Investigating the utility of saliva immunoglobulins for the detection of myeloma and using myeloma proteins to clarify partition between oral and systemic immunity

Jennifer Heaney, Sian Faustini, Lili Evans, Alec Rapson, Emily Collman, Annabelle Emery, John P. Campbell, Sally Moore, Margaret Goodall, Zaheer Afzal, Iain Chapple, Guy Pratt, Mark Drayson

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Abstract

Objectives
Myeloma is characterised by the presence of monoclonal immunoglobulin (M-protein) and the free light chain (FLC) in blood. We investigated whether these M-proteins and FLC are detectable in myeloma patients’ saliva to evaluate its utility for non-invasive screening and monitoring of haematological malignancies.

Methods
A total of 57 patients with monoclonal gammopathy and 26 age-matched healthy participants provided paired serum and saliva samples for immunoglobulin characterisation and quantification.

Results
Myeloma patients had IgG or IgA M-protein levels ranging up to five times and FLC levels up to a thousand times normal levels of polyclonal immunoglobulins. Despite these highly elevated levels, only two IgG and no IgA M-proteins or FLC could be detected in paired saliva samples. Most patients had reduced levels of serum polyclonal immunoglobulins, but all had normal levels of salivary IgA.

Conclusions
Immunoglobulin transfer from blood is not determined by levels in the systemic circulation and more likely dictated by periodontal inflammation and the integrity of the oral epithelium. Immunoglobulins secreted by bone marrow plasma cells do not substantially enter saliva, which represents a poor medium for myeloma diagnosis. These findings, along with normal salivary IgA levels despite systemic immunoparesis, support a strong partitioning of oral from systemic humoral immunity.
Original languageEnglish
JournalEuropean journal of haematology
Early online date20 Feb 2022
DOIs
Publication statusE-pub ahead of print - 20 Feb 2022

Bibliographical note

Publisher Copyright:
© 2022 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd.

Keywords

  • haematological neoplasms
  • immunity, humoral
  • immunoglobulin light chains
  • immunoglobulins
  • multiple myeloma
  • paraproteins
  • plasma cells
  • saliva

ASJC Scopus subject areas

  • Hematology

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