Histotopographic evidence that amyloid deposits in sclerocalcific heart valves and other chronic lesions of the cardiovascular system are related to old thrombotic material

Elastic fibers and amyloid deposition in vascular tissue

Amyloid fibrils are associated with a large number of diseases, such as Alzheimer’s dementia and others. Evidence links Alzheimer’s dementia with vascular diseases and only few data connect amyloids and atherosclerosis and aging via deposits in the aortic intima. Recent results demonstrate that some elastin polypeptide sequences are also able to produce amyloid fibers. This finding could have useful implications in the study of amyloids in cardiovascular tissue whose main constituent is elastin. In this review, we have also outlined the main characterizing features regarding the structure of amyloid fibrils. Finally, we describe, as a future perspective, the design of proper inhibitors of amyloid deposition in vascular walls as potential therapeutic drugs.

Amyloid in the cardiovascular system: a review

The cardiovascular system is a common target of amyloidosis. This review presents the current clinical and diagnostic approach to amyloidosis, with the emphasis on cardiovascular involvement. It summarises recent nomenclature, classification, and pathogenesis of amyloidosis. In addition, non-invasive possibilities are discussed, together with endomyocardial biopsies in the diagnosis of cardiac amyloidosis. Finally, recent advances in treatment and prognostic implications are presented.

Serum amyloid A and P protein levels are lowered by dextran sulfate cellulose low-density lipoprotein apheresis

The present study describes the short-term effect of dextran sulfate cellulose (DSC) low-density lipoprotein (LDL) apheresis using a plasma separator equipped with a polysulfone (PS) membrane filter (PS/DSC-LDL apheresis) on the serum amyloid A (SAA) and P (SAP) protein levels during treatment in a patient with familial hypercholesterolemia (type IIa, heterozygote). PS/DSC-LDL apheresis markedly lowered both the SAA (reduction percentage, 84.1+/-8.2%) and SAP (91.4+/-5%) levels, which returned to their respective initial levels within 4 days. Experimentally, the levels of both proteins also decreased on passage through the DSC minicolumn without a PS membrane, indicating that the DSC resin had an affinity to both proteins. These results suggest that PS/DSC-LDL apheresis may be advantageous for amyloid protein accumulating disorders, including amyloidosis and atherosclerosis.

Amyloid deposits of the pituitary in old age: Correlation with histopathological alterations

The prevalence and quantification of amyloid formation and the frequency of histomorphological alterations affecting the pituitary gland were studied in a consecutive autopsy series performed on 109 patients older than 84 years of age; 87 (80%) pituitaries had amyloid in the anterior lobe. A polyclonal antibody directed against amyloid of A-light chain origin immunostained pituitary amyloid in every specimen, whereas all other antisera directed against the precursor proteins of the remaining major amyloid syndromes and pituitary hormones did not. Because no case studied suffered from a generalized A-light chain amyloidosis, immunostaining might be due to crossreaction with a hitherto unidentified precursor protein. Histomorphological alterations were observed in many pituitaries, and they were differentiated into regressive changes, cysts of the intermediate zone, so called basophilic invasion of the posterior lobe, hyperplasia, Erdheim's squamous epithelia, and adenomas. Statistical analysis failed to reveal any correlations between the presence of histopathological alterations and the frequency or the amount of interstitial amyloid. Nonetheless, we were not able to explain amyloid formation in old age, especially none that was due to histomorphological alterations of the pituitary gland. Thus, other diseases that primarily do not affect the pituitary may actually influence pituitary amyloid formation.