Identification and Properties of Glycated Monoclonal IgA That Affect the Fructosamine Assay

Fujita, Kiyotaka; Curtiss, Linda K.; Sakurabayashi, Ikunosuke; Kameko, Fumiko; Okumura, Nobuo; Terasawa, Fumiko; Tozuka, Minoru; Katsuyama, Tsutomu

doi:10.1373/49.5.805

Cited by 8 publications

(8 citation statements)

References 21 publications

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“…Monoclonal IgA band from these patients with IgA-albumin complexes were glycated as well as the albumin band 6) . These serum fructosamine concentrations were 5.18±2.53 mmol/L, which extremely exceeded our reference interval (1.94-3.16 mmol/L).…”

Section: Subjectsmentioning

confidence: 91%

“…We recently demonstrated that this is the result of an increase of glycated monoclonal IgA, and that a major factor in causing the glycation of IgA is the increase of the monoclonal IgA molecules which bind to albumin 5,6) . In this previous report, we showed that the fructosamine concentrations of patients with IgA type M-proteinemia were significantly higher than the fructosamine concentrations of patients with IgG or IgM type M-proteinemia, or with polyclonal hyper IgA.…”

Section: Montagna Et Almentioning

confidence: 99%

“…However, it has been reported that the presence of a monoclonal IgA has a marked effect on the serum fructosmine assay [3][4][5][6] . With the fructosmine staining technique after electrophoresis, we demonstrated for the first time that this is the result of an increase of glycated monoclonal IgA, and that a major factor in causing the glycation of IgA is the increase of the monoclonal IgA molecules which bind to albumin 6) . However, it is not clear the mechanism of IgA-albumin complex formation.…”

Section: Introductionmentioning

confidence: 99%

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Mechanism of IgA-albumin complex formation that affects the fructosamine assay

et al. 2006

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SUMMARYWe recently demonstrated glycation of monoclonal IgA and the presence of IgA-albumin complexes, but the mechanism of IgA-albumin complex formation was not clear. We isolated the IgA-albumin complexes from 5 IgA type M-proteinemia patients' sera. To elucidate the mechanism of IgA-albumin complex formation, we performed the dissociation assay of IgA-albumin complexes, the identification of albumin binding sites of monoclonal IgA using immunoelectrophoresis, western blotting and chromatography technologies. In all patients with IgA type M-proteinemia, the IgA-albumin complexes were dissociated by treated with 2-mercaptoethanol (2-ME), but not by treated with a strong acid as acetic acid or NaCl of high concentrations. Moreover, when the purified monoclonal IgA containing IgA-albumin complexes was digested with the IgA protease from Neisseria gonorrhoeae, no macro-albumin was demonstrated. It seems probable that albumin is bound to the monoclonal IgA molecule by covalent disulfide bonds, and that the binding site of albumin is located in near the hinge region of IgA molecule and involve the free SH group thought to be present in the α-chain.

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Section: Subjectsmentioning

confidence: 91%

Section: Montagna Et Almentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mechanism of IgA-albumin complex formation that affects the fructosamine assay

et al. 2006

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“…An inflammatory state, as is seen in hypothyroidism, adds to the generation of free radicals and the resultant ill effects of the same. When Segadeet al, [11], and Fujitaet al, [12], studied the effects of different serum proteins on the fructosamine concentration, they found a significant correlation, not only with albumin, but also with the β and γ globulins, IgG, IgA, IgM and the total protein concentration. Any inflammatory process triggers the γ -globulin synthesis.…”

Section: Resultsmentioning

confidence: 99%

Altred Fructosamine and Lipid Fractions in Subclinical Hypothyroidism

Udupa

Manjrekar

Udupa

et al. 2013

JCDR

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Background: Thyroid function disorders lead to changes in the lipoprotein metabolism.Objectives: To study the lipid and the glycaemic abnormalities in the subclinical hypothyroidism cases and to compare the same with the euthyroid, overt hypothyroid and the hyperthyroid subjects.Methodology: Four groups, euthyroid (Group-I), hypothyroid (Group-II), subclinical hypothyroid (Group-III) and hyperthyroid (Group-IV), which consisted of 30 subjects each, of either sex, who were aged 25-55 years, underwent Fasting Plasma Glucose (FPG), fructosamine, lipid profile and total T3, T4 and TSH estimations. The subjects who were on lipid lowering or thyroid disorder drugs and known diabetics were excluded from the study. Results:In Group-III, all the lipid fractions were comparable to those of Group-II and they were significantly deranged, as compared to those of Group-I. The fructosamine levels were significantly higher in Group-II and Group-III (p<0.05), but the subclinical hypothyroid pool had statistically lower levels than the hypothyroid pool (376.63±54.73, 587.80±65.10). In the Group-IV patients, the LDL-C levels were significantly higher as compared to those in the euthyroid pool. The fructosamine levels were significantly lower in comparison with both the euthyroid and the hypothyroid pools (both in Groups-II and III). The FPG levels were higher in all the classes of the thyroid abnormalities (subclinical hypothyroidnot significant) but within the reference range of 70-100mg/dl.

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“…In human medicine, it is well established that elevated IgA has to be taken into consideration when interpreting fructosamine to avoid misinterpretations. No such effect is seen in patients with elevated polyclonal IgA and monoclonal IgG or IgM myeloma patients [1,2]. …”

Section: Case Nomentioning

confidence: 99%

Elevated fructosamine concentrations caused by IgA paraproteinemia in two dogs

et al. 2010

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An 8-year-old male Austrian Pinscher and a 14-year-old male Golden Retriever were presented for evaluation due to unexplainable high fructosamine values despite euglycemia and epistaxis in combination with polydipsia/polyuria, respectively. Blood analysis revealed severe hyperglobulinemia, hypoalbuminemia and markedly elevated fructosamine concentrations in both dogs. Multiple myeloma with IgA-monoclonal gammopathy was diagnosed by serum and urine electrophoresis including immunodetection with an anti-dog IgA antibody and bone marrow aspirations. Diabetes mellitus was excluded by repeated plasma and urine glucose measurements. Fructosamine values were positively correlated with globulin, but negatively correlated with albumin concentrations. These cases suggest that, as in human patients, monoclonal IgA gammopathy should be considered as a possible differential diagnosis for dogs with high fructosamine concentrations.

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Identification and Properties of Glycated Monoclonal IgA That Affect the Fructosamine Assay

Cited by 8 publications

References 21 publications

Mechanism of IgA-albumin complex formation that affects the fructosamine assay

Mechanism of IgA-albumin complex formation that affects the fructosamine assay

Altred Fructosamine and Lipid Fractions in Subclinical Hypothyroidism

Elevated fructosamine concentrations caused by IgA paraproteinemia in two dogs

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