Valor diagnóstico de la electroforesis de proteínas y cadenas ligeras libres en suero en el mieloma múltiple / Diagnostic value of serum protein electrophoresis and free light chains in the multiple myeloma's diagnosis

RESUMEN Fundamento: La electroforesis de proteínas y las cadenas ligeras libres en suero son técnicas utilizadas en el diagnóstico del mieloma múltiple. Sin embargo, la utilidad diagnóstica de ambas pruebas puede variar según el método empleado y condiciones reales del medio donde se realicen. Objetivo: Determinar el valor diagnóstico de la electroforesis de proteínas y de las cadenas ligeras libres en suero en el mieloma múltiple. Metodología: Se realizó un estudio retrospectivo de los parámetros electroforesis de proteínas en suero y cadenas ligeras libres en suero a 43 pacientes con diagnóstico de mieloma múltiple por evaluación de la médula ósea. La electroforesis de proteínas se realizó por el método convencional de separación de proteínas sobre papel de acetato de celulosa y para las cadenas ligeras libres se aplicó un ensayo inmunoturbidimétrico en el que se usó un analizador químico (Cobas 311). Se calcularon 7 parámetros que evaluaron la exactitud diagnóstica. Resultados: Todos los parámetros que evaluaron la exactitud diagnóstica estuvieron dentro de los intervalos de confianza en ambas pruebas. Conclusiones: La electroforesis de proteínas y las cadenas ligeras libres en suero son ensayos de gran utilidad en el diagnóstico del mieloma múltiple y se deben utilizar en conjunto para la mayor captación posible de casos.

ABSTRACT Background: Protein electrophoresis and serum free light chains are techniques used in the diagnosis of multiple myeloma. However, the diagnostic utility of both tests may vary according to the method used and the actual conditions of the environment where they are performed. Objective: To determine the diagnostic value of protein electrophoresis and serum free light chains in multiple myeloma. Methodology: A retrospective study of serum protein electrophoresis parameters and serum free light chains was conducted in 43 patients diagnosed with multiple myeloma by bone marrow evaluation. Protein electrophoresis was completed by the conventional method of protein separation on cellulose acetate paper and for free light chains an immunoturbidimetric assay was applied in which a chemical analyzer (Cobas 311) was used. Seven parameters were calculated to evaluate diagnostic accuracy. Results: All parameters assessing diagnostic accuracy were within confidence intervals in both tests. Conclusions: Protein electrophoresis and serum free light chains are very useful assays in the diagnosis of multiple myeloma and should be used in conjunction for the highest possible approval of cases.

Proteinograma e inmunoglobulinas séricas en las infecciones cutáneas por Staphylococcus aureus / Proteinogram and serum immunoglobulins in skin infections caused by Staphylococcus aureus

RESUMEN Introducción: lesión típica ocasionada por el Staphylococcus aureus es el furúnculo o cualquier otro absceso localizado. Objetivo: describir el comportamiento del proteinograma y los niveles de inmunoglobulinas séricas. Métodos: se realizó un estudio longitudinal prospectivo con 70 pacientes portadores de forúnculos infectados por Staphylococcus aureus, que acudieron a las consultas de Inmunología en varias localidades de Villa Clara. Resultados: se determinaron las fracciones proteicas por método de elusión; se cuantificaron las inmunoglobulinas séricas por inmunodifusión radial simple, según edad, sexo y color de la piel de los pacientes. Se contrastaron las variables bajo la prueba de Ji cuadrado, con una significación de confianza del 95 %. Predominaron los pacientes con el color de la piel blanca sobre los no blancos. En la electroforesis de proteínas se obtuvieron resultados normales para las proteínas totales y la fracción gamma. Para la albúmina, fracción alfa 1, alfa 2 y beta globulina se obtuvieron valores bajos, por encima del 95 % válido. Conclusiones: todas las inmunoglobulinas resultaron normales o altas, según los intervalos de referencia para cada grupo de edad. Al correlacionar los valores de las inmunoglobulinas con las fracciones de la electroforesis, fue llamativo el resultado obtenido en la correlación entre la IgA y la fracción beta. De manera general, los anticuerpos no mostraron variaciones significativas en sus correlaciones, lo cual evidenció un pobre papel en la infección. Se concluyó que los valores de alfa 1, alfa 2 y beta globulina pueden tener importancia en la enfermedad.

ABSTRACT Introduction: the typical lesion caused by Staphylococcus aureus is the furuncle or any other localized abscess. Objective: to describe the manifestation of the proteinogram and serum immunoglobulin levels. Methods: a prospective longitudinal study was carried out in 70 patients with furuncles infected by Staphylococcus aureus, who came to the Immunology consultations from various locations of Villa Clara. Results: protein fractions were determined by elution method; serum immunoglobulins were quantified according to age, gender and skin color of the patients by simple radial immunodiffusion. Variables were contrasted under the Chi-square test, with 95% confidence significance. White patients predominated over non-white ones. Normal results were obtained for total proteins and gamma fraction in protein electrophoresis. Low values were obtained for albumin, alpha 1, alpha 2 and beta globulin fraction, above 95% valid. Conclusions: all immunoglobulins were normal or high, according to the reference intervals for each age group. The result obtained in the correlation between IgA and the beta fraction was striking when correlating the immunoglobulin values with the electrophoresis fractions. In general, the antibodies did not show significant variations in their correlations, which evidenced a poor role in infection. We concluded that alpha 1, alpha 2 and beta globulin values may be important in the disease.

Predictive value of blood routine and blood biochemical indicators for immunotherapy combined with chemotherapy-related interstitial pneumonia in patients with diffuse large B-cell lymphoma / 白血病·淋巴瘤

Objective:To investigate the predictive value of blood routine and blood biochemical indicators for immunotherapy combined with chemotherapy-related interstitial pneumonia (IP) in patients with diffuse large B-cell lymphoma (DLBCL).Methods:The data of 151 newly-diagnosed DLBCL patients treated with rituximab combined with chemotherapy in the First Affiliated Hospital of Soochow University from December 2017 to October 2020 were retrospectively analyzed. According to whether IP occurred, the patients were divided into IP group and non-IP group. The patient's clinical data and baseline laboratory test results were collected. The differences in clinicopathological features and laboratory indicators between IP group and non-IP group were analyzed. In addition, the relationship between the variety of blood routine and blood biochemical indicators and the occurrence of IP was analyzed. The receiver operating characteristic (ROC) curve of the selected indicators to predict the occurrence of IP was drawn, and the predictive performance of each indicator was analyzed.Results:The incidence of IP was 9.3% (14/151) in DLBCL patients after receiving immunotherapy combined with chemotherapy. The lymphocyte count (LYM) in IP group at the first diagnosis was higher than that in non-IP group [1.60×10 9/L (1.40×10 9/L, 2.51×10 9/L) vs. 1.28×10 9/L (0.89×10 9/L, 1.78×10 9/L), U=-2.194, P=0.028], but there was no significant difference in the levels of platelet count, neutrophil count, monocyte count, lactate dehydrogenase (LDH), α-hydroxybutyrate dehydrogenase (α-HBDH), serum albumin (ALB) and the proportion of patients with elevated C-reactive protein (CRP) between the two groups (all P > 0.05). Compared with the laboratory indicators in non-IP group before the 4th cycle of treatment, LYM and ALB in IP group were significantly reduced at IP onset [0.72×10 9/L (0.46×10 9/L, 0.92×10 9/L) vs. 0.93×10 9/L (0.71×10 9/L, 1.15×10 9/L), 32.9 g/L (28.6 g/L, 34.9 g/L) vs. 40.3 g/L (36.1 g/L, 43.1 g/L)], but LDH and α-HBDH increased [332 U/L (255 U/L, 396 U/L) vs. 233 U/L (200 U/L, 286 U/L), 277 U/L (206 U/L, 315 U/L) vs. 189 U/L (159 U/L, 229 U/L)], and the differences were statistically significant (all P<0.05). The proportion of patients with elevated CRP in IP group was high than that in non-IP group [100.0% (14/14) vs. 56.9% (78/137), P=0.001]. The area under ROC curve of LYM, ALB, LDH and α-HBDH alone for predicting the occurrence of IP was 0.668, 0.820, 0.789 and 0.802. The best cut-off values of ALB, LDH and α-HBDH was 34.6 g/L, 241 U/L and 199 U/L. ALB had the highest sensitivity for predicting the occurrence of IP (81.8%). The areas under ROC curve of ALB+LDH, ALB+α-HBDH, LDH+α-HBDH, ALB+LDH+α-HBDH for predicting the occurrence of IP was 0.850, 0.844, 0.777 and 0.851, respectively. LDH+α-HBDH had the highest predictive sensitivity (92.9%), but the specificity was low (53.3%). The prediction sensitivity (both 78.6%) and specificity (both 86.1%) of ALB+LDH and ALB+LDH+α-HBDH were high. Conclusions:DLBCL patients are at risk of IP during immunotherapy combined with chemotherapy. The increased LYM at initial diagnosis is a risk factor for the occurrence of IP. The variety of LYM, ALB, LDH, α-HBDH and CRP during the treatment may be related to the occurrence of IP. Among them, ALB, LDH and α-HBDH have important predictive values for the occurrence of IP.

Paraproteínas: claridad en la nebulosa / Paraproteins: a review

Hematological neoplasms are tumors of cells in different states of maturation and differentiation. Since monoclonal gammopathies (MG) refer to B mature lymphocyte neoplasms, lymphogenesis should be well known. We must keep in mind that the last stage of maturation of these lymphocytes is the plasma cell. This is how a MG could appear in the context of a plasma cell neoplasm, such as multiple myeloma or amyloidosis, but also in relation to a lymphoma. A monoclonal peak is produced by mature B lymphocytes or plasma cells that secrete a monoclonal protein (Immunoglobulin), and represents a MG. But it must be emphasized that, in the correct clinical context, a hypogammaglobulinemia can represent a MG as well. Another important point is the understanding and interpretation of requested tests, such as protein electrophoresis (PEP), immunofixation (IFx) or serum free light chains (sFLC). The current MG screening panel includes these three studies (PEF, IFx, sFLC), although a simpler panel measuring PEF and sFLC has also been proposed, but not yet formally validated. Therefore, screening done only with PEP is insufficient.

Clinical analysis of three cases with beta-thalassemia / 中华儿科杂志

Objective@#To study the diagnostic strategy of β-thalassemia through retrospective analysis of 3 cases of β-thalassemia.@*Methods@#Three patients were admitted to the Department of Pediatrics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2014 to June 2015. The clinical manifestations, hemoglobin electrophoresis and gene detection of these patients and their parents were analyzed, diagnostic ideas and key points were discussed when beta thalassemia gene detection did not explain clinical manifestations or hemoglobin electrophoresis.@*Results@#Case 1, boy, 5 years old, was diagnosed as compound heterozygotes of β41-42 and IVS-Ⅱ-654 with hereditary persistence of fetal hemoglobin(HPFH) according to the clinical manifestations of mild anemia, normal size of liver and spleen, 92.8% fetal hemoglobin (HbF) and gene analysis. Case 2, girl, 3 years old, was confirmed the diagnosis of thalassemia intermedia with β41-42 heterozygote compound and αααanti3.7 heterozygote in accordance with the manifestations of severe anemia, hepatosplenomegaly, 8.6% HbF, 4.1% hemoglobin A2(HbA2) and gene analysis. Case 3, girl, 3 years old, with severe anemia, hepatosplenomegaly, 51.2% HbF and 3.7% HbA2, was diagnosed as thalassemia major with compound heterozygotes of PolyA (T→C) and β17 by DNA sequencing.@*Conclusion@#The diagnosis of β-thalassemia should be confirmed by clinical manifestations of hemolytic anemia, hemoglobin electrophoresis, gene diagnosis and family survey.

Clinical and laboratory repercussions in patient with hemoglobin SD-Punjab disease: a case report / Repercussões clínicas e laboratoriais em paciente com hemoglobinopatia SD-Punjab: relato de caso

ABSTRACT We report the first case of hemoglobin SD-Punjab disease, a rare form of sickle-cell disease, in the state of Bahia. Detection was possible by a test for the identification of hemoglobin (Hb) variants with the high-resolution liquid chromatography technique. By means of the molecular study of chromosomal polymorphism with beta-globin S gene, the Bantu haplotype was observed. According to studies, there is strong association between the prevalence of Bantu haplotype and reduced levels of fetal Hb and Hb D-Punjab as a stimulating factor for S polymerization, what contributes to the hematological disorders of the disease and organ damage, as gallstones and aseptic necrosis of the femoral head.

RESUMO Reportamos o primeiro caso de hemoglobinopatia SD-Punjab, uma forma rara da doença falciforme, no estado da Bahia. A detecção ocorreu pelo exame para identificação de hemoglobinas (Hb) variantes com técnica de cromatografia líquida de alta resolução. Através do estudo molecular do polimorfismo no cromossomo com gene da betaglobina S, verificou-se a presença do haplótipo Bantu. Segundo estudos, existe forte associação de prevalência do haplótipo Bantu e níveis reduzidos da Hb fetal e da Hb D-Punjab como fator de estímulo à polimerização da S, o que contribui para os distúrbios hematológicos da doença e a lesão de órgãos, como cálculos biliares e necrose asséptica de cabeça de fêmur.

Kinetics of the expressions of radiation-induced plasma proteins of the cardiac territory in electrophoresis / Cinética das expressões de proteínas plasmáticas radioinduzidas do território cardíaco em eletroforese

ABSTRACT Introduction: Radiation induces acute and late alterations in blood proteins. Objective: The present study aims at analyzing in time kinetics the electrophoretic profiles of expression bands of blood protein, in the molecular weight range greater than and equal to that of albumin, modulated by ionizing radiation in the cardiac territory, in animal model. Material and methods: Animals were exposed to a whole-body dose of 5 Gy ionizing radiation (Co-60). Serum samples were collected from isogenic Wistar rats (control and irradiated groups). At a time kinetics of 12, 24, 48, 72, 96 hours and 35 days post-irradiation, thoracolaparotomies were performed with anesthesia, and 0.3 ml of blood was collected between the left ventricle and the pulmonary artery. The samples were held in heparin and their components were separated by centrifugation. Protein bands with similar molecular weight were identified by vertical 10% electrophoresis, silver staining. Results: The findings indicate a systemic acute altered expression of proteins with molecular weight greater than or equal to that of albumin in acrylamide gel, presenting suppression and increased expression due to modulation of preexisting bands, identified in time kinetics. Conclusion: These findings point out to acute alterations of protein expression modulated in time, but also to a late modulation of gene expression.

RESUMO Introdução: A radiação de corpo inteiro induz alterações agudas e tardias no perfil proteico sanguíneo. Objetivo: O presente estudo tem como escopo analisar em cinética de tempo o perfil eletroforético de bandas de expressão das proteínas solúveis do sangue, na faixa de peso molecular superior e igual à albumina, moduladas por radiação ionizante no território cardíaco em modelo animal. Materiais e métodos: Animais foram expostos à radiação de Co-60, em dose de 5 Gy corpo inteiro. Foram coletadas amostras de soro sanguíneo em ratos Wistar isogênicos (no grupo-controle e no irradiado). Em uma cinética de tempo de 12, 24, 48, 72 e 96 horas e 35 dias pós-exposição, foram realizadas toracolaparotomias com anestesia profunda e, posteriormente, foi coletado 0,3 ml de sangue entre ventrículo esquerdo e artéria pulmonar. As amostras foram heparinizadas, sendo, em seguida, separados seus componentes por centrifugação. As bandas proteicas de peso molecular similar foram identificadas por eletroforese vertical a 10%, coradas com prata. Resultados: Os achados indicam alteração aguda sistêmica da expressão das proteínas de peso molecular superior ou igual à albumina em gel de acrilamida, representando supressão e aumento de expressões por meio da modulação de bandas preexistentes identificadas em cinética de tempo. Conclusão: Esses achados apontam tanto para uma alteração aguda modulada no tempo da expressão proteica quanto para uma alteração moderada tardia da expressão gênica.

Comparison of serum protein profiles between people with successful aged 80 years and over in Bama versus Nanning city / 中华老年医学杂志

Objective To compare the serum protein profiles between people with successful aged 80 years and over in Bama versus Nanning,to identify the possible causes of the long life expectancy in Bama.Methods We evaluated the serum protein profiles using surface-enhanced laser desorption ionization time-of-flight mass spectrometry (SELDI-TOF-MS) with 4 different chromatographic surfaces,including the weak cation exchange (CM10),immobilized metal affinity capture (IMAC) 30-Cu,strong anion exchange (Q10) and hydrophobic surface (H50) protein chip arrays in people with successful aged 80 years and over living in Bama versus in Nanning city.SELDI-TOF-MS had a molecular mass detection range of 2000-50,000 D,with a first signal-to noise (S/N) ratio of 5,frequency of peak cluster of over 15 ％,and second S/N ratio of 2 and peak fluctuation of 0.3％ (m/z).Results The total numbers of serum protein (peptide) peaks for people with successful aging in Bama and Nanning were 71 on CM10,46 on IMAC30-Cu,81 on Q10,and 52 on H50.Among subjects from Bama as compared with Nanning (P＜0.05; mean ＞SD for each protein peak),there were 8 differently expressed protein peaks on CM10,of which 2 were upregulated and 6 downregulated; 7 on IMAC-Cu,of which 2 were upregulated and 6 downregulated; 5 on Q10,all of which were upregulated; and 6 on H50,of which 3 were upregulated and 3 downregulated.Conclusions There are marked differences in the serum protein profiles between people with successful aging living in Bama versus in Nanning.Most of the proteins are downregulated among people aged over 80 years in Bama.

The seroimmunological analysis of 117 multiple myeloma cases in xinjiang / 中国基层医药

Objective To analyze the immunological feature of the multiple myeloma. Methods The serum of 117 cases were detected by serum protein electrophoresis and immunofixation electrophoresis;and analyzed quantitatively immune globulin(IgG、IgA、IgM) ,total protein and albumin. Results Monoclone protein peak was found in 67 patients out of 117 patients tested(57.3%) ,it located mainly at γ border. Immunoglobulin G was found in 62 patients out of 117 patients tested(53.0%). Immunoglobulin A was 19 cases(16.3%) ,Immunoglobulin M was 12 cases(10. 1%) ,DL was 2 cases(1.7%) ,free light chain was 22 cases(18.8%). Homotypic immunoglobulin level increased notably and non-correspond constituent was low in immunoglobulin test. The protein quantified displayed that total protein increased and albumin decreased in different level. Conclusion The seroimmunological index played a crucial role in diagnois,clinical stage and prognosis of MM.

Analysis of four cases of hereditable bisaalbuminemia / 中华检验医学杂志

Objective Reporting and analyzing the 4 cases of hereditable bisalbuminemia and its clinical significance and the double-albumin molecules structure.Methods Application ancestry survey,SEBIA electrophoresis system,information searching and collection analysis and result of 18 cases patients in bisalbuminemia among one ancestry of the four that carried hereditable bisalbuminemia.Results The frequency of occurrence of hereditable bisalbuminemia presents as 1/6 050. The result of one ancestry indicates the incidence of the disease among offspring as 46 percents which coincide with the heredity of chromosome dominant gene. The types of the group of 4 patients of bisalbuminemia all belong to As(slow rate in electrophoresis). Biological and N-terminal amino acids analysis exclude the most common As type of genotypic mutation of albumins.Conclusion The occurrence rates and inheritant modes of hereditable bisalbuminemia were studied with the genotypes of bisalbuminemia analysed at the level of the amino acid, which makes rich the information of abnormal albuminemia research and lays the foundation of abnormal albuminemia research at the level of gene.

Automated capillary zone electrophoresis for analysis of human serum protein in clinical application / 中华检验医学杂志

Objective The automated capillary zone electrophoresis (CE) is used for human serum protein analysis and compared with the results of agarose gel electrophoresis (AGE) for human serum protein analysis.Discuss its′ practical application in clinical.Methods With the Capillarys ?1-?2+reagent set, proteins in serum were separated at 7 kV for 4 min in 15.5 cm?25.0 ?m fused-silica capillaries (n=8) at 35.5℃ in a pH 10 buffer with online detection 200 nm.Results Capillary zone electrophoresis compared with agarose gel electrophoresis(AGE;Hydrasys-Hyry; Hydragel protein(e)15/30/54 reagent set;Sebia)in precision, relatives, linearity and potential interferences were analyzed.A samples without Para-protein (n=165) were performed relation test. The coefficient of relation between CE and AGE is 0.929 for albumin, 0.924 for for ?1-globulin, 0.841 for ?2-globulin, 0.789 for ?-globulin, 0.926 for ?-globulin. There was no significant difference (P

Inmunoglobulinas y proteínas de fase aguda en niños atletas de alto rendimiento

En este estudio se cuantificaron las inmunoglobulinas G, A y M, las proteínas de fase aguda: alfa 1 antitripsina, haptoglobina y ceruloplasmina, así como las zonas de la electroforesis de proteínas, en 153 niños atletas de alto rendimiento y en 140 niños supuestamente sanos con actividad física normal para su edad, en busca de variaciones en estos parámetros con carácter permanente por la práctica sistemática de intensos ejercicios físicos. De las inmunoglobulinas dosificadas sólo estuvo marcadamente elevada la IgM y disminuida la zona alfa 2 en los niños atletas; sin embargo, no se obtuvieron diferencias en las proteínas de fase aguda dosificadas para ambos grupos, así como en las proteínas totales cuantificadas.

In this study, G, A and M immunoglobulins, the acute phase proteins: alpha 1-antitrypsin, haptoglobin and ceruloplasmin, as well as the zones of protein electrophoresis were quantified in 153 sportschildren of high performance and in 140 apparently sound children with normal physical activity according to their age, in order to look for variations in these parameters with permanent character due to the systematic practice of intensive physical exercises. Of the dosified immunoglobulins only IgM was significantly elevated, whereas the alpha 2 zone was diminished among sportschildren. Differences were found neither in the actue phase proteins dosified for both groups nor in the quantified total proteins.

EVALUATION OF THE NUTRITIVE VALUE OF PORCINE WHOLE BLOOD PROTEIN / 营养学报

The Present study designed according to AOAC is conducted to evaluate the practical protein quality of the porcine blood solely and mixed with other dietary proteins.Proximate analysis shows the average contents of crude protein and water in the spray-drying porcine blood are 85.0% and 12.0% respectively.The porcine blood protein is scant of Isoleucine (0.5%) and its Leu/Ile ratio is as high as 26. The amino acid pattern results in poor protein quality of the porcine blood, with BV, NPU and NPR value being only 16.5, 15.5 and 0 respectively. Therefore diets containing porcine blood as a sole source of protein can not maintain the normal body weight of rats.But porcine whole blood protein is rich in Lysine (7.8%) . When the spray-drying porcine blood is mixed with the wheat flour in proportion of 3%, the protein quality of the mixed dietary protein comparing with either of its constitutional proteins, is improved remarkably and its nutritive parameter values (BV:73.3, NPU: 61.8, PER: 2.46, Calbrated PER:1.9 and NPR: 4.3 respectively) are higher than those of the wheat flour protein (BV: 55.3, NPU: 46.6, PER: 1.01, Calibrated PER: 0.8 and NPR: 3.1 respectively).