Immunoglobulin gene analysis in polyneuropathy associated with IgM monoclonal gammopathy |
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Authors: | Eurelings Marijke Notermans Nicolette C Lokhorst Henk M van Kessel Berris Jacobs Bart C Wokke John H J Sahota Surinder S Bloem Andries C |
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Affiliation: | Department of Neurology, the Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. m.eurelings@neuro.azu.nl |
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Abstract: | Antineural antibody activity is the implicated pathogenic mechanism in polyneuropathy associated with monoclonal gammopathy. Recognition of antigen depends on immunoglobulin variable regions, encoded by V genes. We studied V(H)DJ(H) and V(L)J(L) gene use in monoclonal B cells by clonal analysis in 20 patients with polyneuropathy and IgM monoclonal gammopathy. V genes associated with bacterial responses appear over-represented and V(H)3-23 was preferentially used, without association with specific D, J(H) or V(L)J(L). V genes revealed somatic mutation and intraclonal variation was found in 9 of 20 patients. Polyneuropathy associated with monoclonal gammopathy may be caused by an immune response to bacterial antigens, which recruit somatically mutated autoreactive B cells. |
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