If you find a monoclonal immunoglobulin on an SPEP (or UPEP), you can characterize it using immunoelectrophoresis or immunofixation. Immunoglobulins usually migrate to the gamma region you can see a small, broad bump in the normal serum (corresponding to the polyclonal immunoglobulins in blood, all of which migrate to a slightly different place on the gel) and a big spike in the blood from the patient with myeloma (corresponding to the monoclonal immunoglobulin, all of which migrates to the same exact spot on the gel). Albumin, as you can see, is the most abundant protein in blood, and it has its own region way on the left. You can see an example above, with normal serum proteins in green, and proteins from a patient with myeloma in red. The gel is stained with a dye, and the percent of protein in the various fractions is is determined. In an SPEP, the proteins in the serum are separated by regular old electrophoresis, using a gel. You also do this procedure using urine, because sometimes myeloma cells will only make light chains, which end up being peed out in the urine (so if you only did a SPEP, you would miss them). On performing serum protein electrophoresis, monoclonal Igs appear as single intense, discrete band on agarose gel and a sharp peak in the densitometer tracing. This procedure tells you whether there is a monoclonal protein present. were the first to demonstrate a tall, narrow based spike by serum protein electrophoresis (SPEP) which was later termed as M component/peak by Moore et al. The first thing that’s usually done in the lab is serum protein electophoresis (SPEP). Background: Previous comparisons of monoclonal protein quantification identified a bias between serum protein electrophoresis (SPEP) and immunonephelometry (NEPH). Both pieces of information are useful in diagnosing and following multiple myeloma. Q. I have multiple myeloma, and I read your post What is an M-spike, and it was excellent contribution which I have been looking for in months. Please, can you tell me how the M-spike is quantifed?Ī. That’s a great question! As you alluded to, there are a couple ways of looking at a monoclonal antibody: identification (i.e., is it IgG kappa, or IgA lamda, or something else) and quantification (how much of it is present).
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