Human parathyroid antigen: characterization and localization with monoclonal antibodies

Enhanced visualization of parathyroid tissue by infusion of a visible dye conjugated to an antiparathyroid antibody

BACKGROUND

The antiparathyroid antibody BB5-G1 conjugated to cibacron blue, a blue dye, was intravenously infused to enhance parathyroid visualization. Previously, we demonstrated selective staining of human parathyroid implants in athymic nude mice after infusion of the conjugate.

METHODS

Mice possessing implanted parathyroid tissue were randomized into the following: group I, infused with cibacron blue alone; group II, infused with the antibody/dye conjugate; and group III, infused with radiolabeled BB5-G1 alone. Implants were surgically explored. Three blinded observers ranked parathyroid visualization in the operative fields, and corresponding histologic sections were computer analyzed.

RESULTS

Group II implants were easily visualized; groups I and III showed no staining. Group III showed high gamma counts. Subjective rankings and computer rankings correlated well (p < .05). Group II showed a higher mean staining intensity of 27.45 picogram protein product (PPP)/cell compared with 7.76 PPP/cell of group I (p = .002).

CONCLUSION

Cibacron blue/BB5-G1 consistently enhances visualization of implanted parathyroid tissue.

Parathyroid visualization with cibacron blue/BB5-G1

BB5-G1 is a murine monoclonal antibody with proven affinity for human parathyroid tissue. The authors conjugated BB5-G1 to cibacron blue, a water-soluble dye, in an attempt to enhance intraoperative parathyroid visualization. Athymic nude mice possessing intramuscularly implanted human parathyroid tissue were infused with the conjugate, then surgically explored. Intraoperative findings were video-captured, then analyzed by three independent observers and by computer, generating subjective and objective data quantifying parathyroid visualization. Parathyroid tissue implants were stained and were easily visualized. The implants in the test mice displayed higher computer-generated color intensity ratings (mean, 10.25 units) compared to control mice (mean, 6.10 units) (p<0.5). Histologic sections confirmed the presence of dye and antibody within parathyroid tissue. This represents the first study to use such a conjugate to selectively enhance parathyroid visualization.

Monoclonal antibodies with exclusive reactivity against parathyroid cells and tubule cells of the kidney

Four monoclonal anti-parathyroid antibodies were generated after immunization of mice with intact cells from human parathyroid tissue. All four monoclonal antibodies reacted in immunohistochemistry with structures present on parathyroid epithelial cells and proximal-tubule cells of the kidney but were unreactive with all other human tissues investigated. Immunofluorescence microscopy on suspended human parathyroid cells showed that the antibodies reacted with structures present on the cell surface. Two of these antibodies efficiently blocked the increase in cytoplasmic calcium concentration of parathyroid cells that is normally associated with increased concentrations of extracellular calcium. The results indicate that these two antibodies interfere with a calcium-sensing mechanism of parathyroid cells--i.e., a potential calcium receptor by which extracellular calcium regulates cytoplasmic calcium and hormone release in these cells.