title: Immunoglobulin gene analysis in polyneuropathy associated with IgM monoclonal gammopathy.
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.
authors.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
authors.forename: Marijke
authors.initials: M
authors.lastname: Eurelings
authors.forename: Nicolette C
authors.initials: NC
authors.lastname: Notermans
authors.forename: Henk M
authors.initials: HM
authors.lastname: Lokhorst
authors.forename: Berris
authors.initials: B
authors.lastname: van Kessel
authors.forename: Bart C
authors.initials: BC
authors.lastname: Jacobs
authors.forename: John H J
authors.initials: JH
authors.lastname: Wokke
authors.forename: Surinder S
authors.initials: SS
authors.lastname: Sahota
authors.forename: Andries C
authors.initials: AC
authors.lastname: Bloem
mesh_terms: D000368:Aged; D016175:B-Lymphocyte Subsets / Q000737:chemistry / Q000276:immunology / Q000378:metabolism; D002999:Clone Cells; D005260:Female; D005803:Genes, Immunoglobulin; D006801:Humans; D007075:Immunoglobulin M / Q000737:chemistry / Q000235:genetics*; D007145:Immunoglobulin kappa-Chains / Q000235:genetics; D007146:Immunoglobulin lambda-Chains / Q000235:genetics; D008297:Male; D008875:Middle Aged; D010265:Paraproteinemias / Q000150:complications / Q000235:genetics* / Q000378:metabolism; D011115:Polyneuropathies / Q000150:complications / Q000235:genetics* / Q000378:metabolism; D017422:Sequence Analysis, DNA
chemical_list: D007075:Immunoglobulin M; D007145:Immunoglobulin kappa-Chains; D007146:Immunoglobulin lambda-Chains