High titer anti-HIV antibody reactivity associated with a paraprotein spike in a homosexual male with AIDS related complex.

Important note: Information in this article was accurate in 1988. The state of the art may have changed since the publication date.

High titer anti-HIV antibody reactivity associated with a paraprotein spike in a homosexual male with AIDS related complex.

Blood. 1988 May;71(5):1397-401. Unique Identifier : AIDSLINE MED/88193369
Ng VL; Hwang KM; Reyes GR; Kaplan LD; Khayam-Bashi H; Hadley WK; McGrath MS; Department of Laboratory Medicine, UCSF.

Abstract: We observed a human immunodeficiency virus (HIV)-infected homosexual male with AIDS related complex (ARC) who had a serum globulin level of 80 g/L. Serum protein electrophoresis revealed a gamma globulin fraction of 40 g/L, of which 50% (20 g/L) was contained within a paraprotein spike, comprised predominantly of IgG kappa. This patient also had high titer anti-HIV antibodies in his serum, which were Western blot reactive at a final dilution of 1:500,000, and recognized gp120env, p66pol, p55gag, p53pol, p41gag, and p24gag. Because paraproteins in the past have been shown to be directed against specific antigens, we purified this patient's paraprotein using a modified high performance liquid chromatography (HPLC)-hydroxylapatite procedure and tested the purified paraprotein for anti-HIV antibody activity. The purified paraprotein retained anti-HIV antibody activity to a final dilution of 1:100,000, and recognized p66pol, p55gag, p53pol, p41gag, and p24gag. The recognition of both gag and pol gene products suggested that the purified paraprotein might not be monoclonal in origin. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) demonstrated that the purified paraprotein contained at least two immunoglobulin light chain species (Mol wt 30 to 33 Kd). Affinity chromatography of the purified paraprotein using a p24-Sepharose 4B matrix separated the gag and pol antibody activities. Immunoglobulin gene rearrangement analysis of a bone marrow aspirate (which contained 15% plasma cells) failed to reveal a clonal population of immunoglobulin producing cells. We conclude that this patient's paraprotein accounted for most of the anti-HIV activity present in whole serum, and that this paraprotein was not monoclonal in origin.

Keywords: Adult Antibodies, Viral/*ANALYSIS/GENETICS Antigens, Viral/IMMUNOLOGY AIDS-Related Complex/BLOOD/*IMMUNOLOGY Case Report DNA/GENETICS Human HIV/*IMMUNOLOGY Immunoglobulins, kappa-Chain/GENETICS/*IMMUNOLOGY Male Paraproteins/GENETICS/*IMMUNOLOGY Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. JOURNAL ARTICLE

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