Antibodies to myelin-associated glycoprotein (anti-Mag) in IgM amyloidosis may influence expression of neuropathy in rare patients

We have examined whether antibodies to myelin-associated glycoprotein (anti-MAG) influence neuropathy occurrence and phenotype in primary (AL IgM) amyloidosis. Anti-MAG and the cross-reacted sulfoglucuronyl paragloboside antibodies (SGPG) were studied in 46 patients with IgM amyloidosis (21 with polyneuropathy), and 21 matched IgM MGUS (monoclonal gammopathies of undetermined significance) controls without neuropathy. We assessed the occurrence, phenotype of neuropathy, and attributes of nerve conduction and their relation to antibody activity. Twenty of 46 patients with IgM amyloidosis (7 with and 13 without polyneuropathy) had elevation of anti-MAG or SGPG by enzyme-linked immunosorbent assay (ELISA). Two of the polyneuropathy patients with IgM amyloidosis had antibodies to MAG based on Western blot (WB) positivity. One of these patients, with the highest anti-MAG titer, had a painful sensory ataxia, with prominent demyelination, and amyloid deposition in sural nerve. The other anti-MAG WB-positive amyloid patient had an axonal neuropathy and dysautonomia. Low levels of anti-MAG antibodies were found in 12 of 21 IgM MGUS controls without neuropathy (mean follow-up, 11 years). We conclude that finding serum anti-MAG antibodies does not exclude the diagnosis of primary amyloidosis. They do not appear to affect the occurrence or expression of polyneuropathy, except possibly in occasional cases with WB positivity.     

HCMV—IgM捕获ELISA法的建立及其应用

目的　建立检测人巨细胞病毒 (HCMV)抗原特异性 Ig M的酶联捕获技术 (Capturing- EL ISA)。方法　应用 Capturing- EL ISA法检测 12 8份巨细胞病毒感染者血清中抗 HCMV- Ig M,并与常用的间接 EL ISA法进行比较。结果　抗原浓度、抗 HCMV抗体酶结合物浓度对所测得的标本 OD值都有不同程度的影响 ,用最适的实验条件建立的 Cap-turing- EL ISA法特异性及敏感性均高于间接 EL ISA法 ,且不受 RF因子的影响。结论　 Capturing- EL ISA敏感性高、特异性强 ,且简便、快速 ,重复性好 ,具有实际应用价值     

抗－HEV－IgM对戊型肝炎诊断的意义

为探讨患者循环中抗－ＨＥＶ－ＩｇＭ和ＩｇＧ对戊型肝炎诊断的意义，本文对１９９２年至１９９５年期间３５７例急性肝炎标本进行了抗－ＨＥＶ－ＩｇＭ检测，对其中１２７例同步作了抗－ＨＥＶ＋ＩｇＧ测定。结果表明：抗－ＨＥＶ－ＩｇＭ经戊肝急性期后很快下降，而抗－ＨＥＶ－ＩｇＧ则经历了急性期、恢复期乃至更长的时间。还发现在单纯ＨＥＶ感染和ＨＥＶ＋ＨＡＶ感染中，抗－ＨＥＶ－ＩｇＭ反应形式基本相同，但抗ＨＥＶ－ＩｇＧ不同。单纯ＨＥＶ感染中，抗－ＨＥＶ－ＩｇＧ从急性期急剧上升至９５％后，恢复期仍维持在８１．８％的较高水平，而在ＨＥＶ＋ＨＡＶ合并感染中，急性期和恢复期抗－ＨＥＶ－ＩｇＧ仅分别为２３．９％和１２．５％，和单纯ＨＥＶ感染有显著性差异（Ｐ＜０．０１）。本研究表明：抗－ＨＥＶ－ＩｇＭ检测对诊断急性戊型肝炎较抗－ＨＥＶ－ＩｇＧ更有价值。     

Significance of tubulointerstitial fibrosis in paediatric IgM nephropathy

Summary: The significance of tubulointerstitial fibrosis in paediatric patients with primary diffuse mesangial proliferative glomerulonephritis and IgM deposition (IgM nephropathy) has not been well documented. the clinical course, therapeutic response and final outcome of 35 patients in whom renal biopsies showed IgM nephropathy are reported. They have been subdivided into two groups according to the absence (19 patients: group I) or presence (16 patients: group II) of superimposed lesion of tubulointerstitial fibrosis. Clinical presentation was similar in both groups but the patients in group I were male predominant (2.8:1 vs 1: 1). 6/19 (31.6%) of the patients in group I and 1/16 (6.3%) in group II responded to corticosteroid, 11/19 (57.9%) in group I and 8/16 (50.0%) in group II had steroid dependent, whereas 2/19 (10.5%) in group I and 7/16 (43.7%) in group II had steroid resistant. About 42% of the patients in group I and 94% in group II required cyclophosphamide therapy by which similar response in both groups (approximately 75%) were observed. the steroid non-responders and cyclophosphosphamide therapy among patients in group II were significantly higher ( P <0.05) than the group I. At the latest assessment, 5/16 (31.3%) in group I and 7/14 (50%) in group II had impaired renal function. the follow-up period in both groups were 3.1 ± 2.8 and 3.4 ± 2.9 years, respectively. In conclusion, the finding of tubulointerstitial fibrosis in a paediatric IgM nephropathy indicates an unfavourable therapeutic response.     

运动神经元病患者血IgM测定及大剂量强的松治疗研究

作者对运动神经元病患者及健康对照者各２０例血清免疫球蛋白单克隆抗体ＩｇＭ含量进行了测定。结果显示在治疗前疾病组ＩｇＭ含量（平均１６９５．５５±５０４．６３ｍｇ／Ｌ）明显高于对照组（７８２±１２７．１１ｍｇ／Ｌ）。经大剂量强的松治疗后，疾病组血清ＩｇＭ平均含量８２１±２２７ｍｇ／Ｌ，较治疗前明显下降，同时症状与体征有改善。表明免疫机制参与了运动神经元病的病理过程，以大剂量强的松治疗本病血清ＩｇＭ含量增高的进行脊肌萎缩症有一定治疗作用。     

应用ELISA法检测119对母婴血中巨细胞病毒

人类巨细胞病毒（ＨＣＭＶ）是引起人类先天性畸形的重要原因之一。本文应用ＥＬＩＳＡ法对鞍山市的１１９对母婴止进行了ＨＣＭＶ－ＩｇＭ、ＨＣＭＶ－ＩｇＡ的检测。检测表明，鞍山市孕母ＨＣＭＶ近期复发及原发感染率为２９．４％，新生儿ＨＣＭＶ先天感染率为１３．４％，具有一定的感染性。同时检测ＨＣＭＶ－ＩｇＭ、ＩｇＡ具有很好的互补性，可以提高感染的检出率。     

Sulphatide-binding properties are shared by serum amyloid P component and a polyreactive germ-line IgM autoantibody,the TH3 idiotype

Serum amyloid P component (SAP) concentration was elevated in sera from leprosy patients, significantly so above endemic controls in lepromatous cases. In the sera of lepromatous leprosy (LL) patients who experienced an erythema nodosum leprosum (ENL) episode the SAP fell at the onset of ENL and remained low throughout, in two of three cases. Changes in SAP concentration parallel anti-sulphatide IgM concentrations. TH3, a monoclonal IgM germ-line antibody derived from a LL patient, and SAP share similar binding patterns. In this study we demonstrate binding to heparin and sulphatide. Moreover, SAP inhibited the binding of TH3 to sulphatide, as well as anti-sulphatide IgM found in a range of sera, and anti-sulphatide IgG in the only sera sample in which it was found. The observation that anti-TH3 idiotype monoclonal and polyclonal anti-SAP antibodies both inhibited the binding of TH3 and IgM in sera (but not IgG) to sulphatide without binding to sulphatide themselves further demonstrated similar binding specificities. The observations of similarity in binding reinforce ideas that SAP may function as a primitive opsonin, but the clear ability to inhibit binding of autoantibodies suggests that SAP may play a role in ameliorating tissue and particularly nerve damage in leprosy patients.     

抗人肺癌单抗LC-1IgM片段对人肺癌免疫放射定位的研究

具有免疫活性的抗人肺癌单抗LC-I IgM经2.5%胰蛋白酶处理后,通过Sephadex G25或G-50柱分离获得LC1-IgM片段.ELISA检测表明单抗IgM片段有免疫活性,并通过SDS-PAGE分离、观察到单抗IgM片段的分子量主要是Fab和F(ah’)_2.此LC-l IgM片段用维生素C还原后与还原~(99m)Tc进行标记,纸层析分析标记率达90%以上.标记物确认无热原反应并无菌过滤后,从静脉注入肺癌患者或肺病患者体内,经24h后,SPECT扫描,同位素能浓聚于肺癌病灶上,显像十分清晰.55例患者中.肺癌患者48例,阳性率81.25%;肺部其它疾病患者7例,阴性率85.11%