GAMMOPATIE MONOCLONALI BENIGNE: PROBABILE SPECIFICITA ANTICORPALE DELLE IMMUNOGLOBULINE MONOCLONALI

40 patients with benign paraproteinemia have been studied in relation to their age and associated diseases. Significantly high frequence of liver disease (CALD, cirrhosis, hepatoma, metastases) has been found (12 over 40 people) and increased incidence of idiopathic paraproteinaemia in the old age has been confirmed. 9 patients have been followed for 5 years, so that one could be sure that they had really benign paraproteinaemia: these patients have been then studied from an immunological point of view, in vivo by means of skin tests (PPD, Candida, Tricophyton, DNCB) and in vitro by searching for circulating immune complexes (using a new highly specific immunoenzymatic method), and compared to controls without paraproteinaemia. Highly positive skin tests have been found only in 7 over 9 patients (even in old subjects) and 6 of them had circulating immune complexes (C.I.C.) in their sera; all the controls were negative both for skin tests and for C.I.C. Immune complexes have been found also in some cases of idiopathic paraproteinaemia, so that they do not seem to be in relation to the associated diseases. The Authors suggest that a genetically determined defect in regulator/suppressor T lymphocyte activity may cause the growth of a benign B cell neoplasm; and the monoclonal immunoglobulins most probably have antibody specificity and are directed against target antigens.