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Pika T.,III. Interni Klinika | Hermanova Z.,Ustav imunologie | Lochman P.,Oddeleni klinicke biochemie a imunogenetiky | Zapletalova J.,Ustav lekarske biofyziky | And 3 more authors.
Klinicka Biochemie a Metabolismus

Objective: Typical features of monoclonal gammopathy (MG) include the presence of monoclonal immunoglobulin (MIG) molecules or their fragments in the serum and/or urine. The latest test which extends the range of MIG examination possibilities is the HevyLite™ system, using principally a couple of specific antibodies against junctional epitopes between the domains of heavy and light immunoglobulin chains in constant regions. The study aimed at implementing the HevyLite™ system and performing a pilot analysis in the group of IgA-type MG patients. Settings: Department of Internal Medicine III, University Hospital Olomouc. Material and methods: The studied group consisted of 24 patients with multiple myeloma (MM) and 7 individuals with monoclonal gammopathy of undetermined significance (MGUS). The HevyLite™ system (The Binding Site, UK) was used to determine the serum levels of IgAκ, IgAλ as well as the BN II analyser (Siemens Healthcare Diagnostics). The ratio of IgAκ/IgAλ was determined by calculation. Results: The patients in the active disease stage revealed highly pathological levels of the dominant MIG, with suppressed levels of the alternative IgA immunoglobulin, and significant influence on the IgAκ/IgAλ ratio. 5 out of the 6 patients who had achieved a complete remission showed a normal IgAκ/IgAλ ratio, 1 patient had suppression of both IgA with a modified IgAκ/IgAλ ratio. All individuals with MGUS revealed abnormal levels as well as ratio of IgAκ/IgAλ, one patient with a low-risk disease type had the IgAκ/IgAλ ratio value slightly above the threshold. When comparing the results of M-protein determination by the method of HevyLite™ and electrophoresis, Spearman's correlation analysis confirmed a very close correlation of M-protein levels regarding IgAκ (r = 0.946, p < 0.0001) as well as IgAλ (r = 0.872, p = 0.0001). The summations of the dominant as well as alternative IgA immunoglobulin levels substantially correlated with the general level of IgA immunoglobulin determined nephelometrically (r = 0.994, p < 0.0001). Conclusion: It seems, that the HevyLite™ system promisingly complements the set of examinations used routinely by MG monitoring, in particular by very low concentrations of MIG, or the mere positivity of the immunofixation electrophoresis. Further experience needs to be gained in order to fully assess the benefits of this examination for clinical practice. Source

Taborsky M.,I. interni klinika | Ost'Adal P.,Kardiologicke Oddeleni | Petrek M.,Oddeleni klinicke biochemie a imunogenetiky | Heinc P.,I. interni klinika | And 3 more authors.
Kardiologicka Revue

Mild alcohol consumption decreases cardiovascular morbidity and mortality as well as it reduces total mortality. Although regular intake of any type of alcoholic beverage appears to have positive influence on health, additional benefits are thought to be associated with wine, particularly red wine. The beneficial effect of wine is ascribed to the presence of ethanol and phenolic substances. This overview is dedicated to epidemiology of coronary artery disease (CAD) and wine consumption, as well as the underlying mechanisms of the biological effects of wine compounds on CAD. Source

Pika T.,III. interni klinika nefrologicka | Minarik J.,III. interni klinika nefrologicka | Lochman P.,Oddeleni klinicke biochemie a imunogenetiky | Bacovsky J.,III. interni klinika nefrologicka | Scudla V.,III. interni klinika nefrologicka
Transfuze a Hematologie Dnes

Introduction. Monoclonal gammopathy of undetermined significance (MGUS) is a potentially malignant condition associated with a certain degree of probable transformation into one of the malignant forms of monoclonal gammopathy (MG). Identifying possible predictive factors of malignant evolution is the focus of several research centres. Determining serum levels of free light chains (FLC) appears to be a relatively significant parameter, enabling the identification of persons at higher risk of malignant transformation. The report aims to present our own experience with determining FLC serum levels in a group of individuals with MGUS. Group and results. The monitored group numbered 191 persons with MGUS. Abnormal κ or λ FLC levels were detected in 119 (62.3%), and pathological values of the κ/λ index in 106 (55.5%) patients. During the six years of monitoring, 11 (5.7%) persons in total experienced transformation into a malignant form of MG, which corresponds approximately to a transformation rate of 0.95%/year in the whole group. Using the stratification system for MGUS based on the combination of quantity, monoclonal immunoglobulin isotype and the κ/λ index value, there were 56 (29.3%) persons in the low-risk group, 87 (45.5%) in the low-intermediate risk group, 45 (23.6%) in the high-intermediate risk group, and only 3 persons (1.6%) in the high-risk group. The transformation percentage for the individual groups corresponded to 0 vs. 4.5 vs. 13.3 vs. 33.3% over the course of 6 years. MGUS evolution was associated with increasing FLC levels and a change in the κ/λ index. Conclusion. The survey results have confirmed the practical benefits of testing FLC serum levels in persons with MGUS, particularly the positive contribution to risk stratification with identification of MGUS high risk forms, allowing early detection of malignant evolution and immediate initiation of adequate treatment. Source

Hermanova Z.,Ustav imunologie | Pika T.,III. interni klinika nefrologicka | Lochman P.,Oddeleni klinicke biochemie a imunogenetiky | Scudla V.,III. interni klinika nefrologicka
Klinicka Biochemie a Metabolismus

Objective: The B cell activating factor (BAFF) is an important protein influencing not only maturation, activation and survival of B lymphocytes and plasma cells but also malignant plasma cells. In the pilot study we compared the concentration of BAFF in the groups of patients with various types of monoclonal gammopathies. Material and methods: We investigated 66 samples of 58 patients with monoclonal gammopathies (MG). 5 patients had Waldenstrom's macroglobulinemia (MW), 10 patients monoclonal gammopathy of undetermined significance (MGUS), 51 samples were from patients with multiple myeloma (MM) - 16 MM at remission, 27 MM at time of diagnosis, 8 MM at relapse. Paired analysis was used at 8 patients with MM at time of diagnosis and MM at remission. The ELISA kit was used to determine serum levels of BAFF protein. Mann - Whitney test, Wilcoxon paired test and Spearman's correlation analysis were used for statistical calculation. Results: The concentrations of BAFF in each group were: MM at remission 2520 ng/l, MM at time of diagnosis 204 ng/l, MM at relapse 331 ng/l, MGUS 257 ng/l, MW 120 ng/l. The values of BAFF protein at MM at remission were statistically significantly higher than the values at all the others groups : MM at time of diagnosis (p < 0,0001), MM at relapse (p = 0,0001), MGUS (p < 0,0001), MW (p = 0,001). Patients in the group with MM at relapse had statistically significantly higher BAFF concentration than in the group with MM at time of diagnosis. Spearman's correlation analysis revealed negative medium strong correlation between the concentration of BAFF and patient's age in the group with MM at time of diagnosis. Conclusion: The highest concentration of BAFF protein was found in the group of patients with MM at remission and it was opposite to literature data and our expectation. It is probable that results of BAFF analysis should be considered in the context of other parameters. Source

Free monoclonal immunoglobulin light chains (FLC) quantification is recommended for diagnosis assessment and monitoring therapy for patients with monoclonal gammopathy. But there are numerous uncertainties regarding the detection, interpretation and FLC quantification. Our interlaboratory study showed that kappa/lambda ratio is strongly influenced by measurement errors and therefore we recommended the preferential use of FLC concentration values. Unified protocols are needed to minimise interlaboratory variability introduced by manual dilution or volume augmentation of clinical sample. Source

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