Monoclonal antibody therapeutics as potential interferences on protein electrophoresis and immunofixation

Clinical Chemistry and Laboratory Medicine : CCLM
Maria A V WillrichMelissa R Snyder

Abstract

The use of therapeutic recombinant monoclonal antibodies (mAbs) has triggered concerns of mis-diagnosis of a plasma cell dyscrasia in treated patients. The purpose of this study is to determine if infliximab (INF), adalimumab (ADA), eculizumab (ECU), vedolizumab (VEDO), and rituximab (RITU) are detected as monoclonal proteins by serum protein electrophoresis (SPEP) and immunofixation electrophoresis (IFE). Pooled normal sera were spiked with various concentrations (ranging from trough to peak) of INF, ADA, ECU, VEDO and RITU. The peak concentration for VEDO and RITU was also added to samples with known monoclonal gammopathies. All samples were analyzed by SPEP (Helena Laboratories) and IFE (Sebia); sera containing peak concentrations of mAbs were reflexed to electrospray-time-of-flight mass spectrometry (AbSciex Triple TOF 5600) for the intact light chain monoclonal immunoglobulin rapid accurate mass measurement (miRAMM). For all mAbs tested, no quantifiable M-spikes were observed by SPEP at any concentration analyzed. Small γ fraction abnormalities were noted on SPEP for VEDO at 300 μg/mL and RITU at 400 μg/mL, with identification of small IgG κ proteins on IFE. Using miRAMM for peak samples, therapeutic mAbs light chain accur...Continue Reading

References

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Jul 27, 2015·International Immunopharmacology·Maria Alice V WillrichMelissa R Snyder

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Citations

Dec 22, 2017·Archives of Pathology & Laboratory Medicine·Jonathan R GenzenMohammad Q Ansari
Nov 1, 2018·Clinical Chemistry·Eszter Lázár-Molnár, Julio C Delgado
Oct 23, 2019·The Journal of Applied Laboratory Medicine·Katie L ThorenLakshmi V Ramanathan
Jan 26, 2021·Practical Laboratory Medicine·José María Gastélum-CanoMarcela Deffis-Court
Mar 11, 2021·Clinical Biochemistry·Mindy C KohlhagenDavid L Murray
May 23, 2021·Clinics in Laboratory Medicine·David L Murray, Surendra Dasari
Jan 1, 2020·Expert Review of Precision Medicine and Drug Development·Matthew HoKenneth C Anderson
Aug 24, 2021·Tierärztliche Praxis. Ausgabe K, Kleintiere/Heimtiere·Neoklis ApostolopoulosUrsula Mayer
Jul 3, 2021·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Mariya LiyasovaSuzanne Trudel

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Methods Mentioned

BETA
electrophoresis
ELISA

Software Mentioned

Analyst TF
miRAMM
Analyst

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