Electrophoretic analysis of enzyme-linked immunoglobulins and their clinical significance

Lactate dehydrogenase-linked immunoglobulin Akappa in a patient with nonimmune chronic idiopathic neutropenia

A 39-year-old patient with cervical cancer, stage Ia, was successfully treated by total hysterectomy. Then, after sustained neutropenia for more than 4 years and coincident with its exacerbation, the serum lactate dehydrogenase (LD) level started to elevate and reached a plateau. A test for antineutrophil antibody was negative and LD-3-linked IgAkappa, which may be responsible for high LD activity, was confirmed. The absolute number of blood NK cells was reduced, and a diagnosis of nonimmune chronic idiopathic neutropenia of adult was made. The successive occurrence of these 3 disorders may be based on interrelated immunological abnormalities.

Hydrolases acting on glycosidic bonds: chromatographic and electrophoretic separations

We describe analyses of unusual human alpha-amylase, performed in our laboratory and review available methods for amylase study. Electrophoretic and chromatographic methods provide an effective means for the analysis of amylase isoenzymes and unusual amylase. The recent identification of a selective inhibitor and a monoclonal antibody to amylase isoenzyme contributes to rapid routine clinical assays of amylase isoenzymes. However unusual amylases such as variants, macroamylasemia and sialyl salivary-type amylasemia cannot be detected by those conventional methods. The unusual amylases can only be detected by electrophoresis and can be easily characterized by combination study with chromatographic methods. Electrophoretic and chromatographic methods are universal means to validate unusual amylases found in patient sera. Further basal studies are needed to define the roles of salivary amylase in exocrine fluids using those separation techniques.

Aspartate aminotransferase-linked immunoglobulin complexes in serum of a patient with primary biliary cirrhosis

A 51-year-old woman who had been treated for primary biliary cirrhosis (PBC) was admitted to our hospital for evaluation of unexplained, isolated, persistently increased aspartate aminotransferase (AST) activity. Results of laboratory tests on admission showed: AST 171 KU, alanine aminotransferase 28 KU, and anti-mitochondrial titer 1/1280. Results of hepatitis B surface antigen (HBs Ag) and hepatitis C virus antibody (HCV Ab; C100-3) assays were negative. Histology of a liver biopsy specimen was compatible with a diagnosis of PBC (stage III of Scheuer's classification). The molecular size of serum AST was estimated to be more than 500,000 by high-performance size-exclusion liquid chromatography. Electrophoretic analysis showed an abnormal band of AST between supernatant AST (sAST) and mitochondrial AST (mAST), which band was characteristic of AST-immunoglobulin complexes (AST-Ig). Ouchterlony double-diffusion and immunoprecipitation tests identified the immunoglobulin component as IgM. The presence of AST-Ig appeared to be responsible for the elevated serum AST.