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LASER Dissection Mass Spectrometry - When and Where?

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Dr Mahesha Vankalakunti, Bengaluru    28 November 2019

  • The pathology and diagnosis of kidney disease is based on examination of the kidney biopsy material by light microscopy, immunofluorescence microscopy and electron microscopy.
  • However, ancillary tests like LASER microdissection (LMD) and mass spectrometry (MS) throw more insights into the composition of abnormal protein when immunohistochemistry results are equivocal.
  • LMD/MS is a new technique that consists of dissection of glomeruli, tryptic digestion of dissected material, analysis by MS and generation of a protein profile using different algorithms.
  • Applications of this technique has been shown and extensively validated in the diagnosis and subtyping of amyloidosis; rarer forms of amyloidosis (such as LECT-2, Gelsolin, Apolipoprotein A-I, II, IV, etc.).
  • Newer primary antigens detection by LMD/MS discovered M-type PLA2R, THSD7A, NELL-1 and secondary antigen (Exostosin-1 and Exostosin-2) in membranous nephropathy.
  • Recently, serum amyloid Pcomponent deposition identified by this technique has proven to be more sensitive and specific feature of membranous-like glomerulonephropathy with masked IgG-kappa deposits.

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