Anti-Kappa Light Chain monoclonal antibody, clone OX-12 [HRP]

The management of gout consists of urate-lowering therapy and acute and chronic anti-inflammatory drugs. Allopurinol, a xanthine oxidase inhibitor, is the primary urate-lowering therapy employed for decades. Recent studies suggest cardiovascular disease and mortality, chronic kidney disease, prostate cancer, and manic symptoms are reduced in patients with gout treated with allopurinol. These findings support that allopurinol contributes to a variety of beneficial effects beyond urate lowering. This manuscript reviews the analgesic and anti-inflammatory properties of allopurinol, which are rarely discussed. Several mechanisms are suggested to confer these benefits including accumulation of adenosine and inhibitory effects of allopurinol on reactive oxygen species, tumor necrosis factor-alpha, nuclear factor kappa-light-chain-enhancer of activated B cells, and the NACHT, LRR and PYD domains-containing protein 3 (NLRP3) inflammasome. Also, allopurinol blocks the stimulating effects of thioredoxin-interacting protein and interacts directly with the redox-active domain of thioredoxin as a negative regulator, decreasing NLRP3 activation. The importance of allopurinol's analgesic and anti-inflammatory properties requires further study and the implications to patient care better understood. (C) 2020 Published by Elsevier Inc.

We analyzed the prognostic impact of levels of free light chains (FLC) in 106 patients with DLBCL, selecting 61 patients with a monoclonal (M) protein in serum, and 45 patients without a M protein as an IPI-matched control group. Patients with a M protein had higher levels of FLC, but these were not of prognostic significance in this group. The presence of a M protein nullified associations of kappa-FLC with several laboratory parameters indicating immune system activation observed in patients without a M protein. Patients without M protein and kappa-FLC >50 mg/L had a significant inferior event-free survival (p = .004). The presence of M protein of an IgM type at diagnosis was a negative outcome predictor (p = .008), while a non-IgM M protein did not significantly impact on prognosis. In conclusion, the prognostic performance of the FLC assay is altered by the presence of a M protein.