Why the study?
Chronic stimulation by infectious pathogens or self-antigen GlcSph can lead to MGUS and MM, but additional targets remain unidentified for purified monoclonal Igs not captured by standard assays.
What are the specific infectious pathogen targets for monoclonal immunoglobulins in patients with MGUS and multiple myeloma?
What are the specific infectious pathogen targets for monoclonal immunoglobulins in patients with MGUS and multiple myeloma?
Monoclonal gammopathy of undetermined significance initiated by poliovirus or coxsackievirus epitopes is not rare, and few of these cases appear to evolve into multiple myeloma.
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Enteroviral epitope binding in MGUS supports infectious trigger hypothesis; leaves open causal role and progression implications.
Chronic stimulation by infectious pathogens or self-antigen glucosylsphingosine (GlcSph) can lead to monoclonal gammopathy of undetermined significance (MGUS) and multiple myeloma (MM). Novel assays such as the multiplex infectious antigen microarray (MIAA) and GlcSph assays, permit identification of targets for >60% purified monoclonal immunoglobulins (Igs). Searching for additional targets, we selected 28 purified monoclonal Igs whose antigen was not represented on the MIAA and GlcSph assays; their specificity of recognition was then analyzed using microarrays consisting of 3760 B-cell epitopes from 196 pathogens. The peptide sequences PALTAVETG and PALTAAETG of the VP1 coat proteins of human poliovirus 1/3 and coxsackievirus B1/B3, respectively, were specifically recognized by 6/28 monoclonal Igs. Re-analysis of patient cohorts showed that purified monoclonal Igs from 10/155 MGUS/SM (6.5%) and 3/147 MM (2.0%) bound to the PALTAVETG or PALTAAETG epitopes. Altogether, PALTAV/AETG-initiated MGUS are not rare and few seem to evolve toward myeloma.
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Harb et al. (2021) studied this question.
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