The Inductive Effect of Purified Streptococcal M-protein on Immunity against Streptococcus pyogenes in Rabbit Model.

Aims: The study aimed to know the effects of the purified M-protein on immune system to produce protection against Streptococcus pyogenes in rabbits. Study Design: Case-control study. Place and Duration of Study: In this study, collection samples and bacterial identification were carried out in two hospitals; Child Protection Hospital and Central Child Hospital in Baghdad city, and experimental work was done in Department of Medical Microbiology, College of Medicine-Babylon university, Iraq. The study was done during the period between January to July 2014. Methodology: A total of 260 samples were collected from tonsillitis and pharyngitis cases. Three main parts involved in this study: the first part is bacterial diagnosis based on relied diagnostic procedures. The second part is detection of serogroup of GAS and antistreptolysin O (ASO) antibodies by using latex agglutination test, and the third part is experimental study conducted on the protective immune response against the group A streptococci using rabbit model. M-protein was purified by using Ion exchange chromatography. The rabbit models were immunized with purified M protein according to standard method. The immune response generated against the M protein was checked in an rabbit population. Results: From a total of 260 samples of tonsillitis and pharyngitis cases among children, only 8 (3.07%) isolates were identified as Streptococcus pyogenes. High amount of M-protein was detected in two isolates by indirect bacterial test. The concentration of purified M-protein ranged from 20-24.68 µg/ml. The purified M protein has important role in an induction of the immune response in experimental model. It leads to increased phagocytosis, stimulation of T-cell, and high level of antibody in serum of an immunized rabbits. Conclusion: The purified streptococcal M protein has strong antigenicity, and it has important role in an induction the strong protective immune response in experimental rabbit model. It may be used in future studies as vaccine against streptococcal infection among humans.

Síndrome de Poems: reporte de un caso clínico / Poems syndrome: a case report

El Síndrome de POEMS (polineuropatía, organomegalia, endocrinopatía, pico gamma monoclonal ycambios en la piel) es una discrasia de células plasmáticas que se manifiesta con un característicoconjunto de trastornos para neoplásicos. Los cambios en la piel, como hiperpigmentación cutáneageneralizada, son debidos al aumento en la secreción del factor de crecimiento del endotelio vascular.Se reporta el caso de una mujer de 67 años de edad que se presentó con astenia, adinamia y uncuadro importante de anemia, asociados a diabetes mellitus, hipotiroidismo y polineuropatía motora ysensitiva de moderada intensidad. Sus cambios en la piel consistieron en hiperpigmentación, manchasvioláceas en los labios y acentuación de los pliegues de las manos. Los estudios subsecuentesevidenciaron el pico gamma monoclonal y la polineuropatía axonal sensitivo-motora en elelectromiograma. Se brindó el tratamiento quimioterapéutico correspondiente pero sufriócomplicaciones mielosupresoras por esta razón, desarrollo una neumonía intrahospitalaria y falleció aconsecuencia.

The POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M-protein and skin changes)is a rare atypical plasma cell dyscrasia with characteristic para neoplastic manifestations. The skinchanges, as generalized skin hyperpigmentation, are related with elevated levels of vascularendothelial growth factor. We report a clinical case of 67 years old woman who presented withasthenia, adynamia and important anemia, associated to diabetes mellitus, hypothyroidism and amoderated intensity motor-sensitive polyneuropathy. The skin changes presented by this patientwere hyperpigmentation, violet spots in the lips and accentuation of the lines in the palm of the hand.Subsequent analysis showed the M–protein and the electromyography showed a motor-sensitivepolyneuropathy in both legs. Adequate chemotherapy was given but mielosuppressive effects wereshown, she acquired nosocomial pneumonia and died as consequence.

Clinical analysis of 639 patients with M-proteinemia / 中国实用内科杂志

Objective To understand the typing and clinical significance of M-protein,to raise the understanding and diagnostic level through analysis of 639 patients with M-protein.Methods To analysis age,sex and disease of M-protein positive patients,charateristic and content difference of multiple myeloma(MM)and monoclonal gammopathy of undeterminal significance(MGUS).Results In 639 patients with M-proteinemia,there were 409 patients with IgG-type(64%),80 IgA-type(12.5%),79 IgM-type(12.4%),4 IgD-type(0.6%),9 ? light chain(1.4%),18 ? light chain(2.8%),27 double clone(4.2%),oligoclone(2.0%).There were 115 MM(18.0%),13 Waldenstrm's macroglobulinemia(2.0%),1 primary amyloidosis of kidney,19 non-Hodgkin's lymphoma(NHL)(3%),5 chronic lymphocytic leukemia(CLL)(0.8%),473 MGUS(74.0%).Conclusion M-proteinemia is a clinical phonomenon,mainly in MM and lymphocytic proliferative disease.There is an improving tendency in MGUS detectable rate.

A Case of Multiple Myeloma with Biclonal (IgG-K and IgA-K) M-proteins / 대한임상병리학회지

Two M-protein peaks in serum protein electrophoresis are rarely present in patients with plasma cell discrasia. We describe a 72-year-old male patient with multiple myeloma secreting biclonal M-proteins, which were confirmed by immunofixation. Immunoelectrophoresis has some difficulties to dectect M components when a very small amount of M-protein develops an equivocally abnormal precipitation arc. In this case, serum protein electrophoresis revealed two M peaks, one in beta and the other in gamma globulin region. An immunoelectrophoresis revealed unequivocally abnormal precipitation arcs in IgA and K light chain regions, but the arc in IgG region was equivocal. We performed an immunofixation and confirmed biclonal gammopathy, IgA-K and IgG-K types. This result supports the view that immunofixation is an useful confirmatory test when immunoelectrophoresis results are equivocal.