Investigating the utility of saliva immunoglobulins for the detection of myeloma and using myeloma proteins to clarify partition between oral and systemic immunity.
Author
Heaney, Jennifer L JFaustini, Sian
Evans, Lili
Rapson, Alec
Collman, Emily
Emery, Annabelle
Campbell, John P
Moore, Sally
Goodall, Margaret
Afzal, Zaheer
Chapple, Iain L
Pratt, Guy
Drayson, Mark T
Publication date
2022-02-28
Metadata
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Objectives: Myeloma is characterised by the presence of monoclonal immunoglobulin (M-protein) and the free light chain (FLC) in blood. We investigated whether these M-proteins and FLC are detectable in myeloma patients' saliva to evaluate its utility for non-invasive screening and monitoring of haematological malignancies. Methods: A total of 57 patients with monoclonal gammopathy and 26 age-matched healthy participants provided paired serum and saliva samples for immunoglobulin characterisation and quantification. Results: Myeloma patients had IgG or IgA M-protein levels ranging up to five times and FLC levels up to a thousand times normal levels of polyclonal immunoglobulins. Despite these highly elevated levels, only two IgG and no IgA M-proteins or FLC could be detected in paired saliva samples. Most patients had reduced levels of serum polyclonal immunoglobulins, but all had normal levels of salivary IgA. Conclusions: Immunoglobulin transfer from blood is not determined by levels in the systemic circulation and more likely dictated by periodontal inflammation and the integrity of the oral epithelium. Immunoglobulins secreted by bone marrow plasma cells do not substantially enter saliva, which represents a poor medium for myeloma diagnosis. These findings, along with normal salivary IgA levels despite systemic immunoparesis, support a strong partitioning of oral from systemic humoral immunity.Citation
Heaney JLJ, Faustini S, Evans L, Rapson A, Collman E, Emery A, Campbell JP, Moore S, Goodall M, Afzal Z, Chapple IL, Pratt G, Drayson MT. Investigating the utility of saliva immunoglobulins for the detection of myeloma and using myeloma proteins to clarify partition between oral and systemic immunity. Eur J Haematol. 2022 Jun;108(6):493-502. doi: 10.1111/ejh.13758. Epub 2022 Feb 28Type
ArticleAdditional Links
http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1600-0609PMID
35184331Journal
European Journal of HaematologyPublisher
Wileyae974a485f413a2113503eed53cd6c53
10.1111/ejh.13758