No abstract

Monoclonal gammapathies are a group of diseases characterized by proliferation of plasma clone cells that produce a certain type of homogenic immunoglobulin containing heavy chains of a, g, m, d, e class aside a type of light k or l chains. Standard methods applied to detect and identify the type of monoclonal protein in patients suspected of monoclonal gammapathy include serum electrophoresis and immunofixation. Quantitative analysis of free light chains (FLCs) by nephelometry has become more popular recently. The purpose of the study was to compare the results and assess the compatibility of free light chains measurements obtained by nephelometry and standard immunofixation. In addition to that, we tried to evaluate the usefulness of serum FLC analysis in the detection of monoclonal protein. The investigation was carried out in the group of 92 patients with suspected monoclonal gammapathy. In most cases concentrations of FLCs are increased depending on the type of light chain determined by immunofixation, however normal values of FLCs and normal kappa/lambda ratio do not exclude the presence of monoclonal protein. The analysis of FLC is most useful to identify patients suspected of light chain disease. Immunofixation is more sensitive method to detect gammapathies with complete monoclonal protein in comparison to quantitative FLC analysis.

With the increasing importance of early type 2 diabetes (DM2) and obesity detection, it is useful to reevaluate leptin role in these conditions. Our study aimed at investigating circulating leptin concentrations in a group of patients with DM2, and at assessing in detail whether leptin concentrations correlate with selected biochemical, clinical parameters and markers of systemic inflammation in patients with DM2 and in healthy volunteers. In our work, we analysed samples and data drawn from 71 patients aged 61.4 ± 11.7 years, who have been diagnosed with type 2 diabetes, as well as from a healthy control group (HC) consisting of 51 healthy subjects with a mean age of 57.8 ± 13.7 years. Therein, the concentration of leptin in the DM2 patients was significantly higher than in the HC (p < 0.01), with median value of 16.59 (IQR 8.58-33.39) ng/ml in the DM2, vs median value of 6.66 (IQR 4.52-21.40) ng/ml in the HC. In the analysis of variance, higher leptin concentrations were revealed in the DM2 group as compared to the HC, and this figure remained significant after adjusting for gender and age (p < 0.001). Moreover, it was independent of HOMA-IR (p = 0.003). However, the differences in leptin levels between the groups disappeared when additional adjustments for anthropometric parameters (BMI, waist circumference) were applied (p = 0.088). Beyond the aforementioned, significant positive correlations were found in the DM 2 group between leptin level and CRP (r=0.256; p < 0.05) and IL-6 (r = 0.345; p < 0.01). Among the selected variables, only gender and BMI were included in the predictive model explaining the variability of leptin, and, in total, were responsible for 72.6% of the original variation of the studied adipocytokine. The results of this study have led to conclusion that leptin may participate in the complex pathogenesis of DM2 and be a predictor of the development of this disease. As higher concentrations of leptin coexist with obesity, and this situation correlates positively with markers of inflammation (CRP, IL-6), leptin level, hence, should be considered in the pathogenesis of DM2.

Determination of FLCs in the blood serum has been useful to diagnose patients with monoclonal gammapathies. Besides, the test has been widely used to assess response to treatment and detect progressive conditions. In the course of gammapathy monoclonal light chains constitute homogenic population of chains made of kappa and lambda light immunoglobulins produced by malignant plasmocytes and/or B lymphocytes. Quantitative analysis of FLC by nephelometry and turbidimetry uses specific antibodies which recognize antigenic determiners of light chains. The purpose of our investigation was to compare nephelometric and turbidimetric methods applied in FLC determinations. Comparative determinations were done in the group of 64 patients suspected of monoclonal gammapathy: 30 females (mean age 66yrs) and 34 males (mean age 64yrs). The analysis of results let conclude that nephelometric and turbidimetric techniques applied to determine kappa and lambda free light chains have comparable diagnostic value.

Electrophoresis is a basic technique used to identify disorders of blood serum protein fractions. Agarose gel is the most frequently used medium for routine protein separations. However, capillary electrophoresis seems to be an attractive alternative to gel electrophoresis. The article presents the results of comparative analysis of two systems (Sebia): Hydrasys designed for electrophoretic separations on agarose gel and Minicap for capillary electrophoresis. The purpose of study was to evaluate comparatively the concentrations of each serum protein fraction obtained by gel and capillary electrophoresis and to analyze the correlations between the results obtained by those two systems depending on the concentrations of each protein fraction. The study was carried out in the group of 98 patients, 46 females and 52 males. Despite slight quantitative differences in certain fractions obtained by both methods, capillary electrophoresis offers a fully automatic process of analysis, high speed and efficiency which proves that capillary electrophoresis is appropriate alternative to gel electrophoresis.