尿中 Light Chain に関する臨床的研究
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概要
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Antisera against free light (FL) chains were prepared and the determination of urinary FL chain was carried out by the single radial immunodiffusion technique clinically in various diseases including monoclonal gammopathy (M'-proteinemia) and malignant neoplasms. The results obtained are as follows. 1) Determinations of both free κ- and λ-chains (Fκ and Fλ) showed good reproducibility in concentrations between 10 to 80mg/dl by use of the standard samples of κ- and/or λ-chain dimer. The error caused by the monomer was negligible in most of the urinary specimens except for those of monomeric Bence-Jones proteinuria. 2) The mean urinary excretions of Fκ and Fλ in control subjects were 4.3 and 0.9mg/day, respectively. The ratio of κ- to λ-chain was in general around 4.8:1 showing a tendency of κ-dominance. 3) A significant increase in urinary excretion of Fκ was found in the aged control as compared with the adult control whereas the relation of Fλ to aging was not clearly seen. 4) In diseases with M-proteinemia, FL chains coincident with the light chain types of serum M-proteins were elevated in urine and identified as Bence-Jones proteins. The serial determinations of these appeared to be useful as a monitor of patients with M-proteinemia. 5) It was noted that urinary excretion of FL chains different from light chain types of serum M-proteins increased together with Bence-Jones proteins. These FL chains were confirmed to be polyclonal in nature by immunoelectrophoresis. 6) Polyclonal FL chains often increased in urine from patients with cancer, leukemia and systemic lupus erythematodes, and only one of either Fκor Fλ increased in urine from some patients. Therefore,it was conjectured that an imbalance in immunoglobulin synthesis might be involved in these disease conditions, and a possible relevance to hypergammaglobulinemia was considered to be one of the factorscausing the increase of FL chain excretion in urine.
- 1979-10-01
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