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Amyloid neuropathy: immunocytochemical localization of intra- and extracellular immunoglobulin light chains

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Summary

Sural nerve specimens from ten patients with amyloidosis (hereditary, associated with lymphoproliferative disorders, or of unknown origin) and peripheral neuropathy were investigated by immunohistochemistry at the light and electron microscopic level. Peroxidase-antiperoxidase and immunogold techniques were applied to glutaraldehyde-fixed, osmicated and epoxy-embedded tissue. In five cases, four of which associated with lymphoproliferative disorders, amyloid deposits strongly and exclusively reacted with antibodies to kappa or lambda light chains, respectively. By electron microscopy, bundles of immunogold-labelled amyloid fibrils could be identified in coated and uncoated single membrane-bound vesicles of endoneurial macrophages. Schwann cells did not contain intracellular amyloid but their processes were entangled in amyloid fibrils and their basement membranes were sometimes fused with the fibrillar masses. It is concluded that immunoglobulin light chains in AL (amyloid of immunoglobulin light chain origin) amyloidosis precipitate, forming amyloid fibrils, in the presence of, and presumably with the assistence of, endoneurial cells. Inefficiency of phagocytosis appears to be one of the major causes for the deleterious effects of amyloid.

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References

  1. Bendayan M, Zollinger M (1983) Ultrastructural localization of antigenic sites on osmium-fixed tissues applying the protein A-gold technique. J Histochem Cytochem 31:101–109

    Google Scholar 

  2. Beyreuther K, Multhaupt G, Simms G, Pottgiesser J, Schröder W, Martins RH, Masters CC (1986) Neurofibrillary tangles of Alzheimer's disease and “aged” Down's syndrome contain the same protein as the amyloid of plaque cores and blood vessels. Disc Neurosci 3:68–80

    Google Scholar 

  3. Cohen AS, Rubinow A (1984) Amyloid neuropathy. In: Dyck PJ, Thomas PK, Lambert EN, Bunge R (eds) Peripheral neuropathy. Saunders, Philadelphia London, pp 1866–1898

    Google Scholar 

  4. Coimbra S, Andrade C (1971) Familial amyloid polyneuropathy: an electron microscope study of the peripheral nerve in five cases. Brain 94:199–221

    Google Scholar 

  5. Donini U, Casanova S, DalBosco F, Linke RP (1984) Immunohistochemical typing of amyloid on hydroxyethyl-methacrylate-embedded renal biopsies. Appl Pathol 2:299–307

    Google Scholar 

  6. Durie BGM, Persky B, Soehnlen BJ, Grogan TM, Salmon SE (1982) Amyloid production in human myeloma stemcell culture, with morphological evidence of amyloid secretion by associated macrophages. N Engl J Med 307:1689–1692

    Google Scholar 

  7. Dyck PJ, Lambert EH (1969) Dissociated sensation in amyloidosis. Compound action potential, quantitative histology and teased-fibers, and electron microscopic studies of sural nerve biopsies. Arch Neurol 20:490–507

    Google Scholar 

  8. Franklin EC, Zucker-Franklin D (1972) Current concepts of amyloid. Adv Immunol 15:249–304

    Google Scholar 

  9. Fuks A, Zucker-Franklin D (1985) Impaired Kupffer cell function precedes development of secondary amyloidosis. J Exp Med 161:1013–1028

    Google Scholar 

  10. Ghadially FN (1982) Ultrastructural pathology of the cell and matrix. Butterworths, London, p 971

    Google Scholar 

  11. Glenner GG (1980) Amyloid deposits and amyloidosis. N Engl J Med 302:1283–1292

    Google Scholar 

  12. Gueft B, Ghidoni JJ (1963) The site of formation and ultrastructure of amyloid. Am J Pathol 43:837–854

    Google Scholar 

  13. Hanyu N, Ikeda S, Nakadai A, Yanagisawa N, Powell H (1989) Peripheral nerve pathological findings in familial amyloid polyneuropathy: a correlative study of proximal sciatic nerve and sural nerve lesions. Ann Neurol 25:340–350

    Google Scholar 

  14. Hikita K, Tateishi J, Nagara H (1985) Morphogenesis of amyloid plaques in mice with Creutzfeldt-Jakob disease. Acta Neuropathol (Berl) 68:138–144

    Google Scholar 

  15. Janssen S, Elema JD, van Rijswijk MH, Limburg PC, Meijer S, Mandema E (1985) Classification of amyloidosis: immunohistochemistry versus the potassium permanganate method in differentiating AA from AL amyloidosis. Appl Pathol 31:29–38

    Google Scholar 

  16. Janssen S, Martin H, van Rijswijk MH, Meijer S, Ruinen L, van der Hem K (1986) Clinical evaluation of AA and AL amyloid disease. In: Marrink J, VanRijswijk M (eds) Amyloidosis. Martinus Nijhoff, Dordrecht, pp 61–72

    Google Scholar 

  17. Kirkpatrick CJ, Curry A, Galle J, Melzner I (1986) Systemic kappa light chain deposition and amyloidosis in multiple myeloma: novel morphological observations. Histopathology 10:1065–1076

    Google Scholar 

  18. Kitamoto T, Tateishi J, Hikita K, Nagara H, Takeshita I (1985) A new method to classify amyloid fibril proteins. Acta Neuropathol (Berl) 67:272–278

    Google Scholar 

  19. Kjeldsberg CR, Eyre HJ, Totzke H (1977) Evidence for intracellular amyloid formation in myeloma. Blood 50:493–504

    Google Scholar 

  20. Koeppen AM, Mitzen EJ, Hans MB, Peng SK (1985) Familial amyloid polyneuropathy. Muscle Nerve 8:733–749

    Google Scholar 

  21. Krücke W (1963) Zur pathologischen Anatomie der Paramyloidose. Acta Neuropathol (Berl) [Suppl] II:74–93

    Google Scholar 

  22. Linke RP (1982) Immunohistochemical identification and cross reaction of amyloid fibril proteins in senile heart and amyloid in familial polyneuropathy. Clin Neuropathol 1:172–182

    Google Scholar 

  23. Marrink J, van Rijswijk M (1986) Amyloidosis. Martinus Nijhoff, Dordrecht, p 378

    Google Scholar 

  24. Nakagawa S (1984) Ultrastructural investigation of amyloidosis. Pathogenesis of systemic amyloidosis. Appl Pathol 2:328–340

    Google Scholar 

  25. Neundörfer B, Meyer JG, Volk B (1977) Amyloid neuropathy due to monoclonal gammopathy. J Neurol 216:207–215

    Google Scholar 

  26. Numura S, Kano T, Uchino H (1982) Intracellular formation of amyloid fibrils in myeloma: cytochemical, immunochemical and electron microscopic observations. Acta Haematol Jpn 45:615–621

    Google Scholar 

  27. Pajor L, Kelenyi G (1984) Primary cardiovascular amyloidosis with benign monoclonal gammopathy. Virchows Arch [A] 403:195–203

    Google Scholar 

  28. Peters A, Palay SL, Webster H deF (1976) The fine structure of the nervous system. Saunders, Philadelphia, pp 33–34

    Google Scholar 

  29. Said G, Ropert A, Faux N (1984) Length-dependent degeneration of fibrils in Portuguese amyloid neuropathy. Neurology 34:1025–1032

    Google Scholar 

  30. Shirahama AT, Cohen AS (1970) The association of hemidesmosome-like plaques and dense coating with the pinocytotic uptake of a heterologous fibrillar protein (amyloid)by macrophages. J Ultrastruct Res 33:587–597

    Google Scholar 

  31. Shirahama T, Cohen AS (1971) Lysosomal breakdown of amyloid fibrils by macrophages. Am J Pathol 63:463–485

    Google Scholar 

  32. Shirahama T, Cohen AS (1973) An analysis of the close relationship of lysosomes to early deposits of amyloid. Am J Pathol 73:97–114

    Google Scholar 

  33. Shiramaha T, Cohen AS (1975) Intralysosomal formation of amyloid fibrils. Am J Pathol 81:101–116

    Google Scholar 

  34. Shirahama T, Cohen AS (1985) Immunocytochemical study of hepatocyte syntheses of amyloid AA. Am J Pathol 118:108–115

    Google Scholar 

  35. Shirahama T, Skinner M, Sipe JD, Cohen AS (1985) Widespread occurrence of AP in amyloidotic tissue. Virchows Arch [B] 48:197–206

    Google Scholar 

  36. Sternberger LA (1986) Immunocytochemistry, 3rd edn. Wiley & Sons, New York

    Google Scholar 

  37. Takahashi K, Naito M, Takatsuki K, Kono F, Chitose M, Ooshima S, Mori N, Sakuma H, Uchino F (1987) Multiple myeloma, IgA kappa type, accompanying crystal-storing histiocytosis and amyloidosis. Acta Pathol Jpn 37:141–154

    Google Scholar 

  38. Thomas PK, King RHM (1974) Peripheral nerve changes in amyloid neuropathy. Brain 97:395–406

    Google Scholar 

  39. Uchino F, Takahashi M, Yokota T, Ishihara T (1985) Experimental amyloidosis. The role of Kupffer cells in amyloid formation. Appl Pathol 3:78–87

    Google Scholar 

  40. Van Rijswijk MH, van Heusden CWGJ (1979) The potassium permanganate method. Am J Pathol 97:43–58

    Google Scholar 

  41. Viale G, Dell'Orto P, Colombi R, Coggi G (1986) Ultrastructural localization of extracellular immunoglobulins in immune-complex-mediated glomerulonephritis. Histochemistry 84:1–4

    Google Scholar 

  42. Vital C, Lacoste D, Deminiere C, Lagueny A, Boisseau C, Reiffer J, Amouretti M, Broustet A (1983) Amyloid neuropathy and multiple myeloma. Eur Neurol 22:106–112

    Google Scholar 

  43. Vital C, Vallat JM (1988) Ultrastructural study of the human diseased peripheral nerve, 2nd edn. Elsevier, New York, pp 113–116, 149–166

    Google Scholar 

  44. Westermark P (1986) Amyloid of the islets ofLangerhans and its connection with diabetes mellitus. In: Marrink J, Van Rijswijk N (eds) Amyloidosis. Martinus Nijhoff, Dordrecht, pp 255–259

    Google Scholar 

  45. Zucker-Franklin D (1970) Immunophagocytosis of human amyloid fibrils by leucocytes. J Ultrastruct Res 32:247–257

    Google Scholar 

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Supported in part by a grant from the Deutsche Forschungsgemeinschaft (FE 255/1/1) (CS). Presented in Part at the Fourth International Meeting of the Periveral Nerve Association of America, Halifax, July 19–23, 1988

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Sommer, C., Schröder, J.M. Amyloid neuropathy: immunocytochemical localization of intra- and extracellular immunoglobulin light chains. Acta Neuropathol 79, 190–199 (1989). https://doi.org/10.1007/BF00294378

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  • DOI: https://doi.org/10.1007/BF00294378

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