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Hayes AM, Kastl B, Perry E, Moore AR, Springer NL. Multiple myeloma presenting as blepharitis in a horse. Vet Clin Pathol 2023; 52:514-520. [PMID: 37248209 DOI: 10.1111/vcp.13227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/21/2022] [Accepted: 12/07/2022] [Indexed: 05/31/2023]
Abstract
Myeloma-related disorders, including multiple myeloma, extramedullary plasmacytoma, and solid osseous plasmacytoma, are rare in horses. Clinical complaints for myeloma-related disorders are nonspecific, and when present, M-protein location is more variable on protein electrophoresis in horses relative to dogs and cats. Here, we describe a case of a 15-year-old Thoroughbred mare who presented with recurrent blepharitis. Marked hyperglobulinemia was an incidental finding on routine hematologic and biochemical testing. Bone marrow aspiration consisted of >30% plasma cells, and serum protein electrophoresis demonstrated a monoclonal gammopathy in the alpha 2 fraction leading to a diagnosis of multiple myeloma. Immunofixation and radial immunodiffusion confirmed the presence of an IgG M-protein. Based on a restricted peak in the alpha 2 location, the specific M-protein is suspected to be IgG(T), an IgG isotype unique to horses. M-protein migration in horses is variable relative to dogs and cats, yet immunofixation can still be used to identify equine IgG M-protein isotypes. The unique clinical presentation in this case also serves as a reminder to consider neoplasia in horses with unusual or nonspecific clinical signs.
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Affiliation(s)
- Allison M Hayes
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, Kansas, USA
| | - Brandy Kastl
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, Kansas, USA
| | | | - A Russell Moore
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, USA
| | - Nora L Springer
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, Kansas, USA
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2
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Moore AR, Brown K, Chapman C, Broeckling C. Mass spectrometric-based assessment of the serum kappa to lambda immunoglobulin light chain ratio (κ:λ) in dogs with immunoglobulin secretory diseases. Vet Comp Oncol 2023; 21:460-468. [PMID: 37154287 DOI: 10.1111/vco.12905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/21/2023] [Accepted: 04/25/2023] [Indexed: 05/10/2023]
Abstract
The ratio of κ light chains to λ light chains (κ:λ) in serum is used as a biomarker of immunoglobulin secreting neoplasia in humans but has not been evaluated in dogs. A mass-spectrometry based method for determining the canine serum κ:λ was developed and used to evaluate samples from control dogs, dogs with an infectious aetiology, dogs with secretory plasma cell tumours (sPCT) and dogs with non-secretory B cell neoplasia. A human-targeted immunoturbidometric κ:λ assay and immunofixation using antisera targeting human κ light chain or λ light chain was also performed on all samples. Using whole serum samples, the MS-based κ:λ method identified 5 sPCT as κ-predominant (mean κ:λ = 3.307) and 5 sPCT as λ-predominant (mean κ:λ = 0.023) and documented differences between these groups and all other groups (p < 0.05 for all). The infectious aetiology group had a lower mean κ:λ ratio (mean κ:λ = 0.069) than control samples (mean κ:λ = 0.103, p = 0.035). Similar results were obtained when samples were enriched for proteins between 10 and 50 kDa using size exclusion chromatography, except for the statistical difference between the control and infectious aetiology group. All λ-predominant cases had only anti-human λ light chain labelling by immunofixation. Three κ-predominant cases had only anti-human κ-light chain labelling and the remaining two cases did not label with either antisera by immunofixation. The immunoturbidometric method had high analytical CV% (λ light chain CV = 13%, κ light chain CV = 50%), was unable to measure light chains in 20.5% of samples and did not distinguish groups. The data suggests that the human-targeted immunoturbidometric method would not be diagnostically useful and that the MS-derived serum κ:λ may be a useful biomarker of canine immunoglobulin secretory neoplasia which may have the ability to distinguish neoplasia from infectious causes of immunoglobulin secretion.
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Affiliation(s)
- A Russell Moore
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, USA
| | - Kitty Brown
- Analytical Resources Core-Bioanalysis and Omics, Colorado State University, Fort Collins, Colorado, USA
| | - Cecelia Chapman
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, USA
| | - Corey Broeckling
- Analytical Resources Core-Bioanalysis and Omics, Colorado State University, Fort Collins, Colorado, USA
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Guerlin M, Mourou K, Martini V, Soetart N, Comazzi S, Trumel C, Granat F. Waldenström's Macroglobulinemia in a Normoproteinemic Dog with Atypical Bimorphic Plasmacytoid Differentiation and Monoclonal Gammopathy. Vet Sci 2023; 10:vetsci10050355. [PMID: 37235438 DOI: 10.3390/vetsci10050355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/02/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
A 2-year-old neutered female Small Munsterlander dog was presented for an insect bite. Physical examination revealed a poor body condition, a peripheral lymphadenomegaly, and suspected splenomegaly. A complete blood count (Sysmex XN-V) revealed marked leukocytosis with lymphocytosis and abnormal dot plots. An abnormal monomorphic lymphoid population and marked rouleaux formation were noted on the blood smear. Lymph node aspirates contained an atypical bimorphic population of lymphocytes, either with a plasmacytoid or a blastic appearance. This double population was also found in the spleen, liver, bone marrow, tonsils, and other tissues. Peripheral blood and lymph node clonality assays revealed clonal BCR gene rearrangement. Flow cytometry revealed a mixed population of small-sized B-cells (CD79a+ CD21+ MHCII+) and medium-sized B-cells (CD79a+ CD21- MHCII-) in lymph nodes and a dominant population of small-sized mature B-cells (CD21+ MHCII+) in peripheral blood. Though normoproteinemic, serum protein electrophoresis revealed an increased α2-globulin fraction with an atypical restricted peak, identified as monoclonal IgM by immunofixation. Urine protein immunofixation revealed a Bence-Jones proteinuria. A diagnosis of Waldenström's macroglobulinemia was made. Chemotherapy was initiated, but the dog was euthanized 12 months after the initial presentation due to marked clinical degradation.
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Affiliation(s)
- Maud Guerlin
- Département des Sciences Cliniques des Animaux de Compagnie et de Sport, Université de Toulouse, ENVT, 31000 Toulouse, France
- CREFRE, Université de Toulouse, INSERM, ENVT, UPS, 31000 Toulouse, France
| | - Kévin Mourou
- Département des Animaux de Compagnie, Université de Lyon, VetAgro Sup, Marcy L'Etoile, 69007 Lyon, France
| | - Valeria Martini
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Via dell'Università 6, 26900 Lodi, Italy
| | - Nicolas Soetart
- LabOniris-Department of Biology, Pathology and Food Science, Oniris-Nantes Atlantic National College of Veterinary Medicine, Food Science and Engineering, 44300 Nantes, France
| | - Stefano Comazzi
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Via dell'Università 6, 26900 Lodi, Italy
| | - Catherine Trumel
- Département des Sciences Cliniques des Animaux de Compagnie et de Sport, Université de Toulouse, ENVT, 31000 Toulouse, France
- CREFRE, Université de Toulouse, INSERM, ENVT, UPS, 31000 Toulouse, France
| | - Fanny Granat
- Département des Sciences Cliniques des Animaux de Compagnie et de Sport, Université de Toulouse, ENVT, 31000 Toulouse, France
- CRCT, Université de Toulouse, INSERM, UMR 1037, ENVT, 31000 Toulouse, France
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4
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Hughes KL, Rout ED, Avery PR, Pavuk AA, Avery AC, Moore AR. A series of heterogeneous lymphoproliferative diseases with CD3 and MUM1 co-expressed in cats and dogs. J Vet Diagn Invest 2023; 35:22-33. [PMID: 36424869 PMCID: PMC9751460 DOI: 10.1177/10406387221139799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Lymphoma diagnosis in dogs and cats is continually evolving as new subtypes and human correlates are being recognized. In humans, T-cell lymphomas with MUM1 expressed and plasma cell neoplasia or B-cell lymphomas with CD3 expressed aberrantly are reported only rarely. We report here a case series of tumors in dogs and cats with CD3 and MUM1 co-expressed as determined by immunocytochemistry or immunohistochemistry. Lineage was assigned for these tumors by 3 board-certified pathologists and a veterinary immunologist based on review of clinical and cellular features and the results of ancillary testing including PCR for antigen receptor rearrangements, flow cytometry, and serum protein electrophoresis with immunofixation. In cats, 7 of 7 tumors, and in dogs, 3 of 6 tumors with CD3 and MUM1 co-expressed had clonal rearrangement of the immunoglobulin gene or serum monoclonal immunoglobulin, consistent with a diagnosis of a plasma cell neoplasia or myeloma-related disorder with CD3 expressed aberrantly. Disease was often disseminated; notably, 3 of 7 feline cases had cutaneous and/or subcutaneous involvement in the tarsal area. In dogs, 3 of 6 cases had a clonal T-cell receptor gamma result and no clonal immunoglobulin gene rearrangement and were diagnosed as a T-cell tumor with MUM1 expressed. The use of multiple testing modalities in our series of tumors with plasma-cell and T-cell antigens in dogs and cats aided in the comprehensive identification of the lymphoproliferative disease subtype.
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Affiliation(s)
- Kelly L. Hughes
- Department of Microbiology, Immunology, Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Emily D. Rout
- Department of Microbiology, Immunology, Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Paul R. Avery
- Department of Microbiology, Immunology, Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | | | - Anne C. Avery
- Department of Microbiology, Immunology, Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - A Russell Moore
- Department of Microbiology, Immunology, Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
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Tovar-Lopez G, Evans S, Muñoz Gutiérrez JF, Moore AR, Sadar MJ. Multiple Myeloma with Aberrant CD3 Expression in a Red-Lored Amazon Parrot (Amazona autumnalis). J Avian Med Surg 2022; 36:316-324. [DOI: 10.1647/21-00019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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6
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Harris RA, Gary EB, Rout ED, Avery AC, Moore AR. Detection and Characterization of Paraproteinemia in Canine Chronic B-cell Lymphocytic Leukemia Using Routine and Free Light Chain Immunofixation. Vet Clin Pathol 2022; 51:551-559. [PMID: 35883213 PMCID: PMC10087490 DOI: 10.1111/vcp.13156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 04/14/2022] [Accepted: 05/02/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hyperglobulinemia is reported in 26% of canine chronic B-cell lymphocytic leukemia (B-CLL) cases. However, few cases have been characterized by protein electrophoresis and immunofixation (IF), and the incidence of a monoclonal protein (M-protein) is unknown using these techniques. OBJECTIVE To characterize and determine the proportion of canine B-CLL cases with an M-protein using plasma protein electrophoresis (PPE), routine and free light chain (fLC) IF, and to assess if productive B-CLL cases express MUM1/IRF4 by cell tube block (CTB). METHODS PPE, routine (targeting IgG, IgA, IgM, IgG4, and light chain) and fLC IF were performed using 48 dog B-CLL plasma samples from patients diagnosed via peripheral blood flow cytometry. CTB was performed on a separate cohort of 15 patients. RESULTS Hyperproteinemia (>7.5 g/dL) was present in 17/48 cases (35%). An M-protein was detected in 32/48 cases (67%). Of these, 19/32 cases (59%) had only complete (monoclonal heavy and light chain) M-proteins detected, 10/32 cases (31%) had both complete and fLC M-proteins detected, and 3/32 cases (9%) had only an fLC M-protein detected. IgM was the most common clonal immunoglobulin isotype detected (23 cases). CD21+ cell counts were higher in cases with detectable M-protein. Plasma fLC IF suggested β-γ region interference, likely caused by clotting proteins. All B-CLL cases consistently expressed PAX5 and did not express MUM1/IRF4. CONCLUSIONS Most B-CLL cases had an M-protein and were not hyperproteinemic. Most cases with paraproteins had a complete IgM monoclonal gammopathy; a subset had documented fLCs. The prognostic significance of heavy and fLC presence should be evaluated.
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Affiliation(s)
- R Adam Harris
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, USA
| | - Erik B Gary
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, USA
| | - Emily D Rout
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, USA
| | - Anne C Avery
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, USA
| | - A Russell Moore
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, USA
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Bizikova P, Linder KE, Mamo LB. Trunk-dominant and classic facial pemphigus foliaceus in dogs - comparison of anti-desmocollin-1 and anti-desmoglein-1 autoantibodies and clinical presentations. Vet Dermatol 2022; 33:414-425. [PMID: 35670648 DOI: 10.1111/vde.13094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 01/25/2022] [Accepted: 03/15/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Canine trunk-dominant pemphigus foliaceus (PF) is mentioned rarely in the literature. HYPOTHESIS/OBJECTIVES The goal of this study was to provide clinical description of trunk-dominant PF and to demonstrate the prevalence of serum antikeratinocyte, anti-desmocollin-1 (DSC1) and anti-desmoglein-1 (DSG1) antibodies, and determine their diagnostic value in this particular PF phenotype. MATERIALS AND METHODS Clinically relevant information was collected from 31, 25 and 34 dogs with trunk-dominant and facial PF and superficial pyoderma (SP), respectively. Sera from these dogs were tested for antikeratinocyte, anti-DSC1 and anti-DSG1 antibodies using indirect immunofluorescence on canine tissues and DSC1- and DSG1-transfected cells. Sera from healthy dogs and dogs with clinically irrelevant diseases served as controls. RESULTS Footpad involvement and grouped/polycyclic lesion organisation were identified as features of both PF phenotypes, and not of SP. Antikeratinocyte immunoglobulin (Ig)G was not specific for canine PF. By contrast, antigen-specific IgG was detected only in PF sera; anti-DSC1 IgG in 100% and 58% of dogs with facial and trunk-dominant PF, respectively, and anti-DSG1 IgG in 7% of dogs with trunk-dominant PF only. CONCLUSIONS Trunk-dominant PF shares DSC1 as a major autoantigen with facial PF. The ability to detect anti-DSC1 IgG is lower in trunk-dominant PF, yet despite the lower sensitivity, the positive predictive value and accuracy of this particular anti-DSC1 IgG test are high. A negative test result, however, cannot exclude the diagnosis, and characteristic clinical features such as footpad involvement and/or grouped/polycyclic lesions must be considered when distinguishing trunk-dominant PF from its most relevant differential diagnosis: SP.
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Affiliation(s)
- Petra Bizikova
- Department of Clinical Sciences, College of Veterinary Medicine, NC State University, Raleigh, NC, USA
| | - Keith E Linder
- Department of Population Health and Pathobiology, College of Veterinary Medicine, NC State University, Raleigh, NC, USA
| | - Lisa B Mamo
- Department of Clinical Sciences, College of Veterinary Medicine, NC State University, Raleigh, NC, USA
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Hullsiek R, Li Y, Snyder KM, Wang S, Di D, Borgatti A, Lee C, Moore PF, Zhu C, Fattori C, Modiano JF, Wu J, Walcheck B. Examination of IgG Fc Receptor CD16A and CD64 Expression by Canine Leukocytes and Their ADCC Activity in Engineered NK Cells. Front Immunol 2022; 13:841859. [PMID: 35281028 PMCID: PMC8907477 DOI: 10.3389/fimmu.2022.841859] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 01/31/2022] [Indexed: 12/15/2022] Open
Abstract
Human natural killer (NK) cells can target tumor cells in an antigen-specific manner by the recognition of cell bound antibodies. This process induces antibody-dependent cell-mediated cytotoxicity (ADCC) and is exclusively mediated by the low affinity IgG Fc receptor CD16A (FcγRIIIA). Exploiting ADCC by NK cells is a major area of emphasis for advancing cancer immunotherapies. CD64 (FcγRI) is the only high affinity IgG FcR and it binds to the same IgG isotypes as CD16A, but it is not expressed by human NK cells. We have generated engineered human NK cells expressing recombinant CD64 with the goal of increasing their ADCC potency. Preclinical testing of this approach is essential for establishing efficacy and safety of the engineered NK cells. The dog provides particular advantages as a model, which includes spontaneous development of cancer in the setting of an intact and outbred immune system. To advance this immunotherapy model, we cloned canine CD16A and CD64 and generated specific mAbs. We report here for the first time the expression patterns of these FcγRs on dog peripheral blood leukocytes. CD64 was expressed by neutrophils and monocytes, but not lymphocytes, while canine CD16A was expressed at high levels by a subset of monocytes and lymphocytes. These expression patterns are similar to that of human leukocytes. Based on phenotypic characteristics, the CD16A+ lymphocytes consisted of T cells (CD3+ CD8+ CD5dim α/β TCR+) and NK cells (CD3− CD5− CD94+), but not B cells. Interestingly, the majority of canine CD16A+ lymphocytes were from the T cell population. Like human CD16A, canine CD16A was downregulated by a disintegrin and metalloproteinase 17 (ADAM17) upon leukocyte activation, revealing a conserved means of regulation. We also directly demonstrate that both canine CD16A and CD64 can induce ADCC when expressed in the NK cell line NK-92. These findings pave the way to engineering canine NK cells or T cells with high affinity recombinant canine CD64 to maximize ADCC and to test their safety and efficacy to benefit both humans and dogs.
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Affiliation(s)
- Robert Hullsiek
- Department of Veterinary and Biomedical Sciences, University of Minnesota, St. Paul, MN, United States
| | - Yunfang Li
- Department of Veterinary and Biomedical Sciences, University of Minnesota, St. Paul, MN, United States
| | - Kristin M Snyder
- Department of Veterinary and Biomedical Sciences, University of Minnesota, St. Paul, MN, United States.,Animal Cancer Care and Research Program, University of Minnesota, St. Paul, MN, United States
| | - Sam Wang
- Department of Veterinary and Biomedical Sciences, University of Minnesota, St. Paul, MN, United States
| | - Da Di
- Department of Veterinary and Biomedical Sciences, University of Minnesota, St. Paul, MN, United States
| | - Antonella Borgatti
- Animal Cancer Care and Research Program, University of Minnesota, St. Paul, MN, United States.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, United States.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States.,Center for Immunology, University of Minnesota, Minneapolis, MN, United States.,Clinical Investigation Center, University of Minnesota, St. Paul, MN, United States
| | - Chae Lee
- Department of Veterinary and Biomedical Sciences, University of Minnesota, St. Paul, MN, United States
| | - Peter F Moore
- Department of Pathology, Microbiology, Immunology, School of Veterinary Medicine, University of California, Davis, CA, United States
| | - Cong Zhu
- Department of Veterinary and Biomedical Sciences, University of Minnesota, St. Paul, MN, United States
| | - Chiara Fattori
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, United States.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States
| | - Jaime F Modiano
- Animal Cancer Care and Research Program, University of Minnesota, St. Paul, MN, United States.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, United States.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States.,Center for Immunology, University of Minnesota, Minneapolis, MN, United States.,Stem Cell Institute, University of Minnesota, Minneapolis, MN, United States.,Institute for Engineering in Medicine, University of Minnesota, Minneapolis, MN, United States.,Department of Laboratory Medicine and Pathology, School of Medicine, University of Minnesota, Minneapolis, MN, United States
| | - Jianming Wu
- Department of Veterinary and Biomedical Sciences, University of Minnesota, St. Paul, MN, United States.,Animal Cancer Care and Research Program, University of Minnesota, St. Paul, MN, United States.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States
| | - Bruce Walcheck
- Department of Veterinary and Biomedical Sciences, University of Minnesota, St. Paul, MN, United States.,Animal Cancer Care and Research Program, University of Minnesota, St. Paul, MN, United States.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States.,Center for Immunology, University of Minnesota, Minneapolis, MN, United States.,Stem Cell Institute, University of Minnesota, Minneapolis, MN, United States
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Jeffries C, Moore AR, Schlemmer SN. Urinary bladder wall mass with neoplastic lymphoid cells in the urine: Diagnosis of an IgG secretory B-cell lymphoma with Bence-Jones proteinuria in a dog. Vet Clin Pathol 2022; 51:426-431. [PMID: 35488188 DOI: 10.1111/vcp.13102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/08/2021] [Accepted: 11/16/2021] [Indexed: 11/28/2022]
Abstract
In this study, we describe a multimodal approach to diagnose a unique case of myeloma-related disease, extranodal secretory B-cell lymphoma with urinary bladder involvement, an IgG4 monoclonal gammopathy, and Bence-Jones proteinuria in a dog with a 6-year history of hyperglobulinemia that had not been further evaluated. A 12-year-old dog was presented for evaluation of a 1-week history of tenesmus. Urine sediment cytologic evaluation revealed low to moderate numbers of intermediate to large-sized lymphocytes. We describe a technique that yielded adequate numbers of viable neoplastic cells in shipped urine sediment for PARR and flow cytometry. Those studies demonstrated a clonal immunoglobulin gene rearrangement and an expansion of CD21-positive and MHC Class II-negative B cells, respectively. Protein electrophoresis with immunofixation and proteomic evaluation revealed a serum and urine IgG4 monoclonal gammopathy with Bence-Jones proteinuria. MUM1 immunocytochemistry performed on the urine sediment slides failed to label the neoplastic cells; thus, a plasma cell tumor was considered unlikely. Lack of response to a cyclophosphamide, vincristine, and prednisone chemotherapy regimen led to euthanasia without necropsy 21 days after diagnosis. Lymphoma is the most common hematopoietic malignancy and accounts for up to a quarter of all neoplasms in dogs, but lymphoid neoplasms arising primarily from extranodal sites are infrequently reported. Urinary tract neoplasia can be diagnosed by urine evaluation in about one-third of canine cases, but the diagnosis of lymphoid neoplasia via urine evaluation is rarely reported. This case highlights the utility of ancillary diagnostics on urine for detection of lymphoid malignancies.
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Affiliation(s)
- Christina Jeffries
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, USA
| | - A Russell Moore
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, USA
| | - Samantha N Schlemmer
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
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10
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Jeffries CM, Harris RA, Ashton L, Moore AR. Method comparison for serum protein electrophoretic M-protein quantification: Agarose gel electrophoresis and capillary zone electrophoresis in canine and feline sera. Vet Clin Pathol 2021; 50:543-550. [PMID: 34862629 DOI: 10.1111/vcp.13029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 04/13/2021] [Accepted: 04/15/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Densitometric quantification of myeloma paraproteins (M-proteins) is used to monitor secretory myeloma related disorders in humans and dogs. The previous work in dogs used agarose gel electrophoresis (AGE) but did not establish if other methods of serum protein electrophoresis, such as capillary zone electrophoresis (CZE), were comparable. OBJECTIVES We aimed to determine if the densitometric quantification of M-proteins using CZE would yield results comparable to AGE methods. METHODS Fifty-one serum samples from 22 dogs and 18 cats with confirmed monoclonal gammopathies and previously performed AGE were evaluated using CZE on a Sebia Minicap system. Samples were run in duplicate, and their M-proteins were densitometrically measured using the corrected perpendicular drop method previously described. Human-based quality control samples were used to determine the inter-run coefficient of variation (CV). Patient samples were used to calculate the intra-run CV. Method comparison was performed using simple linear regression, Passing-Bablok regression, and Bland-Altman analyses, and Medx evaluations. RESULTS Inter-run and intra-run CVs for CZE were 3.71%-7.65% and 2.89%-4.74%, respectively. Simple linear regression demonstrated an excellent correlation (r > 0.98). Passing-Bablok regression was compatible with the presence of proportional bias in the entire population, and Bland-Altman plots revealed a proportional bias in the feline cases. The Medx evaluation suggested that the two methods did not perform similarly in clinical samples with poor performance at a decision limit of 0.5 gm/dL. CONCLUSIONS Capillary zone electrophoresis is an acceptable method for M-protein densitometric quantification in canine and feline sera but cannot be used interchangeably with AGE-based evaluations.
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Affiliation(s)
- Christina M Jeffries
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, USA
| | - R Adam Harris
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, USA
| | - Laura Ashton
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, USA
| | - A Russell Moore
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, USA
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11
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Moore AR, Harris RA, Jeffries C, Ashton L, Avery PR. Diagnostic performance of routine electrophoresis and immunofixation for the detection of immunoglobulin paraproteins (M-Proteins) in dogs with multiple myeloma and related disorders: Part 2-Toward improved diagnostic performance. Vet Clin Pathol 2021; 50:249-258. [PMID: 33855710 DOI: 10.1111/vcp.12940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/28/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND The diagnostic performance of routine electrophoresis (agarose gel electrophoresis [AGE] and capillary zone electrophoresis [CZE]) and species-specific immunofixation (IF) for the detection of immunoglobulin paraproteins (M-proteins) and diagnosis of secretory myeloma-related disorders (sMRD) can be improved. Available canine IF targets were IgG-FC, IgA, IgM, light chain (LC), IgG4, and free LC (fLC) antibodies. OBJECTIVE We aimed to review specific features associated with the presence of M-proteins in canine serum samples and the common features causing inaccurate reporting of M-proteins to improve the diagnostic performance of routine electrophoresis and IF for the detection of M-proteins. METHODS Features found in AGE, CZE, routine IF, IgG4 IF, and fLC IF of 100 canine serum samples from Part 1 of this study were evaluated by simple and multivariate logistic regression to identify factors associated with the presence of M-proteins. Cases falsely called negative or positive for M-proteins were reviewed to identify the common features that could be used to increase the diagnostic performance of SPE and IF for M-protein detection. RESULTS The presence of hypogammaglobulinemia or any peak taller than albumin was associated with an M-protein. Total protein concentrations, globulin concentrations, or peaks wider than albumin were not associated with an M-protein. Free LC sMRD cases were not diagnosed by SPE and routine IF. Cases with infectious and inflammatory etiologies had a restricted polyclonal gammopathy with multiple γ-globulin restrictions resulting in some false-positive results. SPE combined with all available IF results and the specific features identified in this study had an estimated sensitivity of 95.1% and specificity of 81.4%. CONCLUSIONS The identified criteria of this study increase the diagnostic performance of the electrophoretic evaluation for M-proteins.
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Affiliation(s)
- A Russell Moore
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, USA
| | - R Adam Harris
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Christina Jeffries
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Laura Ashton
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Paul R Avery
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, USA
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Moore AR, Harris RA, Jeffries C, Ashton L, Avery PR. Diagnostic performance of routine electrophoresis and immunofixation for the detection of immunoglobulin paraproteins (M-Proteins) in dogs with multiple myeloma and related disorders: Part 1 - Current performance. Vet Clin Pathol 2021; 50:240-248. [PMID: 33847384 DOI: 10.1111/vcp.12993] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/21/2020] [Accepted: 12/30/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Routine electrophoresis [agarose gel electrophoresis (AGE) and capillary zone electrophoresis (CZE)] and species-specific immunofixation (IF) can be used alone or in combination to detect immunoglobulin paraprotein (M-protein) and diagnose secretory myeloma-related disorders (sMRD). OBJECTIVE We aimed to evaluate the performance of AGE, CZE, CZE plus IF (CZE-IF), and AGE plus IF (AGE-IF) for detecting canine serum M-proteins. METHODS One hundred canine cases that had AGE, CZE, and routine IF performed on serum, and where B-cell lineage neoplasia (such as B-cell lymphoma and plasma cell tumors) had been diagnosed or excluded, were evaluated. Routine IF protocols targeted IgG-FC, IgA, and IgM heavy chains and light chains. IgG4 IF and free light chain IF were also performed. B-cell lineage neoplasms with an M-protein detected, using any available method, were classified as sMRD. Datasets from AGE, CZE, IF, CZE-IF, and AGE-IF (electrophoretograms, gel images, and fraction concentrations) were composed and reviewed. The sensitivity, specificity, and Youden's index for M-protein detection were determined for each dataset. RESULTS The combination of AGE-IF or CZE-IF was more sensitive (82.9%) than CZE alone (72.0%) or AGE alone (64.6%) and more specific (66.1%, 48.3%, 51.7%, respectively). Immunofixation could be used alone to detect M-proteins (sensitivity 82.9%, specificity 61.9%), but there were technical challenges that complicated the performance and evaluation of the test. Myeloma with free light chains only was found in 5/41 cases of sMRD. CONCLUSIONS Adding routine IF to routine electrophoresis increases the ability to accurately identify M-proteins; however, there is still room for further diagnostic performance improvements.
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Affiliation(s)
- A Russell Moore
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, USA
| | - R Adam Harris
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Christina Jeffries
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Laura Ashton
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Paul R Avery
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, USA
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13
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Harris RA, Miller M, Donaghy D, Ashton L, Langston C, Shockey T, Moore AR. Light chain myeloma and detection of free light chains in serum and urine of dogs and cats. J Vet Intern Med 2021; 35:1031-1040. [PMID: 33634914 PMCID: PMC7995444 DOI: 10.1111/jvim.16070] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 01/28/2021] [Accepted: 02/04/2021] [Indexed: 01/07/2023] Open
Abstract
Background Detection of free light chains (fLC) in animals relies on protein electrophoresis or the Bence‐Jones protein test on urine. Objective To describe the detection of both serum fLC (sfLC) and urine fLC (ufLC) in 8 dogs and 2 cats using a commercially available human immunofixation (IF) kit. Animals Archived serum or urine samples from 27 dogs and 2 cats submitted to the Colorado State University Veterinary Diagnostic Laboratory for routine diagnostics. Methods Retrospective study evaluating the presence of fLC in dogs and cats using agarose gel electrophoresis and routine and fLC IF performed on serum and urine. The performance of the fLC IF reagents was evaluated using samples characterized by routine IF, tandem mass spectrometry, and a combination of fLC IF and western blotting. Free light chains were documented by paired electrophoresis and fLC IF. Results The fLC only myeloma case developed end‐stage renal failure 5 months post initial diagnosis. All electrophoresis‐defined urinary Bence‐Jones proteins were labeled by the anti‐free λ light chain (anti‐fλ) reagent; none were labeled by the anti‐free κ light chain (anti‐fκ); 2 of these were identified as fκ by mass spectrometry. An electrophoretically identical protein restriction that was labeled by the anti‐fλ reagent was present in the paired serum from 5/8 of cases, documenting sfLC. Conclusions and Clinical Importance Commercially available human IF reagents identified sfLC and ufLC in both dogs and cats. Free light chains may be nephrotoxic in dogs.
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Affiliation(s)
- Robert Adam Harris
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, Colorado, USA
| | - Matthew Miller
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Dillon Donaghy
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, Colorado, USA
| | - Laura Ashton
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, Colorado, USA
| | - Catherine Langston
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Todd Shockey
- Parkersburg Veterinary Hospital, Parkersburg, West Virginia, USA
| | - A Russell Moore
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, Colorado, USA
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14
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Priest JW, Ngandolo BNR, Lechenne M, Cleveland CA, Yabsley MJ, Weiss AJ, Roy SL, Cama V. Development of a Multiplex Bead Assay for the Detection of Canine IgG 4 Antibody Responses to Guinea Worm. Am J Trop Med Hyg 2021; 104:303-312. [PMID: 33124546 DOI: 10.4269/ajtmh.20-0914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Increased levels of guinea worm (GW) disease transmission among dogs in villages along the Chari River in Chad threaten the gains made by the GW Eradication Program. Infected dogs with preemergent worm blisters are difficult to proactively identify. If these dogs are not contained, blisters can burst upon submersion in water, leading to the contamination of the water supply with L1 larvae. Guinea worm antigens previously identified using sera from human dracunculiasis patients were coupled to polystyrene beads for multiplex bead assay analysis of 41 non-endemic (presumed negative) dog sera and 39 sera from GW-positive dogs from Chad. Because commercially available anti-dog IgG secondary antibodies did not perform well in the multiplex assay, dog IgGs were partially purified, and a new anti-dog IgG monoclonal antibody was developed. Using the new 4E3D9 monoclonal secondary antibody, the thioredoxin-like protein 1-glutathione-S-transferase (GST), heat shock protein (HSP1)-GST, and HSP2-GST antigen multiplex assays had sensitivities of 69-74% and specificities of 73-83%. The domain of unknown function protein 148 (DUF148)-GST antigen multiplex assay had a sensitivity of 89.7% and a specificity of 85.4%. When testing samples collected within 1 year of GW emergence (n = 20), the DUF148-GST assay had a sensitivity of 90.0% and a specificity of 97.6% with a receiver-operating characteristic area under the curve of 0.94. Using sera from two experimentally infected dogs, antibodies to GW antigens were detected within 6 months of exposure. Our results suggest that, when used to analyze paired, longitudinal samples collected 1-2 months apart, the DUF148/GST multiplex assay could identify infected dogs 4-8 months before GW emergence.
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Affiliation(s)
- Jeffrey W Priest
- 1Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Christopher A Cleveland
- 4Southeastern Cooperative Wildlife Disease Study, Department of Population Health, College of Veterinary Medicine, University of Georgia, Athens, Georgia
| | - Michael J Yabsley
- 4Southeastern Cooperative Wildlife Disease Study, Department of Population Health, College of Veterinary Medicine, University of Georgia, Athens, Georgia.,5Warnell School of Forestry and Natural Resources, University of Georgia, Athens, Georgia
| | | | - Sharon L Roy
- 7Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia.,8World Health Organization Collaborating Center for Dracunculiasis Eradication, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Vitaliano Cama
- 7Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia.,8World Health Organization Collaborating Center for Dracunculiasis Eradication, Centers for Disease Control and Prevention, Atlanta, Georgia
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15
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te Kamp V, Friedrichs V, Freuling CM, Vos A, Potratz M, Klein A, Zaeck LM, Eggerbauer E, Schuster P, Kaiser C, Ortmann S, Kretzschmar A, Bobe K, Knittler MR, Dorhoi A, Finke S, Müller T. Comparable Long-Term Rabies Immunity in Foxes after IntraMuscular and Oral Application Using a Third-Generation Oral Rabies Virus Vaccine. Vaccines (Basel) 2021; 9:vaccines9010049. [PMID: 33466701 PMCID: PMC7828770 DOI: 10.3390/vaccines9010049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/07/2021] [Accepted: 01/10/2021] [Indexed: 12/25/2022] Open
Abstract
The live genetically-engineered oral rabies virus (RABV) variant SPBN GASGAS induces long-lasting immunity in foxes and protection against challenge with an otherwise lethal dose of RABV field strains both after experimental oral and parenteral routes of administration. Induction of RABV-specific binding antibodies and immunoglobulin isotypes (IgM, total IgG, IgG1, IgG2) were comparable in orally and parenterally vaccinated foxes. Differences were only observed in the induction of virus-neutralizing (VNA) titers, which were significantly higher in the parenterally vaccinated group. The dynamics of rabies-specific antibodies pre- and post-challenge (365 days post vaccination) suggest the predominance of type-1 immunity protection of SPBN GASGAS. Independent of the route of administration, in the absence of IgG1 the immune response to SPBN GAGAS was mainly IgG2 driven. Interestingly, vaccination with SPBN GASGAS does not cause significant differences in inducible IFN-γ production in vaccinated animals, indicating a relatively weak cellular immune response during challenge. Notably, the parenteral application of SPBN GASGAS did not induce any adverse side effects in foxes, thus supporting safety studies of this oral rabies vaccine in various species.
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Affiliation(s)
- Verena te Kamp
- Institute of Molecular Virology and Cell Biology, Friedrich-Loeffler-Institut (FLI), WHO Collaborating Centre for Rabies Surveillance and Research, OIE Reference Laboratory for Rabies, 17493 Greifswald-Insel Riems, Germany; (V.t.K.); (C.M.F.); (M.P.); (A.K.); (L.M.Z.); (E.E.); (S.F.)
- Boehringer Ingelheim GmbH, 55216 Ingelheim am Rhein, Germany
| | - Virginia Friedrichs
- Institute of Immunology, Friedrich-Loeffler-Institut (FLI), 17493 Greifswald-Insel Riems, Germany; (V.F.); (M.R.K.); (A.D.)
| | - Conrad M. Freuling
- Institute of Molecular Virology and Cell Biology, Friedrich-Loeffler-Institut (FLI), WHO Collaborating Centre for Rabies Surveillance and Research, OIE Reference Laboratory for Rabies, 17493 Greifswald-Insel Riems, Germany; (V.t.K.); (C.M.F.); (M.P.); (A.K.); (L.M.Z.); (E.E.); (S.F.)
| | - Ad Vos
- Ceva Innovation Center, 06861 Dessau-Rosslau, Germany; (A.V.); (P.S.); (C.K.); (S.O.); (A.K.); (K.B.)
| | - Madlin Potratz
- Institute of Molecular Virology and Cell Biology, Friedrich-Loeffler-Institut (FLI), WHO Collaborating Centre for Rabies Surveillance and Research, OIE Reference Laboratory for Rabies, 17493 Greifswald-Insel Riems, Germany; (V.t.K.); (C.M.F.); (M.P.); (A.K.); (L.M.Z.); (E.E.); (S.F.)
| | - Antonia Klein
- Institute of Molecular Virology and Cell Biology, Friedrich-Loeffler-Institut (FLI), WHO Collaborating Centre for Rabies Surveillance and Research, OIE Reference Laboratory for Rabies, 17493 Greifswald-Insel Riems, Germany; (V.t.K.); (C.M.F.); (M.P.); (A.K.); (L.M.Z.); (E.E.); (S.F.)
| | - Luca M. Zaeck
- Institute of Molecular Virology and Cell Biology, Friedrich-Loeffler-Institut (FLI), WHO Collaborating Centre for Rabies Surveillance and Research, OIE Reference Laboratory for Rabies, 17493 Greifswald-Insel Riems, Germany; (V.t.K.); (C.M.F.); (M.P.); (A.K.); (L.M.Z.); (E.E.); (S.F.)
| | - Elisa Eggerbauer
- Institute of Molecular Virology and Cell Biology, Friedrich-Loeffler-Institut (FLI), WHO Collaborating Centre for Rabies Surveillance and Research, OIE Reference Laboratory for Rabies, 17493 Greifswald-Insel Riems, Germany; (V.t.K.); (C.M.F.); (M.P.); (A.K.); (L.M.Z.); (E.E.); (S.F.)
- Thüringer Landesamt für Verbraucherschutz, 99947 Bad Langensalza, Germany
| | - Peter Schuster
- Ceva Innovation Center, 06861 Dessau-Rosslau, Germany; (A.V.); (P.S.); (C.K.); (S.O.); (A.K.); (K.B.)
| | - Christian Kaiser
- Ceva Innovation Center, 06861 Dessau-Rosslau, Germany; (A.V.); (P.S.); (C.K.); (S.O.); (A.K.); (K.B.)
| | - Steffen Ortmann
- Ceva Innovation Center, 06861 Dessau-Rosslau, Germany; (A.V.); (P.S.); (C.K.); (S.O.); (A.K.); (K.B.)
| | - Antje Kretzschmar
- Ceva Innovation Center, 06861 Dessau-Rosslau, Germany; (A.V.); (P.S.); (C.K.); (S.O.); (A.K.); (K.B.)
| | - Katharina Bobe
- Ceva Innovation Center, 06861 Dessau-Rosslau, Germany; (A.V.); (P.S.); (C.K.); (S.O.); (A.K.); (K.B.)
| | - Michael R. Knittler
- Institute of Immunology, Friedrich-Loeffler-Institut (FLI), 17493 Greifswald-Insel Riems, Germany; (V.F.); (M.R.K.); (A.D.)
| | - Anca Dorhoi
- Institute of Immunology, Friedrich-Loeffler-Institut (FLI), 17493 Greifswald-Insel Riems, Germany; (V.F.); (M.R.K.); (A.D.)
| | - Stefan Finke
- Institute of Molecular Virology and Cell Biology, Friedrich-Loeffler-Institut (FLI), WHO Collaborating Centre for Rabies Surveillance and Research, OIE Reference Laboratory for Rabies, 17493 Greifswald-Insel Riems, Germany; (V.t.K.); (C.M.F.); (M.P.); (A.K.); (L.M.Z.); (E.E.); (S.F.)
| | - Thomas Müller
- Institute of Molecular Virology and Cell Biology, Friedrich-Loeffler-Institut (FLI), WHO Collaborating Centre for Rabies Surveillance and Research, OIE Reference Laboratory for Rabies, 17493 Greifswald-Insel Riems, Germany; (V.t.K.); (C.M.F.); (M.P.); (A.K.); (L.M.Z.); (E.E.); (S.F.)
- Correspondence: ; Tel.: +49-38351-71659
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Moore AR, Harris A, Jeffries C, Avery PR, Vickery K. Retrospective evaluation of the use of the International Myeloma Working Group response criteria in dogs with secretory multiple myeloma. J Vet Intern Med 2020; 35:442-450. [PMID: 33215766 PMCID: PMC7848390 DOI: 10.1111/jvim.15967] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 10/24/2020] [Accepted: 11/05/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Current recommendations for monitoring disease progression and response to treatment in humans with multiple myeloma include evaluation of serum paraprotein (M-protein) concentration. Densitometry, species-specific radial immunodiffusion (RID) and ELISA methods can be used to quantify M-proteins. OBJECTIVE Retrospectively evaluate use of the International Myeloma Working Group (IMWG) response criteria for humans in dogs with multiple myeloma. ANIMALS Sixteen dogs with a diagnosis of multiple myeloma, M-protein documented by serum protein electrophoresis (SPE) and immunofixation (IF) in an initial sample and subsequent electrophoretic evaluation of serial samples. METHODS Retrospectively, densitometric M-proteins, RID and globulins were measured and characterized according to IMWG criteria. Available clinical history was reviewed. Overall survival time (OST) was calculated from initial electrophoretic evaluation to death or last contact. RESULTS All cases received some form of nonstandardized chemotherapy. Complete response (CR), a lack of detectable M-protein by SPE and IF, was documented in 1 case. Median survival was longer for dogs that attained ≥90% densitometric M-protein reduction (630 days) than for those that did not attain at least 50% reduction in densitometric M-protein (284 days; log rank P = .006). Five dogs were defined as having progressive disease (M-protein increase of >25% and at least 0.5 g/dL from nadir), which correlated with concurrent or subsequent clinical deterioration. Response criteria categorized by serum globulins or RID was not correlated with OST or clinical findings. CONCLUSIONS AND CLINICAL IMPORTANCE Densitometric M-protein characterized using IMWG response criteria correlated with OST and clinical findings. Densitometric M-protein detection should be used to monitor dogs with multiple myeloma.
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Affiliation(s)
- A Russell Moore
- Department of Microbiology, Immunology and Pathology, Colorado State University, Ft. Collins, Colorado, USA
| | - Adam Harris
- Department of Microbiology, Immunology and Pathology, Colorado State University, Ft. Collins, Colorado, USA
| | - Christina Jeffries
- Department of Microbiology, Immunology and Pathology, Colorado State University, Ft. Collins, Colorado, USA
| | - Paul R Avery
- Department of Microbiology, Immunology and Pathology, Colorado State University, Ft. Collins, Colorado, USA
| | - Kate Vickery
- Department of Clinical Sciences, Colorado State University, Ft. Collins, Colorado, USA
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Rout ED, Moore AR, Burnett RC, Labadie JD, Hughes KL, Navin PA, Yoshimoto JA, Avery PR, Avery AC. Polyclonal B-cell lymphocytosis in English bulldogs. J Vet Intern Med 2020; 34:2622-2635. [PMID: 33058280 PMCID: PMC7694837 DOI: 10.1111/jvim.15913] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 09/02/2020] [Accepted: 09/16/2020] [Indexed: 12/20/2022] Open
Abstract
Background English bulldogs disproportionally develop an expansion of small B‐cells, which has been interpreted as B‐cell chronic lymphocytic leukemia (BCLL). However, clonality testing in these cases has often not been supportive of neoplasia. Hypothesis English bulldogs have a syndrome of nonneoplastic B‐cell expansion. Animals Eighty‐four English bulldogs with small‐sized CD21+ B‐cell lymphocytosis in the blood as determined by flow cytometry. Methods This is a retrospective study. We characterized this syndrome by assessing B‐cell clonality, clinical presentation, flow cytometric features, and immunoglobulin gammopathy patterns. We identified 84 cases with CD21+ lymphocytosis among 195 English bulldogs with blood samples submitted to the Colorado State University‐Clinical Immunology laboratory for immunophenotyping between 2010 and 2019. Flow cytometry features were compared to normal B‐cells and BCLL cases. PCR for antigen receptor rearrangements (PARR) by multiple immunoglobulin primers was performed to assess B‐cell clonality. A subset of cases with gammopathy were examined by protein electrophoresis, immunofixation, and immunoglobulin subclass ELISA quantification. Results Seventy percent (58/83) of cases had polyclonal or restricted polyclonal immunoglobulin gene rearrangements, suggesting nonmalignant B‐cell expansion. The median age of all dogs in the study was 6.8 years and 74% were male. The median (range) lymphocyte count was 22 400/μL (2000‐384 400/μL) and B‐cells had low expression of class II MHC and CD25. Splenomegaly or splenic masses were detected in 57% (26/46) of cases and lymphadenopathy in 11% (7/61). Seventy‐one percent (52/73) of cases had hyperglobulinemia and 77% (23/30) with globulin characterization had IgA ± IgM polyclonal or restricted polyclonal gammopathy patterns. Conclusions and Clinical Importance Polyclonal B‐cell lymphocytosis in English bulldogs is characterized by low B‐cell class II MHC and CD25 expression, splenomegaly and hyperglobulinemia consisting of increased IgA ± IgM. We hypothesize that this syndrome has a genetic basis.
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Affiliation(s)
- Emily D Rout
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - A Russell Moore
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Robert C Burnett
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Julia D Labadie
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Kelly L Hughes
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Paul A Navin
- VCA All Pets Animal Hospital, Lockport, Illinois, USA
| | - Janna A Yoshimoto
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Paul R Avery
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Anne C Avery
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
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Moore AR, Colopy LJ, Shiu KB, Snyder LA, Avery AC, Rout ED. Response to letter to editor regarding Immunoglobulin G4-related disease in a dog. J Vet Intern Med 2020; 34:544-545. [PMID: 32107803 PMCID: PMC7096637 DOI: 10.1111/jvim.15733] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 02/04/2020] [Indexed: 01/13/2023] Open
Affiliation(s)
- A Russell Moore
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, Colorado, USA
| | - Lydia J Colopy
- VCA Veterinary Emergency Service, Veterinary Specialty Center, Middleton, Wisconsin, USA
| | - Kai-Biu Shiu
- VCA Veterinary Emergency Service, Veterinary Specialty Center, Middleton, Wisconsin, USA
| | - Laura A Snyder
- Marshfield Labs, Veterinary Services, Marshfield, Wisconsin, USA
| | - Anne C Avery
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, Colorado, USA
| | - Emily D Rout
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, Colorado, USA
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