Abuse Of Trust by Allan Hall

By Allan Hall

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Doctors call this excess light chain protein the Bence Jones protein after its discoverer, English physician Henry Bence Jones who described it in 1847. About 3 out of 4 people with malignant myeloma have high amounts of Bence Jones protein in their blood and urine. Excessive M protein can have dire consequences. M protein can thicken the blood, which reduces blood flow to the brain and causes headaches and blurred vision, or it can cause increased bruising and nose bleeds. Bence Jones protein causes blood clots in the arms, legs, kidneys, eyes, and heart, which ultimately lead to kidney problems, loss of vision, heart disease, and numbness in the arms and legs because of nerve damage.

The presence of IgG or IgA is often associated with different myeloma symptoms. Myeloma cells making IgA are more often found in the blood, whereas myeloma cells that make IgG are most often in the bone. Electrophoresis of blood plasma can also be used to measure any changes in M protein over time. This allows doctors to monitor M protein and track the progress of the disease and perhaps assess how well the patient’s myeloma is responding to drug treatments. If M protein levels are going down after drug treatment, the drugs are working but if M protein rises after therapy, the cancer is coming back.

Plasmablasts sometimes undergo one final genetic fine tuning of their antibody genes, which involves a focused alteration or trimming of the antibody variable region gene segments called somatic hypermutation before they finally transform into a plasma cell. Somatic hypermutation changes the antibody gene code in such a way that the antibody now binds more strongly to its antigen. Plasma cells are like “miniature antibody factories,” whose sole function is to make large amounts of antibody. It is estimated that one plasma cell can make two thousand antibody molecules per second.

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