed lytic activity, which we termed "accessory CDC," remained to be dependent on C1 and the classical pathway. We hypothesized that CD20 Ab-induced clustering of the IgM or IgG BCR was involved in accessory CDC. Indeed, accessory CDC was consistently observed in B cell lines expressing an IgM BCR and in some cell lines expressing an IgG BCR, but it was absent in BCR- B cell lines. A direct relationship between BCR expression and accessory CDC was established by transfecting the BCR into CD20+ cells: OFA-F(ab')2 fragments were able to induce CDC in the CD20+BCR+ cell population, but not in the CD20+BCR- population. Importantly, OFA-F(ab')2 fragments were able to induce CDC ex vivo in malignant B cells isolated from patients with mantle cell lymphoma and Waldenström macroglobulinemia. In summary, accessory CDC represents a novel effector mechanism that is dependent on type I CD20 Ab-induced BCR clustering. Accessory CDC may contribute to the excellent capacity of type I CD20 Abs to induce CDC, and thereby to the antitumor activity of such Abs in the clinic.

Real World Treatment Outcomes of Multiple Myeloma in Korea

Once believed to be a homogeneous disease entity, multiple myeloma now represents epitome of heterogeneous genomic evolution and mutational profiles. Various groups have reported different risk stratification methodologies based on cytogenetic data, especially the fluorescent in situ hybridization (FISH) results. Reflecting the racial disparities, Oh et al. have previous described prognostic model specific to Koreans using a nationwide registry. However their main focus has been on conventional cytogenetics. We sought to analyze the predictive and prognostic value of FISH on top of conventional cytogenetics from a large cohort of Korean multiple myeloma patients.From a single tertiary academic center, 1006 newly diagnosed MM patients were retrospectively identified during the period of January 2005 to June 2015. Adult patients, defined as 18 years old or older were included, while cases with smoldering myeloma, monoclonal gammopathy, solitary plasmacytoma and plasmoblastic leukemia were excluded in the first place. After excluding additional 441 patients for insufficient data, a total of 565 patients with complete set of molecular information were evaluated. Progression free survival (PFS) was defined as the duration from the start of first line treatment to disease progression or death, and data available up to June 2016 were used. On a different note, Korea has an unique public medical insurance system that is mandatory and covers approximately 98% of the overall Korean population Although the insurance covers comprehensive aspects of healthcare, the range of coverage is restricted. In this study, autologous stem cell transplantation (autoSCT) eligible patients were defined as those under the age of 65 years according to such insurance coverage restrictions. For the same reason, first line treatment were diverse according to the patient's financial standings.The median age was 63 years (18-92 years), and there were 309 males (54.7%). As for MM subtype, IgG type was 49.0%, IgA type 18.1%, and light chain type 28.8%. The proportion of patients at ISS stage III was 32.2%, and 45.8% had poor performance status (ECOG 2 or more). Overall, the median line of treatment was 2 (range 1-16) and 42.7% of the patients underwent autoSCT. The patients who actually underwent autoSCT had significantly better PFS compared to those who did not (not reached vs 18 months, P <0.001). The median PFS for each first line chemotherapy regimen are listed in Table. For autoSCT ineligible patients, novel agents such as lenalidomide and carfilzomib were more frequently used and this translated into surprisingly long median survival of 51 months.FISH results showed p53 deletion in 9.1% (27/296), 13q14 deletion in 36.0% (174/484), IgH rearrangement in 47.6% (231/485), and 1q21 amplification in 40.0% (193/483) of cases. Those with p53 had the worst prognosis with median PFS at 13 months, and its presence significantly altered overall PFS (P=0.002). This phenomenon was observed both in autoSCT eligible group (PFS for p53 deletion present 20 months vs not present 77 months, P<0.001), and in ineligible group (PFS for p53 deletion present 7 months vs not present 24 months, P<0.001). The presence of p53 was associated with reduced bortezomib sensitivity (P=0.003), but not thalidomide. On the other hand, the presence of 13q14 deletion was not significant for PFS in autoSCT eligible group (P=0.726), but was significant in ineligible group (P=0.023). The presence of 13q14 was associated with reduced sensitivity to MP/VAD regimen (P=0.005). The presence of 1q21 did not have survival implications or treatment predictive values. Likewise, IgH rearragements did not affect PFS and were not useful for individualizing therapy.MM patients in Korea presents a unique set of population associated with different survival benefits per therapy compared with other ethnicities. Since FISH data can be readily used to predict the treatment outcomes of particular agents, a panel markers specific to Korean race should ensue to establish risk-adaptive therapeutic approaches for equitable distribution of limited medical resources. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Lupus anticoagulant-hypoprothrombinemia syndrome presenting with co-existing cerebral venous thrombosis and subdural hemorrhage

The lupus anticoagulant-hypoprothrombinemia syndrome (LA-HPS)-the association of acquired factor II deficiency and lupus anticoagulant-is a rare disease that may cause a predisposition not only to thrombosis but also to severe bleeding. We are reporting on a 36-year-old female patient presenting with co-existing cerebral venous thrombosis and subdural hemorrhage. The coagulation screening showed a prolonged prothrombin time (PT), activated partial thromboplastin time (aPTT), and a normal fibrinogen level and platelet count. Evaluation of the clotting factors revealed decreased levels of factors II (37%). Factors V, VIII, IX and XI were normal. Lupus anticoagulant (LA) was demonstrated by the Dilute Russell's Viper Venom Test (DRVVT). Immunological work-up was positive for IgG type anticardiolipines antibodies (aCL). Successful management consisted first of oral prednisone (60mg/d). Thus, anticoagulation was introduced once factor II had stabilized.

Isolation and characterization of autoantibodies against human cystatin C.

Hereditary cystatin C amyloid angiopathy (HCCAA) is a severe neurodegenerative disorder related to the point mutation in cystatin C gene resulting in human cystatin C (hCC) L68Q variant. One of the potential immunotherapeutic approaches to HCCAA treatment is based on naturally occurring antibodies against cystatin C. A recent growing interest in autoantibodies, especially in the context of neurodegenerative diseases, emerges from their potential use as valuable diagnostic markers and for controlling protein aggregation. In this work, we present characteristics of natural anti-hCC antibodies isolated from the IgG fraction of human serum by affinity chromatography. The electrophoresis (1-D and 2-D) results demonstrated that the isolated NAbs are a polyclonal mixture, but their electrophoretic properties did not allow to classify the new autoantibodies to any particular type of IgG. The Fc-glycan status of the studied autoantibodies was assessed using mass spectrometry analysis. For the isolated NAbs, the epitopic fragments in hCC sequence were identified by MS-assisted proteolytic excision of the immune complex and compared with the ones predicted theoretically. The knowledge of hCC fragments binding to NAbs and other ligands may contribute to the search for new diagnostic methods for amyloidosis of different types and the search for their treatment.

Clinical features of unilateral oculomotor nerve palsy related to multiple myeloma: a case report and literature review

Objective To analyze the clinical features of unilateral oculomotor nerve palsy caused by multiple myeloma(MM). Methods A 79-year-old female diagnosed MM for 3 years was admitted due to the disease relapse. The patient presented left oculomotor nerve palsy, bone marrow biopsy showed 4.5% of myeloma cells, the serum level of λ light chain was up to 18 g/L, and brain CT/MRI scan revealed left parasphenoidsinus lesion. A diagnosis of relapsing intramedullary and extramedullary MM, IgGλ type, stage ⅢA was made. Ten cases were retrieved from literature since 1990, the clinical features of 11 cases were analyzed as follows. Results Among 11 cases of unilateral oculomotor nerve palsy caused by MM, 7 were males and 4 females with a mean age of (60±12) years (40-79 years). The sub-types of MM were IgG type (7 cases), IgA type (2 cases), biclonal of IgG and IgA type (1 case), and IgD type (1 case). Oculomotor nerve palsy was presented as the initial manifestation of MM in 9 cases, as a sign of relapse of MM in 1 case, and during MM treatment in 1 case. In 7 cases, oculomotor nerve was the only cranial nerve involved, while in other 4 cases, the Ⅳ, Ⅴ, Ⅵ cranial nerves were also involved. Neuroimaging revealed parasphenoid sinus lesions in 9 cases, and myeloma meningitis in 2 cases. Most of the reviewed cases achieved significant clinical improvement after chemotherapy and/or radiotherapy, except 2 cases with myeloma meningitis. The case in our department was improved significantly and rapidly after receiving chemotherapy with bortezomib. Conclusion MM should be considered when unilateral oculomotor nerve palsy is presented with or without the history of MM, the disease is sensitive to chemotherapy in most circumstances. Key words: Multiple myeloma; Oculomotor nerve diseases; Drug therapy; Bortezomib

Clinical Features of 46 Multiple Myeloma Patients with Different Renal Pathology

To explore the clinical features of multiple myeloma with different renal pathology, and to evaluate its prognosis. Clinical features and prognosis of 46 multiple myeloma patients with different renal pathology were analyzed retrospectively. According to renal pathology, the 46 patients were divided into 3 groups: cast nephropathy (24 cases), amyloidosis (15 cases) and other type (7 cases). By durie-Salmon staging system, 70.8% cases (17/24) in the cast nephropathy group were in Phase III, 90.9% (20/24) were in subtype B, while in amyloidosis group 53.3% (8/15) were in Phase I, 40% (6/15) were in subtype B, and in other types group, 71.4% (5/7) were in phase III, 57.1% (4/7) were in subtype B, the differences among them were statisticaily significant (P < 0.05). In cast nephropathy group, the monoclonal immunoglobulin could not be detected in 75% (18/24) cases, which was light chain type, while immunoglobulin in amyloidosis and other type groups were mainly IgG type in 73.3% (11/15) and 71.4% (5/7) respectively, the difference among them also was statistically significant (P < 0.05). The median survival time of patients in cast nephropathy group was 11 months, while that in amyloidosis and other type groups was 19 and 18 months, the differences among 3 groups were not significant (P > 0.05). In renal pathologic types, the cast nephropathy is the most common, followed by amylordosis. The multiple mycloma patients with defferent renal pathology show different clinical features. The multiple myeloma patients with renal amyloidosis have slighter clinical manifestations possibly with a better prognosis. Meanwhile, the non-amyloidosis types, especially cast nephropathy may predict a more serious manifications with poor prognosis.

Relationship between M-Protein of Multiple Myeloma and False Positive Syphilis Serological Results

The false positive in conventional syphilis serological test was found in patients with multiple myeloma (MM). To investigate the relationship between the M-protein of patients with MM and the false positive in conventional syphilis serologic test. The M-protein of 68 MM cases was typed with immunofixation electrophoresis and 68 cases of MM were screened with non-specific and specific syphilis serologic tests, then the samples with syphilic serological positive were chosen and confirmed with immonobloting test, finally the relationship between M protein of MM and the false positive of syphilis serological test were analysed. Four out of 68 cases showed the positive in syphilis serological test and further were confimed to be false positive by immunoblotting test, the false positive rate was nearly 6%. The M-protein of MM patients in our hospital mostly possessed IgG, κ type, followed by IgA, κ type, light chain κ type. In general, κ : λ = 2.4 : 1. Among samples of 4 cases with syphilis serological positive 2 cases were of IgG and κ type, 1 case was of IgG, λ type, another 1 case was IgA, κ type. The M-protein of IgG and IgA types in MM patients results in syphilis serological false positive reaction. The clinicians and laboratorial technicians should pay a great attention to screen the MM patients for the false positive syphilis serological test so as to avoid the misdiagnosis and subsequent embarassment.

PROFILE IN GANGLIOSIDE ANTIBODIES IN BENIGN PROSTATIC HYPERPLASIA

Molecular pathology of benign prostatic hyperplasia is multifactorial and involves endocrine, biochemical, immunological interactions. The mechanisms involved in the onset and progression of benign prostatic hyperplasia are: infections, older than 50 years, imbalances in hormones and neurotransmitters, inflammation, oxidative stress. It is estimated that an infectious etiology can be a cause of wrong immune response directed at the prostate. Inflammatory neuropathies often occur after infections with various microorganisms. It is also known, that the presence of microorganisms is heterogeneous in patients with benign prostatic hyperplasia. In this paper we documented the antibody profile of anti-GM1, -GM2, -GM3, -GD1a, -GD1b, -GT1b, -GQ1b IgG and IgM type in 30 patients with benign prostatic hyperplasia and in 30 controls. The results showed an increasing anti-GD1a and anti-GQ1b titer in patients with benign prostatic hyperplasia compared to control. The authors suggest that a careful monitoring of the patients developing an endogenous anti-gangliosidic immune response is required in order to assess these antibodies as potential risk factors for neuropathy in patients with benign prostatic hyperplasia.

Bortezomib-induced severe pulmonary complications in multiple myeloma: A case report and literature review.

The proteasome inhibitor bortezomib is indicated for use in the treatment of multiple myeloma (MM) patients. The most common side effects are neurological and gastrointestinal, while severe pulmonary complications are rarely described. The present study reports the case of a 62-year-old man with immunoglobulin (Ig)G-type MM who was treated with bortezomib, thalidomide and dexamethasone. Subsequent to the administration of chemotherapy, the patient developed an acute respiratory distress syndrome. High-resolution computed tomography of the chest showed bilateral diffuse alveolar infiltrations and multiple subpleural lesions. A diagnosis of bortezomib-induced severe pulmonary complications was formed. Systemic corticosteroid therapy led to a rapid improvement in clinical conditions and radiological findings. In addition, the present study reviewed the characteristics, including medical history, clinical manifestations, treatment strategies and outcomes, of all 16 MM patients with bortezomib-induced severe pulmonary complications reported previously in Pubmed. It was indicated that patients who were male, of IgG type, with a relapse status and a previous history of auto-PBSCT had a higher possibility of developing bortezomib-induced severe pulmonary complications. Additionally, a relatively low dose rather than a high dose of corticosteroids could obtain a better outcome.