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Csako G, Costello R, Shamim EA, O'Hanlon TP, Tran A, Clauw DJ, Williams HJ, Miller FW. Serum proteins and paraproteins in women with silicone implants and connective tissue disease: a case-control study. Arthritis Res Ther 2008; 9:R95. [PMID: 17875216 PMCID: PMC2212583 DOI: 10.1186/ar2295] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2007] [Revised: 08/09/2007] [Accepted: 09/17/2007] [Indexed: 11/14/2022] Open
Abstract
Prior studies have suggested abnormalities of serum proteins, including paraproteins, in women with silicone implants but did not control for the presence of connective-tissue disease (CTD). This retrospective case–control study, performed in tertiary-care academic centers, assessed possible alterations of serum proteins, including paraproteins, in such a population. Seventy-four women with silicone implants who subsequently developed CTD, and 74 age-matched and CTD-matched women without silicone implants, were assessed in the primary study; other groups were used for additional comparisons. Routine serum protein determinations and high-sensitivity protein electrophoresis and immunofixation electrophoresis were performed for detection of paraproteins. Women with silicone implants, either with or without CTD, had significantly lower serum total protein and α1-globulin, α2-globulin, β-globulin, γ-globulin, and IgG levels compared with those without silicone implants. There was no significant difference, however, in the frequency of paraproteinemia between women with silicone implants and CTD (9.5%) and age-matched and CTD-matched women without silicone implants (5.4%) (odds ratio, 1.82; 95% confidence interval, 0.51–6.45). Paraprotein isotypes were similar in the two groups, and the clinical characteristics of the 13 women with paraproteinemia were comparable with an independent population of 10 women with silicone breast implants, CTD, and previously diagnosed monoclonal gammopathies. In summary, this first comprehensive study of serum proteins in women with silicone implants and CTD found no substantially increased risk of monoclonal gammopathy. Women with silicone implants, however, had unexpectedly low serum globulin and immunoglobulin levels, with or without the subsequent development of CTD. The causes and clinical implications of these findings require further investigation.
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Affiliation(s)
- Gyorgy Csako
- Department of Laboratory Medicine, Clinical Center, NIH, DHHS, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Rene Costello
- Department of Laboratory Medicine, Clinical Center, NIH, DHHS, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Ejaz A Shamim
- Environmental Autoimmunity Group, National Institute of Environmental Health Sciences, NIH, DHHS, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Terrance P O'Hanlon
- Environmental Autoimmunity Group, National Institute of Environmental Health Sciences, NIH, DHHS, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Anthony Tran
- Department of Laboratory Medicine, Clinical Center, NIH, DHHS, 9000 Rockville Pike, Bethesda, MD 20892, USA
- Association of Public Health Laboratories, 8515 Georgia Avenue, Suite 700, Silver Spring, MD 20910, USA
| | - Daniel J Clauw
- Division of Rheumatology, Department of Medicine, University of Michigan Medical School, 101 Simpson Drive, Ann Arbor, MI 48109, USA
| | - H James Williams
- Division of Rheumatology, Department of Internal Medicine, University of Utah Medical Center, 50 North Medical Drive, Salt Lake City, UT 84132, USA
| | - Frederick W Miller
- Environmental Autoimmunity Group, National Institute of Environmental Health Sciences, NIH, DHHS, 9000 Rockville Pike, Bethesda, MD 20892, USA
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Ehrenstein M, Longhurst C, Isenberg DA. Production and analysis of IgG monoclonal anti-DNA antibodies from systemic lupus erythematosus (SLE) patients. Clin Exp Immunol 1993; 92:39-45. [PMID: 8385586 PMCID: PMC1554857 DOI: 10.1111/j.1365-2249.1993.tb05945.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
This study compares recently devised methods for producing IgG anti-DNA MoAbs from patients with SLE and analyses the antibodies generated from one patient at different phases of disease. Lymphocytes from SLE patients were transformed with Epstein-Barr virus(EBV) and/or fused with a heteromyeloma cell line, CB-F7. Direct fusion with CB-F7 resulted in the highest proportion of IgG-secreting lines, whereas EBV transformation resulted in a high percentage of IgM-secreting lines. Using direct fusion, five IgM anti-DNA antibody-secreting hybridomas were generated using lymphocytes from a patient with relatively inactive SLE. Six months later when the disease was active, only IgG anti-DNA antibodies were produced. The antigen-binding patterns of the MoAbs were analysed. Only one of the IgM anti-DNA antibodies reacted with dsDNA by ELISA and none by Crithidia immunofluorescence, whereas two of the IgG antibodies reacted with dsDNA by ELISA and Crithidia but did not bind to ssDNA. Only the two IgG high affinity anti-dsDNA antibodies bound to histones, and this was enhanced by added DNA, whereas three IgM antibodies bound to cardiolipin. This study supports the notion that MoAbs derived from a patient with SLE represent those found in the serum of SLE patients at different stages of disease activity. The binding to histones by the two IgG anti-dsDNA antibodies supports the recently expressed view that antibodies binding DNA/histone may be important in the pathogenesis of SLE.
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Affiliation(s)
- M Ehrenstein
- Department of Rheumatology Research, University College and Middlesex Hospital Medical School (UCMSM), London, UK
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