1. High prevalence of the MYD88 L265P mutation in IgM anti-MAG paraprotein-associated peripheral neuropathy
- Author
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Steven T. Pals, Josephine M.I. Vos, Mary M. Reilly, Rajeev Gupta, Monique C. Minnema, Jane Chalker, Michael P. Lunn, Marie José Kersten, Willem Kraan, Nicolette C. Notermans, Shirley D'Sa, W. Ludo van der Pol, Pathology, and Clinical Haematology
- Subjects
biology ,business.industry ,Cold agglutinin disease ,medicine.disease ,Malignancy ,Asymptomatic ,IgM Monoclonal Gammopathy ,03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,medicine.anatomical_structure ,Peripheral neuropathy ,Immunoglobulin M ,hemic and lymphatic diseases ,Immunology ,biology.protein ,Medicine ,Surgery ,Neurology (clinical) ,Bone marrow ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Multiple myeloma ,030215 immunology - Abstract
Immunoglobulin M (IgM) anti-myelin-associated glycoprotein (MAG) paraprotein-associated peripheral neuropathy (anti-MAG PN) is the most frequent type of paraprotein-associated neuropathy. It typically presents as a chronic demyelinating disorder with progressive ataxia, tremor and sensory disturbance.1 By definition, IgM paraproteinaemia and high-titre anti-MAG antibodies are present. Up to 50% of patients develop significant disability. Progressive disease-related disability is considered an indication to start treatment. However, there is no consensus on the optimal treatment approach and a high clinical need for effective therapies.1 IgM paraproteinaemia is the hallmark of Waldenstrom’s macroglobulinaemia (WM) and IgM monoclonal gammopathy of unknown significance (MGUS). WM is an indolent B-cell malignancy with lymphoplasmacytic differentiation typically localised in the bone marrow (BM), while IgM MGUS is considered a premalignant condition, defined as asymptomatic IgM paraproteinaemia with 90%) of patients with WM and approximately 50% of patients with IgM MGUS. The mutation is absent in healthy donors, multiple myeloma and non-IgM MGUS.3 MYD88 is an adaptor protein of the interleukin-1R and toll-like receptor signalling pathways that ultimately lead to activation of nuclear factor …
- Published
- 2018