The story of Bence Jones Proteins

In the last post, we saw the timelines in the discovery of Multiple myeloma.

In this post, we shall see how Bence Jones protein was discovered.

It was in 1845, in  St. George’s Hospital in London, William MacIntyre, Henry Bence Jones and John Dalrymple examined a patient of MacIntyre’s who was  admitted with vague uninterrupted pain in the chest, back, and pelvis.

Henry Bence Jones, Picture taken from wikipedia.

MacIntyre asked Henry Bence Jones to test the patient’s urine. Bence Jones found a substance in the urine that was precipitated by the addition of nitric acid. He noted that the precipitate was soluble in boiling water but re-precipitated after the urine was cooled. He stated the patient had  “albumosuria” and concluded that the protein was an ‘oxide of albumen’ and after subsequent analysis concluded it was the ‘hydrated deutoxide of albumen’.  The patient died soon after the urine was tested.

John  Dalrymple, was the pathologist who performed autopsy and noted that the sternum, cervical, thoracic and lumbar vertebrae were so soft, fragile, and easily breakable that it could be easily cut with a knife. He also noticed multiple hemorrhagic cavities in bones throughout the body.

 In 1846, John Dalrymple summarized the important postmortem findings and suggested that the disease must have begun in the cancellous bone and extended through the periosteum.

In 1847, a year later, Henry Bence Jones reported his pre-mortem findings in a short note in the Lancet.

In 1850, MacIntyre summarized the clinical findings of the case.

The cause of death was given as “atrophy from albuminuria”. At that time, albuminuria was the term used nonspecifically to mean proteinuria.

In 1880, Fleischer used the term “Bence Jones protein” for the first time.

In 1898, Weber postulated that the bone marrow is the site of production of the Bence Jones protein.

In 1917 and 1921, respectively, Jacobson and Walters recognized Bence Jones proteins in the bloodstream and considered that they were probably derived from blood proteins through the action of abnormal cells in the bone marrow.

In 1922, Bayne-Jones and Wilson described two groups of Bence Jones protein by immunizing rabbits with Bence Jones proteins from patients.

In 1956, Korngold from Memorial Hospital and Rose Lipari, his technician, identified different classes of Bence Jones proteins. They also demonstrated that antisera to Bence Jones protein also reacted with the myeloma protein in the blood. As a tribute to Korngold and Lipari, the two classes of Bence Jones proteins have been designated kappa and lambda.

In 1958, Harold Porter from England split the antibody into two major parts, the heavy chains and the light chains.

In 1962, Gerald M Edelman and Rodney R Porter discovered the chemical structure of antibodies for which they were awarded Nobel Prize in Medicine or Physiology in 1972.

Gerald M Edelman, Picture from Wikipedia. 

Gally looked at the light chains of a patient who had a multiple myeloma with a typical M-spike in the serum. Edelman demonstrated that the light chains in the immunoglobulin molecule in the spike of the monoclonal protein was absolutely identical to the Bence-Jones protein that the patient excreted.

As Edelman wrote: “Given my hypothesis about myelomas, the thought arose that perhaps Bence-Jones protein was one of the chains of the myeloma protein that spilled into the urine because of its relatively low molecular weight (about 22,000)”.

Bence-Jones proteins were simple excreted light chains. Edelman heated a sample of light chain obtained from normal human serum gamma globulins and demonstrated that they had the behavior of Bence-Jones proteins becoming insoluble and then resolubilizing with continued heating.

 In 1967, Putman et al. demonstrated that different Bence-Jones proteins were different in their peptide sequence. As Edelman wrote: “The key experiment was to use the recently discovered starch gel electrophoresis to take a whole bunch of patients’ urine samples, separate their Bence-Jones proteins, and simultaneously separate and compare their serum proteins. When we ran the electrophoresis we demonstrated that the light chains were the Bence-Jones proteins and they were pure and no two had the same mobility pattern”.

It took more than 120 years for us to know the exact nature of Bence Jones proteins.

References:

Domenico Ribatti. A historical perspective on milestones in multiple myeloma research. Eur J Haematol.2018 Mar;100(3):221-228.

                                                                               Written by Dr.Priyavadhana B

 

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