Correlated atomic force and transmission electron microscopy of nanotubular structures in pulmonary surfactant

Pulmonary surfactant stabilizes the lung by reducing surface tension at the air-water interface of the alveoli. Surfactant is present in the lung in a number of morphological forms, including tubular myelin (TM). TM is composed of unusual 40 x 40 nm square elongated proteolipid tubes. Atomic force microscopy (AFM) was performed on polymer-embedded Lowicryl and London Resin-White (LR-White) unstained thin sections. AFM was used in imaging regions of the sections where TM was detected by transmission electron microscopy (EM) of corresponding stained sections. Tapping- and contact-mode AFM imaging of the unstained sections containing TM indicated a highly heterogeneous surface topography with height variations ranging from 10 to 100 nm. In tapping-mode AFM, tubular myelin was seen as hemispherical protrusions of 30-70 nm in diameter, with vertical dimensions of 5-8 nm. In contact-mode AFM and with phase imaging using a sharper (>10 nm nominal radius) probe, square open-ended tubes which resembled typical electron micrographs of such regions were observed. The cross-hatch structures observed inside the tubes using EM were not observed using AFM, although certain multilobe structures and topographic heterogeneity were detected inside some tubes. Other regions of multilamellar bodies and some regions where such bilayer lamella appear to fuse with the tubes were found in association with TM using AFM. EM of acetone-delipidated tubes in LR-White revealed rectangular tubular cores containing cross-hatched structures, presumably protein skeletons. AFM surface topography of these regions showed hollow depressions at positions at which the protein was anticipated instead of the protrusions seen in the lipid-containing sections. Gold-labeled antibody to surfactant protein A was found associated somewhat randomly within the regions containing the protein skeletons. The topography of the gold particles was observed as sharp peaks in contact-mode AFM. This study suggests a method for unambiguous detection of three-dimensional nanotubes present in low abundance in a biological macromolecular complex. Only limited detection of proteins and lipids in surfaces of embedded tubular myelin was possible. EM and AFM imaging of such unusual biological structures may suggest unique lipid-protein associations and arrangements in three dimensions.

Filaments of surfactant protein A specifically interact with corrugated surfaces of phospholipid membranes

Pulmonary surfactant, a mixture of lipids and surfactant proteins (SPs), plays an important role in respiration and gas exchange. SP-A, the major SP, exists as an octadecamer that can self-associate to form elongated protein filaments in vitro. We have studied here the association of purified bovine SP-A with lipid vesicle bilayers in vitro with negative staining with uranyl acetate and transmission electron microscopy. Native bovine surfactant was also examined by transmission electron microscopy of thinly sectioned embedded material. Lipid vesicles made from dipalmitoylphosphatidylcholine and egg phosphatidylcholine (1:1 wt/wt) generally showed a smooth surface morphology, but some large vesicles showed a corrugated one. On the smooth-surfaced vesicles, SP-As primarily interacted in the form of separate octadecamers or as multidirectional protein networks. On the surfaces of the striated vesicles, SP-As primarily formed regularly spaced unidirectional filaments. The mean spacing between adjacent striations and between adjacent filaments was 49 nm. The striated surfaces were not essential for the formation of filaments but appeared to stabilize them. In native surfactant preparations, SP-A was detected in the dense layers. This latter arrangement of the lipid bilayer-associated SP-As supported the potential relevance of the in vitro structures to the in vivo situation.

Formation of membrane lattice structures and their specific interactions with surfactant protein A

Biological membranes exist in many forms, one of which is known as tubular myelin (TM). This pulmonary surfactant membranous structure contains elongated tubes that form square lattices. To understand the interaction of surfactant protein (SP) A and various lipids commonly found in TM, we undertook a series of transmission-electron-microscopic studies using purified SP-A and lipid vesicles made in vitro and also native surfactant from bovine lung. Specimens from in vitro experiments were negatively stained with 2% uranyl acetate, whereas fixed native surfactant was delipidated, embedded, and sectioned. We found that dipalmitoylphosphatidylcholine-egg phosphatidylcholine (1:1 wt/wt) bilayers formed corrugations, folds, and predominantly 47-nm-square latticelike structures. SP-A specifically interacted with these lipid bilayers and folds. We visualized other proteolipid structures that could act as intermediates for reorganizing lipids and SP-As. Such a reorganization could lead to the localization of SP-A in the lattice corners and could explain, in part, the formation of TM-like structures in vivo.

Values in action

St. John Health System, Detroit, is committed to the values of wisdom, compassion, service to the neighbor, stewardship and servant leadership. When a patient walks through any one of the six St. John Hospitals, they see these words displayed many times. But what do they mean to the employees? Patients? The community? According to Anthony R. Tersigni, EdD, St. John president and CEO, "The values remind us of who we are and what our responsibilities are to the communities we serve."

Fine needle aspiration cytology of metastatic olfactory neuroblastoma

OBJECTIVE

Olfactory neuroblastoma (ONB) is an uncommon malignant neoplasm that originates in the upper nasal cavity. Cytomorphologic descriptions of ONB have been limited to isolated case reports. The features of a series of metastatic ONB diagnosed by fine needle aspiration (FNA) are described.

STUDY DESIGN

Cytologic findings in four patients with ONB metastatic to cervical lymph nodes who underwent FNA were reviewed, and the cytomorphologic findings were summarized. Immunocytochemical findings and ultrastructural features with selected immunoelectron microscopy from three cases are described.

RESULTS

Aspiration cytology revealed a predominance of single cells with intermixed small, loosely cohesive, three-dimensional cell groups. Cell size was small to intermediate, with round nuclei. There was an overall monomorphic appearance, with minimal nuclear pleomorphism. Chromatin was finely granular and stippled, with multiple, small chromocenters. Cytoplasm in the cell groups had a fibrillary quality and was moderate in amount. Single nuclei were frequently stripped of cytoplasm. Occasional pseudorosettes were noted. Immunocytochemical stains were positive for both neuronspecific enolase and synaptophysin. Ultrastructural examination showed neuritic cell processes with neurosecretory granules and microtubules. Immunoelectron microscopy showed positive labeling of neurosecretory granules by chromogranin A.

CONCLUSION

FNA cytomorphology, in combination with ancillary studies, can provide an accurate diagnosis of metastatic ONB.

Surfactant-associated protein A is important for maintaining surfactant large-aggregate forms during surface-area cycling

Alveolar surfactant can be separated into two major subfractions, the large surfactant aggregates (LAs) and the small surfactant aggregates (SAs). The surface-active LAs are the metabolic precursors of the inactive SAs. This conversion of LAs into SAs can be studied in vitro using a technique called surface-area cycling. We have utilized this technique to examine the effect of trypsin on aggregate conversion. Our results show that trypsin increases the conversion of LAs into SAs in a concentration- and time-dependent manner. Immunoblot analysis revealed that surfactant-associated Protein A (SP-A) was the main target of trypsin. To examine further the role of SP-A in aggregate conversion, we tested the effect of Ca2+ and mannan on this process. The absence of Ca2+ (l mM EDTA) and the presence of mannan both increased the formation of SAs. Electron microscopy revealed that highly organized multilamellar and tubular myelin structures were present in samples that converted slowly to SAs. We concluded that SP-A is important for maintaining LA forms during surface-area cycling by stabilizing tubular myelin and multilamellar structures.

Carcinoid tumour of the middle ear: case report and review of the literature

This is a case report of middle-ear carcinoid tumour in a patient with a 20-year history of aural tinnitus, fullness, and hearing loss. The patient was treated surgically, with no evidence of recurrence 20 months later. The natural history of this tumour appears to be relatively benign, with a long clinical course and little destruction of surrounding tissues. Immunohistochemical and electron microscopic studies are of great value in distinguishing carcinoid from other tumours of the middle ear. The pathologic features that contribute to the differential diagnosis are presented. Local conservative surgery appears to be the treatment of choice.

Surface-area cycling of different surfactant preparations: SP-A and SP-B are essential for large-aggregate integrity

Surface-area cycling is an in vitro procedure for the conversion of large into small surfactant aggregates. In this procedure a tube containing a surfactant suspension is rotated end-over-end at 37 degrees C so that the surface area of the suspension changes twice each cycle. We have utilized this method to study the mechanisms involved in aggregate conversion. Several different surfactant preparations were analysed: (1) bovine natural surfactant, a sucrose-gradient-purified material containing surfactant phospholipid and surfactant-associated proteins (SP-) SP-A, SP-B and SP-C; (2) bovine lipid-extract surfactant, which contains the surfactant phospholipids and SP-B and SP-C; (3) mixtures of dipalmitoyl phosphatidylcholine and phosphatidylglycerol (7:3, w/w) reconstituted with one or more surfactant proteins. Aggregate conversion was measured by phosphorus analysis of a 40,000 g supernatant (small aggregate) and pellet (large aggregates) before and after surface-area cycling. Surface-area cycling of lipid extract surfactant or lipids plus SP-B or SP-C resulted in rapid aggregate conversion. Lipids alone were not converted. Only a small percentage of purified natural surfactant was converted into small aggregates. Addition of SP-A to lipid extract surfactant could inhibit aggregate conversion of this material, but this was only observed when an additional 1% (w/w) of SP-B was added to the lipid extract. It is concluded that SP-A is important for large-aggregate integrity. It appears that SP-A acts in conjunction with SP-B. The presence of SP-B and/or SP-C is required for aggregate conversion; it is proposed that this reflects the necessity for lipid adsorption in aggregate conversion.

Degradation of surfactant-associated protein B (SP-B) during in vitro conversion of large to small surfactant aggregates

Pulmonary surfactant obtained from lung lavages can be separated by differential centrifugation into two distinct subfractions known as large surfactant aggregates and small surfactant aggregates. The large-aggregate fraction is the precursor of the small-aggregate fraction. The ratio of the small non-surface-active to large surface-active surfactant aggregates increases after birth and in several types of lung injury. We have utilized an in vitro system, surface area cycling, to study the conversion of large into small aggregates. Small aggregates generated by surface area cycling were separated from large aggregates by centrifugation at 40,000 g for 15 min rather than by the normal sucrose gradient centrifugation. This new separation method was validated by morphological studies. Surface-tension-reducing activity of total surfactant extracts, as measured with a pulsating-bubble surfactometer, was impaired after surface area cycling. This impairment was related to the generation of small aggregates. Immunoblot analysis of large and small aggregates separated by sucrose gradient centrifugation revealed the presence of detectable amounts of surfactant-associated protein B (SP-B) in large aggregates but not in small aggregates. SP-A was detectable in both large and small aggregates. PAGE of cycled and non-cycled surfactant showed a reduction in SP-B after surface area cycling. We conclude that SP-B is degraded during the formation of small aggregates in vitro and that a change in surface area appears to be necessary for exposing SP-B to protease activity.

Transitional cell carcinoma of the renal pelvis with choriocarcinomatous differentiation. Immunohistochemical and immunoelectron microscopic assessment of human chorionic gonadotropin production by transitional cell carcinoma of the urinary bladder

BACKGROUND

There have been 12 documented cases of choriocarcinoma arising in the urinary bladder, either alone or in combination with other epithelial tumors. It has been shown that some high-grade transitional cell carcinomas (TCC), without obvious syncytiotrophoblastic elements, can produce human chorionic gonadotrophins (HCG).

METHODS

A case of choriocarcinoma, in association with high-grade TCC of the renal pelvis, was encountered in an 80-year-old man. For additional evaluation of HCG production by TCC, 25 consecutive cases of invasive high-grade TCC of the bladder were stained with an anti-HCG antibody. Immunogold staining also was performed in two of the cases studied.

RESULTS

Immunoperoxidase staining of the renal pelvis tumor showed focal positivity for HCG within the TCC and a more intense reaction as the tumor cells differentiated into choriocarcinoma elements. Seven of the 25 cases (28%) displayed varying degrees of reactivity within individual cells or groups of cells. In an additional case, typical syncytiotrophoblastic giant cells without cytotrophoblasts were seen in a high-grade TCC. Immunogold studies demonstrated positive labeling in the cytoplasm of carcinoma cells in a case of TCC without syncytiotrophoblasts and in the syncytiotrophoblastic giant cells in the one case in which these were present.

CONCLUSIONS

The findings support a metaplastic origin of cases of choriocarcinoma arising primarily in the urothelial tract.

Corticosteroid-binding globulin biosynthesis in the mouse liver and kidney during postnatal development

Plasma corticosteroid-binding globulin (CBG) is produced by the liver, but low levels of CBG mRNA have been detected in other tissues, including the kidney. Glucocorticoids influence postnatal renal development in rodents, and CBG production in the kidney may influence the local bioavailability of glucocorticoids. We, therefore, used in situ hybridization and immunohistochemistry to define the sites of CBG biosynthesis during postnatal development and have found that the liver and kidney are major sites of CBG biosynthesis in the first weeks of life. Both CBG and its mRNA were undetectable in the neonatal liver, and only a weak hybridization signal for CBG mRNA was present in the 7-day-old mouse liver. In neonatal mice, the developing tubules of the kidney represent the most active site of CBG biosynthesis, and immunoreactive CBG was also detected in the same cells. By 7 days of age, CBG and its mRNA were colocalized to the proximal convoluted tubules of the juxtamedullary nephrons. The abundance of CBG mRNA in the liver increased from 10 days of age and was accompanied by similar increases in serum CBG until adult levels were reached by 4 weeks of age. In contrast, CBG mRNA in the kidney increased to a maximum during the third week of life, but was undetectable 3 weeks later. The CBG within the proximal convoluted tubules was located in secretory granules close to the luminal surface of the epithelial cells, suggesting that it is secreted into the tubular lumen. Western analysis revealed that marked proteolytic degradation of CBG occurs in the urine concurrently with an increase in CBG biosynthesis in the developing kidney. Thus, the liver is not the only site of CBG biosynthesis in the developing mouse, and CBG production by the epithelial cells of the proximal convoluted tubules may influence glucocorticoid-dependent maturation of the kidney tubules by a process that somehow involves proteolytic degradation.

Primary localized amyloidosis of the lacrimal glands

Primary localized amyloidosis causing bilateral lacrimal enlargement is rare. The pathogenesis of amyloid deposition within the orbit and other body tissues has not been fully elucidated. The authors report the case of a 72-year-old woman who presented with bilateral lacrimal gland enlargement secondary to amyloid infiltration. The chemical nature of the deposit was characterized using light microscopy, immunohistochemistry, and immunoelectron microscopy. The primary (immunocytic) nature of the amyloid was confirmed by immunohistochemistry demonstrating the presence of monoclonal lambda light chains in the amyloid deposits and in the plasma cells. Using immunoelectron microscopy, amyloid deposits were seen containing lambda light chains in macrophages. It has been postulated that the macrophage has a role in amyloid deposition. The authors believe this to be the first published report of immunoelectron microscopy use in orbital amyloidosis, and that this technique has helped further their understanding of the nature and pathogenesis of this condition.

Immunoelectron microscopic localization of chlamydial lipopolysaccharide (LPS) in McCoy cells inoculated with Chlamydia trachomatis

Interactions between Chlamydia trachomatis, host cells, and the immune system are believed to involve lipopolysaccharide (LPS). We used immunogold techniques to study the distribution of chlamydial LPS in cultured cells infected with C. trachomatis LGV-L1. McCoy cells inoculated with C. trachomatis were cultured and then fixed and embedded in situ with acrylic resins. Sections were immunolabeled with a protein A-gold method using antisera to the genus-specific, periodate-sensitive epitope on chlamydial LPS. Pre-embedding immunogold labeling on permeabilized cells was also done. By post-embedding methods, labeling for LPS was equally abundant over the outer membranes of elementary (EB) and reticulate bodies (RB). By post-embedding labeling, the sub-surface side of the EB outer membrane was more heavily labeled than the surface side. By pre-embedding labeling, LPS was found to be less abundant on the surface of EBs than RBs. Labeling for LPS was found over apparent lysosomes in McCoy cells and over electron-dense blebs on or near the surface of the plasma membranes of McCoy cells. These results indicate that the concentration of LPS in chlamydial membranes is constant during development but that with development its location changes from being mostly cell-surface to sub-surface. These results show that the post-embedding immunogold technique can be a useful approach for the cell culture-based study of chlamydial LPS.

Immunogold quantitation of immunoglobulin light chains in renal amyloidosis and kappa light chain nephropathy

By quantitative immunoelectron microscopy using protein A-gold, the authors compared the content and distribution of immunoglobulin light chain (LC) antigens in glomeruli from 11 cases of renal amyloidosis with that in two cases of kappa LC glomerulopathy and two cases of diabetic glomerulosclerosis. In a supplementary study and using a similar immunogold technique, the authors identified amyloid A in deparaffinized renal tissue from three of the 11 cases of renal amyloidosis. Each patient had similar clinical manifestations (chronic renal failure with proteinuria) and similar glomerular morphology (thickened glomerular basement membranes and nodular expansion of the mesangium). In 12 cases (10 amyloid, 2 kappa LC), immunoelectron microscopy localized LC antigens over the glomerular deposits and allowed indirect tissue quantitation of each LC antigen to the various cellular and interstitial compartments. In 6 of the 11 cases of renal amyloidosis, the amyloid labeled only for lambda, and in one, only for kappa. In one patient with Waldenström's macroglobulinemia, who had a biclonal gammopathy, both LC were identified in the amyloid. In two cases, both of whom had a history of chronic suppurative lung disease, both LC antigens as well as amyloid A were localized to the amyloid fibrils. In only one case, in which glomerular amyloid labeled for amyloid A, the amyloid did not label for either LC. Whereas lambda LC-derived fibrils often appeared as spicules in the glomerular subepithelial space, other amyloid deposits usually accumulated in the subendothelial zone and did not form spicules. The epimembranous location of spicules suggested that the amyloid precursor protein transformed into amyloid fibrils after filtration into the urinary space. Presence of epimembranous spicules may explain the more severe proteinuric renal failure and the more rapid progression to glomerulosclerosis described in primary amyloidosis.

Immunogold labelling of tumour cells during NK/target cell interactions

Using a system of immunocolloidal gold labelling, we have monitored the expression and distribution of transferrin receptors (TfRs) within the K562 cell line, during NK/target cell interactions. An indirect method of immunolabelling was used to effectively immunolabel tumour cells without disrupting the natural effector:target interactions. Successful localization of TfRs demonstrates the potential of the described technique for discerning antigenic distribution of other cell:cell interactions. Immunolabelling has also provided a useful method for demonstrating receptor down-regulation within NK target cells, as a proposed cause of reduced receptor expression by TPA-treated cells. Following 30 and 60 min incubation periods with TPA, approximately 15 and 30%, respectively, of the gold/antibody complexes were relocated from the surface membrane to an intracellular location within endocytotic vesicles. The demonstration of receptor down-regulation is important as a proposed cause of TPA-induced tumour cell resistance to NK-mediated cytolysis.

Primary endodermal sinus tumor of the endometrium. A clinicopathologic, immunocytochemical, and ultrastructural study

We report a case of primary endodermal sinus tumor (EST) of the endometrium in a 42-year-old female. Although numerous extragonadal EST have been reported, primary EST of the endometrium is exceedingly rare. To our knowledge this is the fourth documented case of this nature. The tumor had the typical microscopic features of EST, with papillary, tubular, reticular, and solid growth patterns; occasional Schiller-Duval bodies and many intracellular and extracellular periodic-acid Schiff positive hyaline globules were seen. The neoplastic cells stained positively for alpha-fetoprotein (AFP), alpha-1-antitrypsin (A1AT), cytokeratin, and placental alkaline phosphatase. The globules were positive for AFP, A1AT, albumin, transferrin, and fibronectin. The tumor cells were negative for type IV collagen and the beta subunit of human chorionic gonadotropin (B hcG). Electron microscopic examination showed intracellular and extracellular basement membrane-like material, intracytoplasmic lumina with microvilli, and glycogen. The patient was treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy, followed by four cycles of adjunct chemotherapy (vinblastine, bleomycin, and cisplatinum) repeated every 3 weeks. The serum AFP level was elevated significantly before the surgery and the tumor response was monitored by serial determination of serum AFP level. There was no evidence of recurrence 24 months after surgery.

Proteinaceous lymphadenopathy due to monoclonal nonamyloid immunoglobulin deposit disease

We report two cases of lymph node enlargement due to massive extracellular nonamyloid immunoglobulin deposits that obscured the underlying cellular pathologic condition. In both cases, the deposits were demonstrated to be restricted to a single heavy and light chain, consistent with a monoclonal paraprotein, and cytoplasmic staining in the lymphocytes or plasma cells was identical to that of the paraprotein. The use of the protein A-gold technique was instrumental in revealing a monoclonal pattern in one case in which light microscopic immunohistochemistry did not reveal a clear-cut monoclonal pattern in the extracellular deposits. This case was subsequently shown to have multiple myeloma, while the second case has had an unusual history of hypocomplementemic vasculitis and normal bone marrow. Neither case had evidence of significant renal disease.

Neuropathy in IgM lambda paraproteinemia. Immunoreactivity to neural proteins and chondroitin sulfate

In axonal neuropathies associated with IgM paraproteinemia, reports of antigen specificity of the M-protein are few. A patient with IgM paraproteinemia presented with progressive mononeuritis multiplex. IgM was found deposited in striking amounts in endoneurium and shown to bind specifically to neural proteins and chondroitin sulfates. Direct immune mechanisms, as well as the physical effects of IgM deposition, likely contributed to the development of the neuropathy.

Postembedding immunogold electron microscopy for S100, tubulin, and cytoskeletal proteins in an amelanotic malignant melanoma

A postembedding Protein A-colloidal gold technique was used for the ultrastructural immunocytochemical investigation of S100, tubulin, and cytoskeletal proteins in a Lowicryl K4M-embedded melanoma with numerous microtubules. S100 protein was localized in the cytoplasm and the nuclei of tumor cells. Melanosomes were not labeled with S100. Perinuclear intermediate filaments and filaments in cytoplasmic processes reacted positively for vimentin. The straight, rod-shaped, parallel intracisternal microtubules failed to react with antisera to tubulin, S100, vimentin, cytokeratin, neurofilaments, desmin, glial fibrillary acidic protein, and immunoglobulin light chains. These results give an improved correlation between the ultrastructural and immunocytochemical characteristics of the tumor, confirm the melanocytic origin of it, and demonstrate the application and usefulness of the postembedding immunogold method in the investigation of the protein composition of subcellular structures.

Calcitonin and chromogranin A localization in medullary carcinoma of the thyroid by immunoelectron microscopy

We used a post-embedding immunoelectron microscopy method, using protein A-gold, to detect calcitonin and chromogranin A immunoreactivity in three cases of human medullary thyroid carcinoma. Because the epoxy-embedded tissue had been fixed (glutaraldehyde or formaldehyde) and osmicated before embedment, the proteins were identified in optimally preserved tissue. Uranyl and lead staining was used after immunolabeling, so that the tissue was also optimally contrasted. The morphological advantage provided by osmication was tested by labeling rat thyroid gland C-cells for calcitonin. The protein A-gold technique allowed localization of both antigens to the contents of membrane-bound secretory granules in the tumor cells. In one case, labeling density for each antigen was measured over several intercellular compartments and the interstitium. Calcitonin, but not chromogranin A, reactivity was also identified in intracellular amyloid fibrils in two cases, showing that the constant region of calcitonin is preserved in amyloid deposits related to the tumor cells.

Electron microscopic localization of chromogranin A in osmium-fixed neuroendocrine cells with a protein A-gold technique

An antibody (LK2H10) to chromogranin A has been recommended for use in ultrastructural identification of neuroendocrine secretory granules. Previous studies have demonstrated immunoreactive chromogranin A in specimens prepared for electron microscopy by glutaraldehyde fixation only. In this study, the effect of specimen post-fixation by osmium tetroxide on post-embedding localization of chromogranin A was evaluated. Human tissues from benign endocrine glands, neuroendocrine tumors, and non-neuroendocrine tumors were post-fixed in osmium, embedded in epoxy resin, and the sample thin sections immunolabeled using a protein A-gold technique. Chromogranin A-positive neurosecretory granules were detected in pancreatic islets, adrenal medulla, stomach, ileum, anterior pituitary, and parathyroid. Mid-gut carcinoids, bronchial carcinoids, pheochromocytomas, paragangliomas, carotid body tumors, and thyroid medullary carcinomas contained immunoreactive granules. Cytoplasmic granules in non-neuroendocrine tumors did not react for chromogranin A. Tissues post-fixed in osmium tetroxide had optimally preserved ultrastructural features, and use of this fixative is compatible with postembedding localization of chromogranin A in neurosecretory granules.

Postembedding immunoelectron microscopy using protein A-gold

Immunogold techniques offer the advantage of identifying antigens in tissues that show optimal ultrastructural morphology. The technique is applicable to any antigen that can be shown to withstand the denaturizing effects of fixation, osmication, dehydration, and embedding in epoxy resin. The list of antigens that survive these procedures is long and growing.

Renal and systemic kappa light chain deposits and their plasma cell origin identified by immunoelectron microscopy

Kappa light chain determinants were identified by immunoelectron microscopy in nodular glomerulosclerotic lesions and systemic interstitial deposits from a man who died several years after the onset of proteinuric renal failure treated by hemodialysis. He developed adrenal and hepatic failure preterminally but not overt malignant myeloma. Specific labeling was most concentrated over the inner aspect of glomerular basement membrane and the mesangium, which suggested that the protein was nonfiltrable. Tubular basement membrane labeling was densest over the outer aspect, which suggested that the protein perfused from the interstitium rather than from the tubular lumen. We identified the source of the protein as a population of plasma cells present within bone marrow and renal interstitium; these showed specific immunogold labeling for kappa light chain protein over organelles concerned with protein synthesis, secretion, and storage. This appears to be the first identification of light chain determinants in human interstitial para-amyloid deposits with the use of immunogold ultrastructural techniques in tissues prepared for electron microscopy by standard methods and stored as epoxy resin blocks.

Immunoelectron microscopic labeling of immunoglobulin in plasma cells after osmium fixation and epoxy embedding

Previous studies have found that immunoglobulin cannot be immunolabeled in tissues prepared for electron microscopy by usual methods. To test this conclusion, we used a protein A-gold postembedding immunolabeling method on tissues that were fixed in glutaraldehyde, post-fixed in osmium tetroxide, and embedded in epoxy resin; sections were pretreated with sodium metaperiodate. A variety of common fixation protocols were also used and the most suitable conditions for immunolabeling were determined. This technique permitted the ultrastructural localization of immunoglobulin light chains in optimally preserved and contrasted plasma cells from human tonsil, lymph nodes, plasmacytomas, and a renal biopsy. We were able to demonstrate multiple antigens in the same tissue and label antigens in tissues that had been stored for many years in epoxy resin. The technique allows quantitation of the gold label over plasma cell organelles and therefore gives information about the immunoglobulin secretory pathway in these cells. We found that the protein A-gold procedure compares favorably in technical ease with the immunoperoxidase, avidin-biotin peroxidase, and immunoglobulin-colloidal gold immunolabeling methods, and has added advantages in allowing precise localization and quantitation of the labeled antigen.