Studies on Hyperlipidemia in Multiple Myeloma Interaction between Serum Ig-A and LDL-Fraction - of a Patient Bearing Ig-A, Lambda Type Multiple Myelom
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1 Studies on Hyperlipidemia in Multiple Myeloma Interaction between Serum Ig-A and LDL-Fraction - of a Patient Bearing Ig-A, Lambda Type Multiple Myeloma with Hyperlipidemia Keika KAN, Tadao HOSHINO and Takao WADA Department of Chemotherapy, Pharmaceutical Institute, and Department of Internal Medicine, School of Medicine, Keio University, Tokyo Yasuhiro ISHIKAWA and Rokuichi IGA Department of Internal Medicine, Social Insurance Saitama Central Hospital, Saitama Toyohiko TEJIMA Laboratories for Biochemical Analysis of Japan, Tokyo Summary Investigations on lipide metabolism have been performed on a seventy years old woman bearing Ig-A, lambda type multiple myeloma with hyperlipidemia of type II -b or type III classified according to Fredrickson. She showed increased serum, levels of cholesterol,cholesterol-ester, triglyceride and phospholipide, and she was accompanied with retention of vitamin-a by vitamin- A tolerance test, delayed FFA release by PHLA test and increased LCAT. The serum of the patient was divided into several fractions by differential ultracentrifugation. The bottom-fraction (d 1.21) made precipitate with the LDL-fraction by ouchterlony's double diffusion technique and also precipitated with other LDL-fractions obtained from a healthy control or a multiple myeloma without hyperlipidemia. In the mixture of patient's bottom- and LDL-fraction some new larger complexes, which were not observed in each fraction, were found by polyacrylamide gradient-gel electorphoresis. The bottom-fraction made precipitin arcs against LDL-fraction and anti Ig-kantiserum by immunoelectrophoresis, and the location of the bottom-ldl precipitate coincided with that of bottom-anti-ig-a. These results suggest that the Ig-A of the patient serum has some affinity for LDL-fraction making complexes to interfere with lipide metabolism.
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4 TABLE I Lipid, Lipoprotein and Immunoglobulin Composition of Patient's Whole Serum and Different Density Lipoprotein Fraction of Patient's Serum EC: Ester Cholesterol FC: Free Cholesterol TG: Triglyceride PL: Phospholipid ( )*: normal range ( ): normal control
5 Fig. 3. patient's Immunoelectrophoresis of patient's whole serum and different density lipoprotein fraction of serum. Fig. 4. Polyacrylamide gradient gel electrophoresis ent density fraction and their mixtuer. of patient's differ- 白 あ る い は 抗 ヘ パ リ ン作 用 と関 係 づ け て 高 脂 血 症 と,bottom分 を説 明 し,autoimmune と考 え られ る こ と が 観 察 さ れ た.こ hyperlipidemiaと い う概 画 でLDL分 念 を発 表 して い る.本 症 例 で は 超 遠 心 で 分 離 した 形 成 にIgAの LDL分 性 が ま ず 考 え ら れ る.ま 画 にbottom分 両 分 画 がcomplexを 画 が 沈 降 反 応 を起 こす こ と, 形 成 して よ り高 分 子 化 す るこ 画 と反 応 す るの はIgA のcomplexの 異 常 が 第 一 義 的 に関 与 して い る可 能 た,PHLAの 遅延 反応等 が示 す 脂 質 代 謝 の異 常 が 第 二 義 的 にIgAの 異常 を
6 Fig. 5. Intreaction between LDL and bottom fraction. B-F: bottom fraction ( N ): normal LDL-F: LDL fraction ( P ): patient WHS: whole human serum ひ き起 こ して い る可 能 性 も考 え られ る.こ れ らの 問 題 を解 明 して ゆ く こ とが,高 に役 立 つ と考 え られ る. 脂血症 の 成因追 求 文献 1) Lewis, L. A., de Wolfe, V. G., Botkus, A., and Page, L. H.: Amer. J. Med., 59, 208 (1975) (1968) 4) Beaumont, J. L., and Beaumont, V.: "Proceedings of the Third International 2) 長 崎 敏 秀, 赤 沼 安 夫: 生 化 学, 46, 551 Symposium," ed. by Jones, R. J., Springer Verlag. New York. p. 579 (1973) 5) Beaumont, J. L.: Ann. Biol. Chem., 27, 611 (1969) (1974) 3) Gotto, A. M., Levy, R. I., Rosenthal, A. S., Birnbaumer, M. E., and Fredrickson, D. S.: Biochem. Biophy. Res. Comm., 31, 699 討論 和 田 光 夫(山 (1)unusual 口 大 第 二 内 科) 甘 macromolecule形 成 様 態 に つ い て, 例 え ば 超 遠 心 分 析 上 の 圧 力 効 果 な ど に つ い て観 察 さ れ て い な い で し ょ う か? (2)Lp-Ig complex形 え ら れ る で し ょ う かIg-Lp 慶華 (1)超 遠 心 操 作 の 過 程 でcomplexが (2)リ ポ 蛋 白 分 画 の う ちLDLと 成 はLp-Ig fragmentと fragmentと 考 考 え られ る で ょ う か? 離 れ る こと は 可 能 性 と して 当 然 考 え ら れ ます. VLDL,HDLと の み 反 応 し, は 反 応 し ませ ん.ま た,現 在 ア ポ 蛋 白の 解 析 を行 って い ます が,IgAとcomplexを 形 成 す るの は 蛋 白 部 分 と考 え られ ます
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