title: High-titre IgM anti-sulfatide antibodies in individuals with IgM paraproteinaemia and associated peripheral neuropathy.
abstract: The common association between monoclonal gammopathy and peripheral neuropathy was studied in seven patients with demyelinating polyneuropathy and IgM paraproteinaemia. Plasma samples from these individuals were thoroughly tested for antiperipheral nerve myelin (PNM) antibodies and then screened for glycoprotein and glycolipid reactivity by western immunoblotting and thin-layer chromatography (TLC) immunostaining. Three of the seven samples showed strong IgM anti-PNM and antisulfatide (GalS) antibody reactivity. Two of these three plasma samples showed extraordinarily high antisulfatide IgM antibody titres, ranging from 1 x 104 to 1 x 106 arbitrary units/L. These same samples also showed intense myelin staining of sciatic nerve sections (paraffin and cryostat) and teased nerve fibres. No axonal immunoreactivity was observed. These results suggest that high titre IgM antisulfatide antibodies may play a pathogenetic role in the immune demyelination associated with IgM paraproteinaemia.
authors.affiliation: Neuropathology Research Laboratory, Department of Anatomical Pathology, Royal Melbourne Hospital, Victoria, Australia. s.petratos@med.monash.edu.au
authors.forename: S
authors.initials: S
authors.lastname: Petratos
authors.forename: V J
authors.initials: VJ
authors.lastname: Turnbull
authors.forename: R
authors.initials: R
authors.lastname: Papadopoulos
authors.forename: M
authors.initials: M
authors.lastname: Ayers
authors.forename: M F
authors.initials: MF
authors.lastname: Gonzales
mesh_terms: D000328:Adult; D000368:Aged; D000906:Antibodies / Q000032:analysis*; D015153:Blotting, Western; D002855:Chromatography, Thin Layer; D003711:Demyelinating Diseases / Q000097:blood / Q000150:complications*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006017:Glycolipids / Q000276:immunology; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis* / Q000097:blood; D008297:Male; D008875:Middle Aged; D009186:Myelin Sheath / Q000276:immunology; D009412:Nerve Fibers / Q000276:immunology; D010265:Paraproteinemias / Q000097:blood / Q000150:complications*; D010523:Peripheral Nervous System Diseases / Q000097:blood / Q000150:complications*; D012584:Sciatic Nerve / Q000276:immunology; D013433:Sulfoglycosphingolipids / Q000276:immunology*
chemical_list: D000906:Antibodies; D006017:Glycolipids; D007075:Immunoglobulin M; D013433:Sulfoglycosphingolipids