Challenges of measuring monoclonal proteins in serum

Clinical Chemistry and Laboratory Medicine : CCLM
D F Keren, Lee Schroeder

Abstract

The measurement of monoclonal protein (M-protein) is vital for stratifying risk and following individuals with a variety of monoclonal gammopathies. Direct measurement of the M-protein spike by electrophoresis and immunochemical measurements of specific isotypes or free light chains pairs has provided useful information about the quantity of M-protein. Nonetheless, both traditional electrophoresis and immunochemical methods give poor quantification with M-proteins smaller than 10 g/L (1 g/dL) when in the presence of polyclonal immunoglobulins that co-migrate with the M-protein. In addition, measurements by electrophoresis of M-proteins migrating in the β- and α-regions are contaminated by normal serum proteins in those regions. The most precise electrophoretic method to date for quantification involves exclusion of the polyclonal immunoglobulins by using the tangent skimming method on electropherograms, which provides a 10-fold improvement in precision. So far, however, tangent measurements are limited to γ migrating M-proteins. Another way to improve M-protein measurements is the use of capillary electrophoresis (CE). With CE, one can employ immunosubtraction to select a region of interest in the β region thereby excluding muc...Continue Reading

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Citations

Dec 22, 2017·Archives of Pathology & Laboratory Medicine·Jonathan R GenzenMohammad Q Ansari
Jan 12, 2020·Clinical Chemistry and Laboratory Medicine : CCLM·Mario Plebani
Mar 20, 2020·Clinical Chemistry and Laboratory Medicine : CCLM·Gian Luca SalvagnoGiuseppe Lippi
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May 1, 2018·The Journal of Applied Laboratory Medicine·Lee F SchroederDavid F Keren

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Methods Mentioned

BETA
electrophoresis

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