Plasma cell dyscrasia and peripheral neuropathy: identification of the myelin antigens that react with human paraproteins.

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Abstract
In some cases of polyneuropathy and plasma cell dyscrasia, the monoclonal antibodies react with human peripheral nerve myelin. To identify the myelin antigens involved, the proteins of human central and peripheral nerve myelin were separated by polyacrylamide gel electrophoresis, transferred onto nitrocellulose sheets and immunoenzymatic technique was used to detect the reactive antigens. Serum IgM but not IgG from 3 patients with neuropathy and complement-fixing anti-human myelin IgM paraproteins immunostained a protein of .apprx. 100,000 daltons in human peripheral nerve myelin and a protein or closely migrating proteins of similar size in human CNS myelin. In a 4th patient, both IgM and IgG immunostained the antigen. Immunostaining was specific for the paraprotein L chain type and absorption of the patients'' sera with human peripheral nerve myelin eliminated the reaction with the CNS proteins. No reaction was seen with rabbit peripheral nerve myelin or with membranes prepared from human myotubes, human T cells or human fibroblasts. Control sera from 6 patients with neuropathy and IgM paraproteins that did not react with myelin, from 4 patients with IgM paraproteins but no neuropathy and from 3 normal subjects did not immunostain myelin.