Paraprotein
In the Para proteins is not normally present in the body protein body - usually non-functional immunoglobulins (antibodies) or its individual parts - in the blood or urine , which in electrophoresis can be found. They can provide a diagnostic indication of certain blood diseases such as multiple myeloma , lymphocytic leukemia, or monoclonal gammopathy .
pathology
In certain types of blood cancer, such as multiple myeloma, the degenerate cells that divide monoclonally usually produce functionless immunoglobulins or only parts of these molecules, for example free light chains . All antibodies, whether functional or non-functional, are made up of protein molecules. In electrophoresis, these often (but not always) run along in the γ fraction, which is why an increase in the immunoglobulin range (so-called M gradient ) can be detected electrophoretically (see Fig.).
Free light chains, which are synthesized as functionless paraproteins, can often only be detected in serum . Although they can be filtered out of the serum through the kidneys , if the kidneys are functioning properly they are reabsorbed and broken down again before they get into the urine . At high concentrations - such as in multiple myeloma - the free light chains can get into the urine and are called Bence-Jones proteins after their discoverer . Whole immunoglobulins rarely get into the urine and are a clear indication of impaired kidney function.
literature
- A. Maniatis (1998). Pathophysiology of paraprotein production. Ren Fail 20 (6): 821-8. PMID 9834980 .
- K. Apitz. The paraproteinoses. About the disorders of protein metabolism in plasmacytomas. Virchows Arch Pathol Anat 1940; 306: 630-699.
- HO McDevitt. Albert Hewett Coons. In: Biographical Memoirs, National Academy of Sciences 1996; 69: 26-37. ISBN 0-309-05346-3 . Excerpt from the National Academies Press
- Riede / Schäfer: Pathology ISBN 3-13-683303-1