Myeloma protein
Image:Monoclonal gammopathy Multiple Myeloma.png|thumb|Serum protein electrophoresis showing a paraprotein in a patient with multiple myeloma.
A myeloma protein is an abnormal antibody or a fragment thereof, such as an immunoglobulin light chain, that is produced in excess by an abnormal monoclonal proliferation of plasma cells, typically in multiple myeloma or Monoclonal gammopathy of undetermined significance. Other terms for such a protein are monoclonal protein, M protein, M component, M spike, spike protein, or paraprotein. This proliferation of the myeloma protein has several deleterious effects on the body, including impaired immune function, abnormally high blood viscosity, and kidney damage.
History
In 1940, senior pathologist Kurt Apitz of the Charité – Berlin University Medicine hospital, introduced the concept and word paraprotein.Cause
Myeloma is a malignancy of plasma cells. Plasma cells produce immunoglobulins, which are commonly called antibodies. There are thousands of different antibodies, each consisting of pairs of heavy and light chains. Antibodies are typically grouped into five classes: IgA, IgD, IgE, IgG, and IgM. When someone has myeloma, a malignant clone, a rogue plasma cell, reproduces in an uncontrolled fashion, resulting in overproduction of the specific antibody the original cell was generated to produce. Each type of antibody has a different number of light chain and heavy chain pairs. As a result, there is a characteristic normal distribution of these antibodies in the blood by molecular weight.When there is a malignant clone, there is usually overproduction of a single antibody, resulting in a "spike" on the normal distribution, which is called an M spike. People will sometimes develop a condition called MGUS, where there is overproduction of one antibody but the condition is benign. An explanation of the difference between multiple myeloma and MGUS can be found in the International Myeloma Foundation's Patient Handbook. and Concise Review
Detection of paraproteins in the urine or blood is most often associated with MGUS, where they remain "silent", and multiple myeloma. An excess in the blood is known as paraproteinemia. Paraproteins form a narrow band, or 'spike' in protein electrophoresis as they are all exactly the same protein. Unlike normal immunoglobulin antibodies, paraproteins cannot fight infection.
Serum free light-chain measurement can detect free light chains in the blood. Monoclonal free light chains in the serum or urine are called Bence Jones proteins.