detection of high molecular weight igg fibronectin complexes in various types of acute myeloid...

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IgG fibronectin complexes International Archives of Integra Copy right © 2015, IAIM, All Righ Original Research Article Detection o fibronectin c Acute Myelo Debkumar Ray 1* , De G 1 Associate Professor, Departm 2 Associate Professor, De 3 Assistant Professor, Departmen 4 RMO cum Clinical Tut 5 Associate Professor, Departm *Correspo How to cite this article: Debk Debabrata Nandy. Detection of Acute Myeloid Leukemia - A stud Availab Received on: 04-01-2015 Abstract To detect presence of high mol with Acute Myeloid Leukemia w ultracentrifugation, and immun circulating high molecular weigh exclusion chromatography to co immunoaffinity chromatograph fibronectin and further showe prominent feature of Acute Mye Key words Acute Myeloid Leukemia, Immun Introduction It is established that serum o primary myelofibrosis yields pos s in various types of Acute Myeloid Leukemia ated Medicine, Vol. 2, Issue 3, March, 2015. hts Reserved. of high molecular weig complexes in various t oid Leukemia - A study world country ebashis Roy Burman 2 , Indranil Dh Ghosh 4 , Debabrata Nandy 5 ment of Biochemistry, Burdwan Medical College, W epartment of Oncopathology, Medical College, K nt of Laboratory Medicine, School of Tropical Me tor, Regional Cancer Centre, Medical College, Kol ment of Radiology, Midnapur Medical College, W onding author email: [email protected] kumar Ray, Debashis Roy Burman, Indranil Dh high molecular weight IgG fibronectin complexe dy in third world country. IAIM, 2015; 2(3): 119-1 ble online at www.iaimjournal.com Accep lecular weight complexes of IgG and fibronectin was examined by polyethylene glycol (PEG) pre noaffinity chromatography. Ultracentrifugation ht IgG in all patients. This was precipitated by PE ontain IgG in a high molecular weight form. Exam hy supported evidence for complex formation ed that abnormal high molecular weight IgG eloid Leukemia and implicate IgG fibronectin com ne complexes, Fibronectin. of patients with sitive results in a variety of assays of immune 4]. Positivity for rheumato nuclear antibody (ANA) is w ISSN: 2394-0026 (P) ISSN: 2394-0034 (O) Page 119 ght IgG types of in third har 3 , Soumik West Bengal, India Kolkata, India edicine, Kolkata, India lkata, India West Bengal, India Dhar, Soumik Ghosh, es in various types of 125. pted on: 10-03-2015 n, plasma of patients ecipitation, analytical identified abnormal EG and was shown by mination of plasma by n between IgG and G complexes are a mplex formation. e complexes [1, 2, 3, oid factor and anti- well documented in

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Debkumar Ray, Debashis Roy Burman, Indranil Dhar, Soumik Ghosh, Debabrata Nandy. Detection of high molecular weight IgG fibronectin complexes in various types of Acute Myeloid Leukemia - A study in third world country. IAIM, 2015; 2(3): 119-125.

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  • IgG fibronectin complexes in various types of Acute Myeloid Leukemia

    International Archives of Integrated Medicine, Vol.

    Copy right 2015, IAIM, All Rights Reserved.

    Original Research Article

    Detection of high molecular weight IgG

    fibronectin complexes in various types of

    Acute Myeloid Leukemia

    Debkumar Ray1*

    , Debashis Roy Burman

    Ghosh1Associate Professor, Department of Biochemistry, Burdwan Medical College, West Bengal, India

    2Associate Professor, Department of Oncopathology, Medical College, Kolkata, India

    3Assistant Professor, Department of Laboratory Medicine, School of Tropical Medi

    4RMO cum Clinical Tutor, Regional Cancer Centre, Medical College, Kolkata, India

    5Associate Professor, Department of Radiology, Midnapur Medical College, West Bengal, India

    *Corresponding author email:

    How to cite this article: Debkumar R

    Debabrata Nandy. Detection of high molecular weight IgG fibronectin complexes in various types of

    Acute Myeloid Leukemia - A study in third world country

    Available online at

    Received on: 04-01-2015

    Abstract

    To detect presence of high molecular weight com

    with Acute Myeloid Leukemia was examined by polyethylene glycol (PEG) precipitation, analytical

    ultracentrifugation, and immunoaffinity chromatograph

    circulating high molecular weight

    exclusion chromatography to contain IgG in a high molecular weight form. Exa

    immunoaffinity chromatography supported evidence for complex formation between IgG and

    fibronectin and further showed that abnormal high molecular weight IgG complexes are a

    prominent feature of Acute Myeloid Leukemia

    Key words

    Acute Myeloid Leukemia, Immune complexes, Fibro

    Introduction

    It is established that serum of patients with

    primary myelofibrosis yields positive results in a

    IgG fibronectin complexes in various types of Acute Myeloid Leukemia

    International Archives of Integrated Medicine, Vol. 2, Issue 3, March, 2015.

    , IAIM, All Rights Reserved.

    Detection of high molecular weight IgG

    fibronectin complexes in various types of

    Acute Myeloid Leukemia - A study in third

    world country

    , Debashis Roy Burman2, Indranil Dhar

    Ghosh4, Debabrata Nandy

    5

    Associate Professor, Department of Biochemistry, Burdwan Medical College, West Bengal, India

    Associate Professor, Department of Oncopathology, Medical College, Kolkata, India

    Assistant Professor, Department of Laboratory Medicine, School of Tropical Medi

    RMO cum Clinical Tutor, Regional Cancer Centre, Medical College, Kolkata, India

    Associate Professor, Department of Radiology, Midnapur Medical College, West Bengal, India

    *Corresponding author email: [email protected]

    Debkumar Ray, Debashis Roy Burman, Indranil Dhar, Soumik

    Detection of high molecular weight IgG fibronectin complexes in various types of

    A study in third world country. IAIM, 2015; 2(3): 119-125.

    Available online at www.iaimjournal.com

    Accepted on:

    To detect presence of high molecular weight complexes of IgG and fibronectin, plasma of patients

    with Acute Myeloid Leukemia was examined by polyethylene glycol (PEG) precipitation, analytical

    ultracentrifugation, and immunoaffinity chromatography. Ultracentrifugation identified a

    circulating high molecular weight IgG in all patients. This was precipitated by PEG and was shown by

    exclusion chromatography to contain IgG in a high molecular weight form. Exam

    ty chromatography supported evidence for complex formation between IgG and

    fibronectin and further showed that abnormal high molecular weight IgG complexes are a

    ature of Acute Myeloid Leukemia and implicate IgG fibronectin complex formation.

    Immune complexes, Fibronectin.

    serum of patients with

    primary myelofibrosis yields positive results in a

    variety of assays of immune complexes

    4]. Positivity for rheumatoid factor and

    nuclear antibody (ANA) is well docume

    ISSN: 2394-0026 (P)

    ISSN: 2394-0034 (O)

    Page 119

    Detection of high molecular weight IgG

    fibronectin complexes in various types of

    A study in third

    , Indranil Dhar3, Soumik

    Associate Professor, Department of Biochemistry, Burdwan Medical College, West Bengal, India

    Associate Professor, Department of Oncopathology, Medical College, Kolkata, India

    Assistant Professor, Department of Laboratory Medicine, School of Tropical Medicine, Kolkata, India

    RMO cum Clinical Tutor, Regional Cancer Centre, Medical College, Kolkata, India

    Associate Professor, Department of Radiology, Midnapur Medical College, West Bengal, India

    oy Burman, Indranil Dhar, Soumik Ghosh,

    Detection of high molecular weight IgG fibronectin complexes in various types of

    125.

    Accepted on: 10-03-2015

    plexes of IgG and fibronectin, plasma of patients

    with Acute Myeloid Leukemia was examined by polyethylene glycol (PEG) precipitation, analytical

    trifugation identified abnormal

    This was precipitated by PEG and was shown by

    mination of plasma by

    ty chromatography supported evidence for complex formation between IgG and

    fibronectin and further showed that abnormal high molecular weight IgG complexes are a

    ectin complex formation.

    variety of assays of immune complexes [1, 2, 3,

    . Positivity for rheumatoid factor and anti-

    ) is well documented in

  • IgG fibronectin complexes in various types of Acute Myeloid Leukemia

    International Archives of Integrated Medicine, Vol.

    Copy right 2015, IAIM, All Rights Reserved.

    Myeloproliferative disorders (MPD

    Myeloid Leukemia (AML).

    composition of any high molecular weight

    antigen-antibody complexes is yet

    defined, these findings have been attributed to

    the presence of high concentrations of

    circulating immune complexes.

    Increased concentrations of polyethylene glycol

    precipitable IgG (PEG IgG) are suggestive of

    circulating high molecular weight forms of IgG in

    patients with primary myelofibrosis, and their

    demonstration in Myeloproliferative disorders

    indicates a common underlying patho

    [5]. A negative correlation between plasma

    concentrations of PEG IgG and fibro

    the high PEG precipitability of native plasma

    fibronectin compared with purified protein,

    suggests that some fibronectin may exist as a

    high molecular weight complex with IgG in the

    plasma of these patients [5]. The purpose of this

    study was to establish the presence of high

    molecular weight complexes in the

    patients with Acute Myeloid Leukemia and to

    determine if these consist of complexed IgG and

    fibronectin.

    Material and methods

    Five patients with Acute Myeloid Leukemia of

    different French-American-British (

    subtypes as per Table - 1 and five healthy

    controls were investigated. The five patients

    were selected from a larger group of patients

    when they attended Oncology OPD (

    Department) of Medical College, Kolkata on the

    basis that none had received chemotherapy or

    transfusion of blood products in the three

    months preceding the study. Plasma of such

    patients was evaluated in School of Tropical

    Medicine, Kolkata from January

    2012.

    Polyethylene glycol (PEG) precipitation

    Proteins were precipitated from plasma anti

    IgG fibronectin complexes in various types of Acute Myeloid Leukemia

    International Archives of Integrated Medicine, Vol. 2, Issue 3, March, 2015.

    , IAIM, All Rights Reserved.

    MPD) and Acute

    Though the

    composition of any high molecular weight

    antibody complexes is yet to be fully

    ings have been attributed to

    the presence of high concentrations of

    trations of polyethylene glycol

    precipitable IgG (PEG IgG) are suggestive of

    ght forms of IgG in

    patients with primary myelofibrosis, and their

    stration in Myeloproliferative disorders

    indicates a common underlying pathophysiology

    . A negative correlation between plasma

    concentrations of PEG IgG and fibronectin, and

    high PEG precipitability of native plasma

    fibronectin compared with purified protein,

    nectin may exist as a

    high molecular weight complex with IgG in the

    . The purpose of this

    presence of high

    molecular weight complexes in the plasma of

    yeloid Leukemia and to

    determine if these consist of complexed IgG and

    Five patients with Acute Myeloid Leukemia of

    British (FAB)

    and five healthy

    controls were investigated. The five patients

    were selected from a larger group of patients

    OPD (Out Patient

    of Medical College, Kolkata on the

    basis that none had received chemotherapy or

    fusion of blood products in the three

    months preceding the study. Plasma of such

    patients was evaluated in School of Tropical

    January, 2012 to May,

    precipitation

    Proteins were precipitated from plasma anti-

    coagulated with Ethylenediaminetetraacetic

    acid (EDTA) by 2% PEG (molecular weight 6000)

    at 4C. The precipitate was washed in 2% PEG,

    resuspended in saline, and the precipitated IgG

    quantitated by radial immunodiffusion.

    Immunoprecipitation of PEG precipitated IgG

    was determined from a plot of immuno

    precipitated reference standard IgG

    concentrations. Thus values should be regarded

    as mg equivalents because enhanced

    immunoprecipitation of macromole

    complexed proteins leads to underestimation

    when concentrations are calculated from a

    standard plot derived from

    immunoprecipitation of low molecular weight

    native proteins.

    Table - 1: Demography and FAB s

    cases.

    FAB

    subtype

    Age

    Case 1 M 5a 26

    Case 2 M 5b 34

    Case 3 M 3 46

    Case 4 M 2 49

    Case 5 M 6 56

    Exclusion chromatography

    A gel column of sepharose 4B was equilibrated

    with 50 mM TRIS-HC1 (pH7

    with proteins of known molecular weight.

    Protein elution was recorded by ultraviolet

    absorption at 280 nm. Samples were

    centrifuged at 1000 x g for 10 minutes, filtered

    through a 2 pm filter to remove any particular

    debris, and applied to the gel in filtered,

    deaerated TRIS-HC1 buffer.

    were analyzed for individual proteins by radial

    immunodiffusion in gels containing appropriate

    antisera.

    Analytical ultracentrifugation

    Samples were centrifuged at 100 000

    in an MSE Centriscan 75 analytical

    ISSN: 2394-0026 (P)

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    Page 120

    Ethylenediaminetetraacetic

    by 2% PEG (molecular weight 6000)

    at 4C. The precipitate was washed in 2% PEG,

    resuspended in saline, and the precipitated IgG

    radial immunodiffusion.

    Immunoprecipitation of PEG precipitated IgG

    termined from a plot of immuno-

    precipitated reference standard IgG

    tions. Thus values should be regarded

    valents because enhanced

    precipitation of macromolecules or

    complexed proteins leads to underestimation

    centrations are calculated from a

    standard plot derived from

    immunoprecipitation of low molecular weight

    Demography and FAB subtype of study

    Age (Years) Sex

    Male

    Female

    Male

    Male

    Female

    A gel column of sepharose 4B was equilibrated

    HC1 (pH7-5) and calibrated

    with proteins of known molecular weight.

    Protein elution was recorded by ultraviolet

    absorption at 280 nm. Samples were

    for 10 minutes, filtered

    filter to remove any particular

    and applied to the gel in filtered,

    HC1 buffer. The eluted fractions

    ed for individual proteins by radial

    containing appropriate

    Analytical ultracentrifugation

    Samples were centrifuged at 100 000 x g at 20C

    in an MSE Centriscan 75 analytical

  • IgG fibronectin complexes in various types of Acute Myeloid Leukemia

    International Archives of Integrated Medicine, Vol.

    Copy right 2015, IAIM, All Rights Reserved.

    ultracentrifuge. The analytical cells were scan

    ned at four minute intervals against a phos

    buffered saline reference solution and

    sedimentation was observed by Schlie

    Sedimentation coefficients were cal

    a minimum of three sedimentation distances per

    sample.

    Affinity chromatography

    Affinity gels were prepared according to the

    method of Axen, et al. [6]. Cyanogen bromide

    activated sepharose 4B was coupled to sub

    strate and uncoupled protein removed by

    washing in carbonate buffer. Any remaining

    active groups were blocked with molar

    ethanolamine (pH90). The gel was then

    repeatedly washed in alternating carbonate

    buffer and 01 M acetate buffer and s

    4C in 1 % azide. Before use gels were packed

    into polypropylene columns and equilibrated

    with 50 mM TRIS-HC1. Loading and elution of

    gels was performed at a constant flow rate and

    protein elution monitored by ultraviolet

    absorption at 280 nm. Individual proteins were

    identified and quantitated by rocket immuno

    electrophoresis using precipitating antibodies.

    Affinity gels were prepared with gelatin,

    arginine, and sheep anti-human fibronectin. A

    fibronectin coupled sepharose gel was made

    from fresh human plasma fibronectin, prepared

    with the gelatin and arginine gels according to

    the method of Vuento and Vaheri

    Results

    Analysis of PEG precipitates by exclusion

    chromatography

    Fresh PEG precipitates were fractionated by

    exclusion chromatography and the IgG content

    of each fraction was measured to determine

    the molecular weight profil

    precipitated IgG. From case 4 is compared with

    fractionation of an untreated solution of

    IgG fibronectin complexes in various types of Acute Myeloid Leukemia

    International Archives of Integrated Medicine, Vol. 2, Issue 3, March, 2015.

    , IAIM, All Rights Reserved.

    ultracentrifuge. The analytical cells were scan-

    ned at four minute intervals against a phosphate

    buffered saline reference solution and

    sedimentation was observed by Schlieren optics.

    mentation coefficients were calculated from

    tion distances per

    Affinity gels were prepared according to the

    Cyanogen bromide

    as coupled to sub-

    strate and uncoupled protein removed by

    washing in carbonate buffer. Any remaining

    active groups were blocked with molar

    ethanolamine (pH90). The gel was then

    repeatedly washed in alternating carbonate

    buffer and 01 M acetate buffer and stored at

    4C in 1 % azide. Before use gels were packed

    into polypropylene columns and equilibrated

    HC1. Loading and elution of

    gels was performed at a constant flow rate and

    protein elution monitored by ultraviolet

    ividual proteins were

    identified and quantitated by rocket immuno-

    electrophoresis using precipitating antibodies.

    Affinity gels were prepared with gelatin,

    human fibronectin. A

    fibronectin coupled sepharose gel was made

    human plasma fibronectin, prepared

    with the gelatin and arginine gels according to

    the method of Vuento and Vaheri [7].

    nalysis of PEG precipitates by exclusion

    Fresh PEG precipitates were fractionated by

    and the IgG content

    of each fraction was measured to determine

    the molecular weight profile of PEG

    4 is compared with

    ated solution of

    polyvalent IgG. Compared with fractionation of

    the solution of IgG, which showed a single peak

    of molecular weight 150 kD, the PEG

    precipitated IgG from case 4 contained a broad

    high molecular weight band up to 1000 kD.

    Similar results were found on studying the PEG

    precipitates of the other patients, and to a

    lesser extent in two of the normal controls,

    though less material was precipitated.

    Fractionation of a PEG precipitate of the IgG

    solution (BPL) showed minimal PEG

    precipitation of IgG (01%) with no high

    molecular weight component.

    Analytical ultracentrifugation of

    untreated plasma

    Ultracentrifugation of untreated fresh plasma

    from the five patients showed multiple peaks of

    high molecular weight material ranging from 8S

    to 21S (sedimentation coefficient in plasma).

    Ultracentrifugation of plasma from five norm

    controls did not show any high molecular

    weight components in four subjects and only a

    single 9S peak in one.

    The plasma of case 3, which contained three

    high molecular weight peaks of 14S, 15S, and >

    15S was PEG precipitated and the prec

    and the supernate analyz

    ultracentrifugation. The PEG precipitate con

    tained three high molecular weight peaks (15S,

    18S, and 33S, sedimentation coefficients in

    saline), while the supernatant plasma contained

    no high molecular weight material. Sedimenta

    tion coefficients in plasma and saline are not

    comparable as the higher viscosity of

    results in a reduced sedimentation velocity and

    hence a lower sedimentation coefficient

    Table - 2.

    Analysis of PEG precipitates and fresh

    untreated plasma by affinity

    chromatography

    ISSN: 2394-0026 (P)

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    Page 121

    . Compared with fractionation of

    which showed a single peak

    of molecular weight 150 kD, the PEG

    precipitated IgG from case 4 contained a broad

    high molecular weight band up to 1000 kD.

    Similar results were found on studying the PEG

    precipitates of the other patients, and to a

    nt in two of the normal controls,

    though less material was precipitated.

    Fractionation of a PEG precipitate of the IgG

    solution (BPL) showed minimal PEG

    precipitation of IgG (01%) with no high

    molecular weight component.

    Analytical ultracentrifugation of fresh

    Ultracentrifugation of untreated fresh plasma

    from the five patients showed multiple peaks of

    high molecular weight material ranging from 8S

    to 21S (sedimentation coefficient in plasma).

    Ultracentrifugation of plasma from five normal

    controls did not show any high molecular

    weight components in four subjects and only a

    The plasma of case 3, which contained three

    high molecular weight peaks of 14S, 15S, and >

    15S was PEG precipitated and the precipitate

    e supernate analyzed by

    ultracentrifugation. The PEG precipitate con-

    tained three high molecular weight peaks (15S,

    18S, and 33S, sedimentation coefficients in

    saline), while the supernatant plasma contained

    no high molecular weight material. Sedimenta-

    n coefficients in plasma and saline are not

    comparable as the higher viscosity of plasma

    results in a reduced sedimentation velocity and

    hence a lower sedimentation coefficient as per

    nalysis of PEG precipitates and fresh

    untreated plasma by affinity

  • IgG fibronectin complexes in various types of Acute Myeloid Leukemia

    International Archives of Integrated Medicine, Vol.

    Copy right 2015, IAIM, All Rights Reserved.

    A fibronectin coupled sepharose gel was

    prepared and used to affinity purify a polyvalent

    sheep anti-human fibronectin anti

    resultant purified antibody was itself

    activated sepharose for use as a fibronectin

    immunoaffinity gel. About half of the purified

    fibronectin was retained by this gel and was

    eluted with 0-5 molar glycine (pH

    was saturable with fibronectin and therefore the

    percentage of fibronectin retained decreased

    when the initial load was in excess. IgG loaded

    on to the gel appeared in the breakthrough with

    no elution of IgG during subsequent treatment

    of the gel with glycine. Thus the gel was specific

    for fibronectin and had no affinity for IgG

    Table - 3.

    PEG precipitate from two patients was pas

    through an uncoupled sepharose gel column to

    exclude non-specific adsorption of IgG by

    sepharose, and the eluate was loaded on to the

    anti-fibronectin antibody immunoaffin

    Elution of the column with 0-

    yielded demonstrable amounts of IgG in

    addition to fibronectin. The column also

    retained small quantities of IgG from the PEG

    precipitate of a normal control subject. To

    determine if the column retained an

    untreated plasma, fresh plasma samples from a

    patient and a control were applied to the anti

    fibronectin antibody column. IgG was retained

    from both plasmas but in greater a

    the patient plasma as per Table

    The plasma of case 5 was examined before and

    after plasmapheresis. The disappearance of a

    20S component from the plasma was associated

    with a reduction in PEG IgG from 477 mg/l to

    338 mg/l as per Table - 2.

    Discussion

    In patients with Acute Myeloid L

    concentrations of plasma PEG precipitable IgG

    IgG fibronectin complexes in various types of Acute Myeloid Leukemia

    International Archives of Integrated Medicine, Vol. 2, Issue 3, March, 2015.

    , IAIM, All Rights Reserved.

    A fibronectin coupled sepharose gel was

    prepared and used to affinity purify a polyvalent

    human fibronectin antiserum. The

    resultant purified antibody was itself coupled to

    activated sepharose for use as a fibronectin

    immunoaffinity gel. About half of the purified

    this gel and was

    5 molar glycine (pH 2-5). The gel

    was saturable with fibronectin and therefore the

    of fibronectin retained decreased

    when the initial load was in excess. IgG loaded

    on to the gel appeared in the breakthrough with

    no elution of IgG during subsequent treatment

    of the gel with glycine. Thus the gel was specific

    ffinity for IgG as per

    PEG precipitate from two patients was passed

    through an uncoupled sepharose gel column to

    specific adsorption of IgG by

    sepharose, and the eluate was loaded on to the

    fibronectin antibody immunoaffinity gel.

    -5 molar glycine

    yielded demonstrable amounts of IgG in

    addition to fibronectin. The column also

    retained small quantities of IgG from the PEG

    precipitate of a normal control subject. To

    determine if the column retained any IgG from

    untreated plasma, fresh plasma samples from a

    patient and a control were applied to the anti--

    fibronectin antibody column. IgG was retained

    from both plasmas but in greater amounts from

    Table - 2.

    was examined before and

    after plasmapheresis. The disappearance of a

    20S component from the plasma was associated

    IgG from 477 mg/l to

    yeloid Leukemia, high

    concentrations of plasma PEG precipitable IgG

    are suggestive of complexed high molecular

    weight IgG, possibly in the form of immune

    complexed IgG. Examination of plasma PEG

    precipitates by exclusion chromatography

    confirmed the presence of IgG with a

    molecular weight profile. This finding may have

    been artefactual, however, as PEG may induce

    aggregation of IgG [8, 9]. In view of this, fresh

    untreated plasma was examined by analytical

    ultracentrifugation and this confirmed th

    patients with Acute Myeloid L

    abnormal circulating high molecular weight

    material in the absence of any artefacts due to

    PEG precipitation. Furthermore, PEG

    precipitated the high molecular weight

    components, leaving a PEG plasma supernate

    free of such material.

    High concentrations of PEG precipitable

    fibronectin and IgG may be due to complex

    formation between these two proteins

    Fibronectin is capable of binding to a variety of

    plasma proteins [10], and complex formation

    between fibronectin and aggregated Ig

    been suggested by others [11, 12, 13]

    evidence for complex formation between

    fibronectin and IgG was obtained in our study

    by examining plasma and PEG precipitates by

    immunoaffinity chromatography. An anti

    fibronectin gel retained IgG from

    plasma and PEG precipitates, and to a lesser

    degree from normal plasma and PEG

    precipitates. As the gel had no affinity for IgG its

    retention is highly suggest

    formation with the retained fibronectin.

    Rheumatoid factor activity has

    some patients with primary myelofibrosis

    and the IgG present in the eluates might

    theoretically have been IgG which bound

    specifically with the sepharose coupled sheep

    antibody. No rheumatoid factor activity,

    however, was identifiable in the plasmas

    examined, though small amounts of IgG

    rheumatoid factor and anti

    ISSN: 2394-0026 (P)

    ISSN: 2394-0034 (O)

    Page 122

    are suggestive of complexed high molecular

    weight IgG, possibly in the form of immune

    complexed IgG. Examination of plasma PEG

    precipitates by exclusion chromatography

    confirmed the presence of IgG with a high

    molecular weight profile. This finding may have

    been artefactual, however, as PEG may induce

    . In view of this, fresh

    untreated plasma was examined by analytical

    ultracentrifugation and this confirmed that

    Myeloid Leukemia have

    abnormal circulating high molecular weight

    material in the absence of any artefacts due to

    PEG precipitation. Furthermore, PEG

    precipitated the high molecular weight

    components, leaving a PEG plasma supernate

    High concentrations of PEG precipitable

    fibronectin and IgG may be due to complex

    formation between these two proteins [5].

    Fibronectin is capable of binding to a variety of

    , and complex formation

    tween fibronectin and aggregated IgG has

    [11, 12, 13]. Further

    evidence for complex formation between

    fibronectin and IgG was obtained in our study

    by examining plasma and PEG precipitates by

    ity chromatography. An anti-

    fibronectin gel retained IgG from patients

    plasma and PEG precipitates, and to a lesser

    degree from normal plasma and PEG

    precipitates. As the gel had no affinity for IgG its

    retention is highly suggestive of complex

    formation with the retained fibronectin.

    Rheumatoid factor activity has been reported in

    some patients with primary myelofibrosis [12]

    and the IgG present in the eluates might

    theoretically have been IgG which bound

    specifically with the sepharose coupled sheep

    antibody. No rheumatoid factor activity,

    e in the plasmas

    examined, though small amounts of IgG

    rheumatoid factor and anti-idiotypic antibody

  • IgG fibronectin complexes in various types of Acute Myeloid Leukemia

    International Archives of Integrated Medicine, Vol.

    Copy right 2015, IAIM, All Rights Reserved.

    cant be excluded.

    Immune complexes must reach a critical size to

    be removed by the reticuloendothelial sys

    When antibody affinity is low or there is

    excess, the antigen-antibody network is small

    and elimination is slow [14]. The size of the

    complexes, and hence their cleara

    increased by opsonisation by other proteins

    for example, complement or rheumatoid fac

    [15]. Opsonisation of immune complexes by

    fibronectin may be a further means of increas

    ing the size of immune complexes. Another

    possibility is an auxiliary clearance mechanism

    for immune complexes via macrophage

    fibronectin receptors [16].

    Conclusion

    In conclusion, abnormal circulating high

    molecular weight IgG is present in the plasma of

    patients with Acute Myeloid Leukemia

    results of PEG precipitation and analytical

    ultracentrifugation suggest that this material is

    IgG in a high molecular weight complex form.

    Examination of plasma by immunoaffinity

    chromatography supports our previous

    evidence for complex formation between IgG

    and fibronectin. Further studies are necessary

    to confirm complex formation between fibro

    nectin and IgG and to evaluate the importance

    of this phenomenon not only in Acute Myeloid

    Leukemia but also in other disorders

    characterized by immune complex formation.

    References

    1. Lewis CM, Pegrum GD.

    complexes in myelofibrosis;

    guide to management.

    1978; 39: 233-9.

    2. Cappio FC, Vigliani R,

    Camussi G, Campana D,

    Idiopathic myelofibrosis;

    for immune-complexes in the

    IgG fibronectin complexes in various types of Acute Myeloid Leukemia

    International Archives of Integrated Medicine, Vol. 2, Issue 3, March, 2015.

    , IAIM, All Rights Reserved.

    Immune complexes must reach a critical size to

    be removed by the reticuloendothelial system.

    When antibody affinity is low or there is antigen

    antibody network is small

    . The size of the

    complexes, and hence their clearance, may be

    ation by other proteins

    for example, complement or rheumatoid factor

    of immune complexes by

    fibronectin may be a further means of increas-

    ing the size of immune complexes. Another

    possibility is an auxiliary clearance mechanism

    complexes via macrophage

    al circulating high

    molecular weight IgG is present in the plasma of

    nts with Acute Myeloid Leukemia. The

    results of PEG precipitation and analytical

    ultracentrifugation suggest that this material is

    IgG in a high molecular weight complex form.

    ation of plasma by immunoaffinity

    chromatography supports our previous

    evidence for complex formation between IgG

    and fibronectin. Further studies are necessary

    to confirm complex formation between fibro-

    nectin and IgG and to evaluate the importance

    s phenomenon not only in Acute Myeloid

    eukemia but also in other disorders

    ed by immune complex formation.

    Pegrum GD. Immune

    complexes in myelofibrosis; a possible

    guide to management. Br J Haematolol,

    R, Novarino A,

    Campana D, Gavosto F.

    Idiopathic myelofibrosis; a possible role

    complexes in the

    pathogenesis of bone marrow fibrosis.

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    3. Gordon BR, Coleman M,

    NK. Immunological abnormalities in

    myelofibrosis with activation of

    complement system.

    904-10.

    4. Vellenga E, Mulder NH,

    HO. A study of the cellular and humoral

    immune responses in patients with

    myelofibrosis. Clin Lab Haematol

    4: 239-46.

    5. Baglin TP, Simpson AW, Price SM,

    Boughton BJ. The composition of

    immune-complexes and their

    relationship to plasma fibronectin in

    chronic myeloproliferative dis

    Clin Pathol, 1987; 40:

    6. Axen R, Porath J, Emback

    coupling of peptides and proteins to

    polysaccharides by means of cyanogen

    halides. Nature, 1967;

    7. Vuento N, Vaheri A. Purification of

    fibronectin from human plasma by

    affinity chromatography under non

    denaturing conditions.

    183: 331-7.

    8. Cooper KM, Moore M. Critical aspects of

    immune complex assays employing

    polyethylene glycol.

    1983; 60: 289-303.

    9. Hack CE. A second look at immune

    complex assays.

    Repro Meppel, 1984.

    10. Yamada KM, Owen K. Fibronectin

    adhesive glycoproteins of cell surface

    and blood. Nature, 1978;

    11. Carter SD, Scott DL, Elson CJ. Fibronectin

    binding with immunoglobulin

    aggregates and its association with

    rheumatic disorders.

    25: 353-8.

    12. Rondeau E, Solal-Celigny P, Dhermy D,

    al. Immune disorders in agnogenic

    ISSN: 2394-0026 (P)

    ISSN: 2394-0034 (O)

    Page 123

    pathogenesis of bone marrow fibrosis.

    1981; 49: 17-21.

    Coleman M, Kohen P, Day

    ogical abnormalities in

    myelofibrosis with activation of

    complement system. Blood, 1981; 58:

    Vellenga E, Mulder NH, The TH, Nieweg

    HO. A study of the cellular and humoral

    immune responses in patients with

    Clin Lab Haematol, 1982;

    Baglin TP, Simpson AW, Price SM,

    Boughton BJ. The composition of

    complexes and their

    relationship to plasma fibronectin in

    chronic myeloproliferative disorders. J

    40: 1468-71.

    Axen R, Porath J, Emback S. Chemical

    coupling of peptides and proteins to

    polysaccharides by means of cyanogen

    1967; 214: 1302-4.

    Vuento N, Vaheri A. Purification of

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    affinity chromatography under non-

    denaturing conditions. Biochem J, 1979;

    Cooper KM, Moore M. Critical aspects of

    immune complex assays employing

    polyethylene glycol. J Immun Methods,

    A second look at immune

    Amsterdam: Krips

    Repro Meppel, 1984.

    Yamada KM, Owen K. Fibronectin-

    adhesive glycoproteins of cell surface

    1978; 275: 179-84.

    Carter SD, Scott DL, Elson CJ. Fibronectin

    binding with immunoglobulin

    aggregates and its association with

    rheumatic disorders. Br J Rheum, 1986;

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    Immune disorders in agnogenic

  • IgG fibronectin complexes in various types of Acute Myeloid Leukemia

    International Archives of Integrated Medicine, Vol.

    Copy right 2015, IAIM, All Rights Reserved.

    myeloid metaplasia: relations to

    myelofibrosis. Br J Haematol

    467-75.

    13. Scott DL, Carter SD, Coppock JS,

    Robinson M, Walton KW. Differences

    between plasma and sy

    fibronectin. Rheumatol Int

    54.

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    BC. Studies on antigen

    complexes. I. Elimination of soluble

    complexes from rabbit circulation.

    Med, 1971; 133: 713-39.

    15. Van Snick JL, Van Roost E, Markowetz B,

    Source of support: Department of Oncology, Medical College, Kolkata, India

    Conflict of interest: None declared.

    Table 2: Sedimentation coefficients and number of identifiable individual sedimentation peaks

    from examination of normal and patient plasmas

    ultracentrifugation.

    Subject Number of peaks

    Controls

    1 0

    2 0

    3 1

    4 0

    5 0

    Patients

    1 2

    2 3

    3 3

    4 4

    5 3

    5 2

    (following plasmapheresis)

    Case 3

    Plasma 3

    PEG 3

    PEG 0

    IgG fibronectin complexes in various types of Acute Myeloid Leukemia

    International Archives of Integrated Medicine, Vol. 2, Issue 3, March, 2015.

    , IAIM, All Rights Reserved.

    myeloid metaplasia: relations to

    Br J Haematol, 1983; 53:

    Scott DL, Carter SD, Coppock JS,

    Robinson M, Walton KW. Differences

    between plasma and synovial fluid

    Rheumatol Int, 1985; 5: 49-

    Mannick M, Arend MP, Hall AP, Gilliland

    BC. Studies on antigen-antibody

    complexes. I. Elimination of soluble

    complexes from rabbit circulation. J Exp

    39.

    Van Snick JL, Van Roost E, Markowetz B,

    Cambiaso CL, Masson PL. Enhancement

    of IgM rheumatoid factor of in vitro

    ingestion by macrophages and in vivo

    clearance of aggregated IgG or antigen

    antibody complexes.

    1978; 8: 279-85.

    16. Bevilacqua MPI, Amrani D, Mosesson

    MW, Bianoco C. Receptors for cold

    insoluble globulin (plasma fibronectin)

    on human monocytes.

    153: 42-60.

    Department of Oncology, Medical College, Kolkata, India

    None declared.

    Sedimentation coefficients and number of identifiable individual sedimentation peaks

    from examination of normal and patient plasmas and PEG precipitates by analytical

    Sedimentation coefficients

    9S

    14S 21S

    13S 15S 20S

    14S 15S > 15S

    8S 9S 10S 17S

    9S 11S 20S

    9S 11S

    14S 15S >15S

    15S 18S 33S

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    Page 124

    Cambiaso CL, Masson PL. Enhancement

    of IgM rheumatoid factor of in vitro

    ingestion by macrophages and in vivo

    clearance of aggregated IgG or antigen-

    antibody complexes. Eur J Immunol,

    Amrani D, Mosesson

    MW, Bianoco C. Receptors for cold

    insoluble globulin (plasma fibronectin)

    on human monocytes. J Exp Med, 1981;

    Sedimentation coefficients and number of identifiable individual sedimentation peaks

    and PEG precipitates by analytical

    PEG IgG (mg/l)

    86

    115

    140

    207

    232

    759

    547

    600

    636

    477

    338

    600

    600

    0

  • IgG fibronectin complexes in various types of Acute Myeloid Leukemia

    International Archives of Integrated Medicine, Vol.

    Copy right 2015, IAIM, All Rights Reserved.

    Table 3: Affinity chromatography of fibronectin and IgG from plasma and PEG precipitates (using

    an anti-fibronectin immunoaffinity gel).

    from the amount eluted divided by the amount loaded onto the gel. The gel retained purified

    fibronectin but not IgG.

    Sample Protein

    Purified fibronectin Fibronectin

    IgG

    IgG solution Fibronectin

    IgG

    Case 1 PEG Fibronectin

    precipitate IgG

    Case 5 PEG Fibronectin

    precipitate IgG

    Control PEG Fibronectin

    precipitate IgG

    Case 5 Fibronectin

    plasma IgG

    Control Fibronectin

    plasma IgG

    IgG fibronectin complexes in various types of Acute Myeloid Leukemia

    International Archives of Integrated Medicine, Vol. 2, Issue 3, March, 2015.

    , IAIM, All Rights Reserved.

    Affinity chromatography of fibronectin and IgG from plasma and PEG precipitates (using

    fibronectin immunoaffinity gel). The percentage of IgG retained by the gel was calculated

    from the amount eluted divided by the amount loaded onto the gel. The gel retained purified

    Protein Load Recovery in

    glycine

    Fibronectin 390 189

    0 0

    Fibronectin 0 0

    2370 0

    Fibronectin 1500 131

    1440 105

    Fibronectin 699 319

    623 75

    Fibronectin 300 149

    147 5

    Fibronectin 222 70

    20,000 259

    Fibronectin 670 241

    11,000 34

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    Page 125

    Affinity chromatography of fibronectin and IgG from plasma and PEG precipitates (using

    The percentage of IgG retained by the gel was calculated

    from the amount eluted divided by the amount loaded onto the gel. The gel retained purified

    of

    Retained

    0

    0

    70

    120

    3-5

    1-3

    0-3