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Bence Jones protein

A crystal of Bence Jones protein.

Bence Jones protein is a monoclonal globulin protein or immunoglobulin light chain found in the urine, with a molecular weight of 22–24 kDa.[1] Detection of Bence Jones protein may be suggestive of multiple myeloma,[2] or Waldenström's macroglobulinemia.[citation needed]

Bence Jones proteins are particularly diagnostic of multiple myeloma in the context of target organ manifestations such as kidney failure, lytic (or "punched out") bone lesions, anemia, or large numbers of plasma cells in the bone marrow. Bence Jones proteins are present in 2/3 of multiple myeloma cases.[3]

The proteins are immunoglobulin light chains (paraproteins) and are produced by neoplastic plasma cells. They can be kappa (most of the time) or lambda.[3] The light chains can be immunoglobulin fragments or single homogeneous immunoglobulins. They are found in urine as a result of decreased kidney filtration capabilities due to kidney failure, sometimes induced by hypercalcemia from the calcium released as the bones are destroyed, dehydration due to polyuria, amyloidosis or from the light chains themselves.[citation needed] The light chains were historically detected by heating a urine specimen (which causes the protein to precipitate) and nowadays by electrophoresis of concentrated urine.[4] More recently, serum free light chain assays have been utilised in a number of published studies which have indicated superiority over the urine tests, particularly for patients producing low levels of monoclonal free light chains, as seen in nonsecretory multiple myeloma[5][6][7] and amyloid light chain amyloidosis (AL amyloidosis).[7][8][9][10]

History

The Bence Jones protein was described by the English physician Henry Bence Jones in 1847 and published in 1848.[11]

References

  1. ^ Bernier, G. M. & Putnam, F. W. (1963). Nature (London), 200, 223±225.
  2. ^ Anderson, Alyssa. "What Is a Bence-Jones Protein Test?". WebMD. Retrieved 27 September 2023.
  3. ^ ab Hoffbrand V, Moss P, Pettit J (2006). Hematología esencial (Esencial) (5ª ed.). Profesional editorial de Blackwell. pag. 218.ISBN​ 978-1-4051-3649-5.
  4. ^ "Prueba de proteína de Bence Jones". TheFreeDictionary.com .
  5. ^ Drayson M, Tang LX, Drew R, Mead GP, Carr-Smith H, Bradwell AR (mayo de 2001). "Medidas de cadenas ligeras libres en suero para identificar y controlar pacientes con mieloma múltiple no secretor". Sangre . 97 (9): 2900–2. doi : 10.1182/sangre.V97.9.2900 . PMID  11313287. S2CID  8779162.
  6. ^ Shaw GR (agosto de 2006). "Mieloma de células plasmáticas no secretoras: cada vez más raro con el ensayo de cadenas ligeras libres en suero: una breve revisión". Archivos de patología y medicina de laboratorio . 130 (8): 1212–5. doi :10.5858/2006-130-1212-NPCMEM. PMID  16879026.
  7. ^ ab Katzmann JA, Abraham RS, Dispenzieri A, Lust JA, Kyle RA (mayo de 2005). "Rendimiento diagnóstico de ensayos cuantitativos de cadenas ligeras libres kappa y lambda en la práctica clínica". Química Clínica . 51 (5): 878–81. doi : 10.1373/clinchem.2004.046870 . PMID  15774572.
  8. ^ Lachmann HJ, Gallimore R, Gillmore JD y col. (Julio de 2003). "Resultado de la amiloidosis AL sistémica en relación con los cambios en la concentración de cadenas ligeras de inmunoglobulinas libres circulantes después de la quimioterapia". Revista británica de hematología . 122 (1): 78–84. doi : 10.1046/j.1365-2141.2003.04433.x . PMID  12823348. S2CID  23475887.
  9. ^ Abraham RS, Katzmann JA, Clark RJ, Bradwell AR, Kyle RA, Gertz MA (febrero de 2003). "Análisis cuantitativo de cadenas ligeras libres en suero. Un nuevo marcador para la evaluación diagnóstica de la amiloidosis sistémica primaria". Revista americana de patología clínica . 119 (2): 274–8. doi : 10.1309/LYWM-47K2-L8XY-FFB3 . PMID  12579999.
  10. ^ Akar H, Seldin DC, Magnani B y col. (Diciembre de 2005). "Ensayo cuantitativo de cadenas ligeras libres en suero en la evaluación diagnóstica de la amiloidosis AL". Amiloide . 12 (4): 210–5. doi :10.1080/13506120500352339. PMID  16399645. S2CID  7839338.
  11. ^ Jones HB (1848). "Sobre una nueva sustancia que aparece en la orina de un paciente con molities ossium". Transacciones filosóficas de la Royal Society . 138 : 55–62. doi :10.1098/rstl.1848.0003. S2CID  186208792.