Identification of amyloid protein AA and AL in formalin-fixed, paraffin-embedded tissue section by immunoperoxidase method
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Classification of amyloidosis of these major proteins has been recently und ertaken. In our previous paper, we reported that immunoperoxidase method with anti-AA serum enabled us to identify protein AA even formalin fixed materials and its method was useful to make diagnosis of protein AA type of amyloidosis, so-called secondary amyloidosis. In this paper, we investigated protein AL derived from immunoglobulin light chain by the same method. We applied indirect immunoperoxidase method with anti-AA, anti-AL (κ), anti-AL (λ), anti-BJP (κ) and anti-BJP (λ) to 25 cases of amyloidosis and 14 cases of amyloidosis with plasma cell dyscrasia (PCD) consisting of primary amyloidosis and myeloma-associated one. The lattar was divided into three groups. Group 1 consisted four cases which presented kappa determinant inthe serum M-component and/or BJP (κ) in the urine. Group 2 included seven cases which presented lambda determinant in the serum M-component and/or BJP(λ) in the urine. Group 3 was three cases which were detected M-component neither in the serum nor in the urine.(1) The most frequent underlying disease was found to be the rheumatoid arthritis in 16 out of 25 cases of secondary amyloidosis. All cases of secondary amyloidosis were sensitive to Congo red stain after treatment of potassium permanganate reaction (Wright's method) and were weakly to strongly positive by means of immunoperoxidase method with anti-AA. (2) All cases of amyloidosis with PCD were resistant by Wright's method. Regarding group 1, one of four was weakly positive by anti-AL (κ), but all were negative by anti-BJP (κ). Regarding group 2, one of seven was weakly positive by anti-AL (λ), but all were negative by anti-BJP (λ). Regarding group 3, all were negative by both anti-ALs and anti-BJPs.Therefore, we would like to emphasize that immunoperoxidase method with anti-AA serumis quite desirable directly to identify protein AA. On the other hand, AL type amyloidosis was resistant by Wright's method and low frequency of positive cases by immunoperoxidase method with anti-AL sera. Our date suggest that making use of some kind of anti-AL sera for immunoperoxidase method enables us to identify protein AL in tissue sections.
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