Beta-2-microglobulin (B2M) is a protein that is found on the surface of almost all cells in the body and is shed by cells into the blood, particularly by B lymphocytes and tumour cells. It is present in most body fluids and its level rises with conditions that increase cell production and/or destruction, or that activate the immune system. This test measures B2M in the blood, urine or rarely, in the cerebrospinal fluid (CSF).
B2M is frequently elevated in the blood with cancers such as multiple myeloma, leukaemia and lymphoma, with inflammatory disorders, infections (e.g. HIV, CMV) and in kidney disease. Because B2M is increased with blood cell cancers, it may be useful as a tumour marker. Though it can also be used to assess kidney function.
In the kidneys, B2M passes through blood filtering units, the glomeruli, and is then reabsorbed by the renal tubules - these are structures that reclaim water, proteins, vitamins, minerals and other substances that are useful to the body. Normally, only small amounts of B2M are present in the urine but when the renal tubules become damaged or diseased, concentrations increase due to the decreased ability of the tubules to reabsorb this protein. When the glomeruli in the kidneys are damaged, then they are unable to filter out B2M, so the level in the blood rises. In people with kidney disease who are undergoing dialysis, B2M can form long protein chains that can be deposited in joints and tissues, causing stiffness and pain. This condition is called B2M dialysis-associated amyloidosis.
B2M levels can be increased in the CSF of individuals with blood cell cancers that have spread (metastasised) to the brain, such as leukaemia and lymphoma, but also with some chronic disorders such as multiple sclerosis, and with viral infections such as HIV.
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