1
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Leung N, Nasr SH. 2024 Update on Classification, Etiology, and Typing of Renal Amyloidosis: A Review. Am J Kidney Dis 2024; 84:361-373. [PMID: 38514011 DOI: 10.1053/j.ajkd.2024.01.530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 12/20/2023] [Accepted: 01/29/2024] [Indexed: 03/23/2024]
Abstract
Amyloidosis is a protein folding disease that causes organ injuries and even death. In humans, 42 proteins are now known to cause amyloidosis. Some proteins become amyloidogenic as a result of a pathogenic variant as seen in hereditary amyloidoses. In acquired forms of amyloidosis, the proteins form amyloid in their wild-type state. Four types (serum amyloid A, transthyretin, apolipoprotein A-IV, and β2-macroglobulin) of amyloid can occur either as acquired or as a mutant. Iatrogenic amyloid from injected protein medications have also been reported and AIL1RAP (anakinra) has been recently found to involve the kidney. Finally, the mechanism of how leukocyte cell-derived chemotaxin 2 (ALECT2) forms amyloid remains unknown. This article reviews the amyloids that involve the kidney and how they are typed.
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Affiliation(s)
- Nelson Leung
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota; Division of Hematology, Mayo Clinic, Rochester, Minnesota.
| | - Samih H Nasr
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
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2
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Cattaneo ER, Gisonno RA, Abba MC, Santana M, Rosú SA, Nucifora E, Aguirre MA, Giordani MC, Tricerri MA, Ramella NA. Hereditary Amyloidosis: Insights Into a Fibrinogen A Variant Protein. Proteins 2024. [PMID: 39031927 DOI: 10.1002/prot.26732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 06/19/2024] [Accepted: 07/04/2024] [Indexed: 07/22/2024]
Abstract
Amyloidosis are a group of diseases in which soluble proteins aggregate and deposit in fibrillar conformation extracellularly in tissues. The effectiveness of therapeutic strategies depends on the specific protein involved, being crucial to accurately determine its nature. Moreover, following the diagnosis, the search for the mutation within relatives allows the clinical advice. Here we report the precise diagnosis and explored the possible reasons of the structural pathogenicity for a renal amyloidosis related to a fibrinogen Aα-chain variant. Whole-exome sequencing and GATK calling pipeline were leveraged to characterize the protein variant present in a patient with kidney failure. Bioinformatics strategies were applied to suggest potential explanations of the variants aggregation. Our pipeline allowed the identification of a single-point variant of fibrinogen Aα-chain, which opened the possibility of curative transplantation. In silico structural analysis suggested that the pathogenicity of the variant may be attributed to a heightened susceptibility to yield a peptide prone to deposit as an oligomer with a β-sheet structure. Exploiting the comprehensive coverage of whole-genome sequencing, we managed to fill a vacant stage in the diagnosis of hereditary amyloidosis and to stimulate the advancement in biomedicine.
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Affiliation(s)
- Elizabeth R Cattaneo
- Facultad de Ciencias Médicas, Departamento de Medicina Interna, Instituto de Investigaciones Bioquímicas de La Plata (INIBIOLP), CONICET, Universidad Nacional de La Plata, Buenos Aires, Argentina
- Facultad de Ciencias Médicas, Departamento de Medicina Interna, Universidad Nacional de La Plata, La Plata, Buenos Aires, Argentina
| | - Romina A Gisonno
- Departamento de Medicina Interna, Institute of Science and Technology Austria, Klosterneuburg, Austria
| | - Martín C Abba
- Facultad de Ciencias Médicas, Departamento de Medicina Interna, Instituto de Investigaciones Bioquímicas de La Plata (INIBIOLP), CONICET, Universidad Nacional de La Plata, Buenos Aires, Argentina
- Facultad de Ciencias Médicas, Departamento de Medicina Interna, Centro de Investigaciones Inmunológicas Básicas y Aplicadas (CINIBA), Universidad Nacional de La Plata, La Plata, Buenos Aires, Argentina
| | - Marianela Santana
- Facultad de Ciencias Médicas, Departamento de Medicina Interna, Instituto de Investigaciones Bioquímicas de La Plata (INIBIOLP), CONICET, Universidad Nacional de La Plata, Buenos Aires, Argentina
| | - Silvana A Rosú
- Facultad de Ciencias Médicas, Departamento de Medicina Interna, Instituto de Investigaciones Bioquímicas de La Plata (INIBIOLP), CONICET, Universidad Nacional de La Plata, Buenos Aires, Argentina
- Facultad de Ciencias Médicas, Departamento de Medicina Interna, Universidad Nacional de La Plata, La Plata, Buenos Aires, Argentina
| | - Elsa Nucifora
- Departamento de Medicina Interna, Hospital Italiano de Buenos Aires (HIBA), Calle Perón, Argentina
| | - María A Aguirre
- Departamento de Medicina Interna, Hospital Italiano de Buenos Aires (HIBA), Calle Perón, Argentina
| | - María C Giordani
- Departamento de Medicina Interna, Hospital Italiano de Buenos Aires (HIBA), Calle Perón, Argentina
| | - M Alejandra Tricerri
- Facultad de Ciencias Médicas, Departamento de Medicina Interna, Instituto de Investigaciones Bioquímicas de La Plata (INIBIOLP), CONICET, Universidad Nacional de La Plata, Buenos Aires, Argentina
- Facultad de Ciencias Médicas, Departamento de Medicina Interna, Universidad Nacional de La Plata, La Plata, Buenos Aires, Argentina
| | - Nahuel A Ramella
- Facultad de Ciencias Médicas, Departamento de Medicina Interna, Instituto de Investigaciones Bioquímicas de La Plata (INIBIOLP), CONICET, Universidad Nacional de La Plata, Buenos Aires, Argentina
- Facultad de Ciencias Médicas, Departamento de Medicina Interna, Universidad Nacional de La Plata, La Plata, Buenos Aires, Argentina
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3
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Aguilan JT, Lim J, Racine-Brzostek S, Fischer J, Silvescu C, Cornett S, Nieves E, Mendu DR, Aliste CM, Semple S, Angeletti R, Weiss LM, Cole A, Prystowsky M, Pullman J, Sidoli S. Effect of dynamic exclusion and the use of FAIMS, DIA and MALDI-mass spectrometry imaging with ion mobility on amyloid protein identification. Clin Proteomics 2024; 21:47. [PMID: 38961380 PMCID: PMC11223398 DOI: 10.1186/s12014-024-09500-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 06/26/2024] [Indexed: 07/05/2024] Open
Abstract
Amyloidosis is a disease characterized by local and systemic extracellular deposition of amyloid protein fibrils where its excessive accumulation in tissues and resistance to degradation can lead to organ failure. Diagnosis is challenging because of approximately 36 different amyloid protein subtypes. Imaging methods like immunohistochemistry and the use of Congo red staining of amyloid proteins for laser capture microdissection combined with liquid chromatography tandem mass spectrometry (LMD/LC-MS/MS) are two diagnostic methods currently used depending on the expertise of the pathology laboratory. Here, we demonstrate a streamlined in situ amyloid peptide spatial mapping by Matrix Assisted Laser Desorption Ionization-Mass Spectrometry Imaging (MALDI-MSI) combined with Trapped Ion Mobility Spectrometry for potential transthyretin (ATTR) amyloidosis subtyping. While we utilized the standard LMD/LC-MS/MS workflow for amyloid subtyping of 31 specimens from different organs, we also evaluated the potential introduction in the MS workflow variations in data acquisition parameters like dynamic exclusion, or testing Data Dependent Acquisition combined with High-Field Asymmetric Waveform Ion Mobility Spectrometry (DDA FAIMS) versus Data Independent Acquisition (DIA) for enhanced amyloid protein identification at shorter acquisition times. We also demonstrate the use of Mascot's Error Tolerant Search and PEAKS de novo sequencing for the sequence variant analysis of amyloidosis specimens.
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Affiliation(s)
- Jennifer T Aguilan
- Laboratory for Macromolecular Analysis and Proteomics Facility, Albert Einstein College of Medicine, New York, 10461, USA
- Department of Pathology, Albert Einstein College of Medicine, New York, 10461, USA
- Montefiore Medical Center, Moses and Weiler Campus, New York, 10461, USA
| | - Jihyeon Lim
- Janssen Research and Development, Malvern, PA, USA
| | | | | | | | | | - Edward Nieves
- Laboratory for Macromolecular Analysis and Proteomics Facility, Albert Einstein College of Medicine, New York, 10461, USA
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - Damodara Rao Mendu
- Clinical Chemistry Laboratory, Mount Sinai School of Medicine, New York, USA
| | - Carlos-Madrid Aliste
- Laboratory for Macromolecular Analysis and Proteomics Facility, Albert Einstein College of Medicine, New York, 10461, USA
- Department of Systems and Computational Biology, Albert Einstein College of Medicine, New York, 10461, USA
| | | | - Ruth Angeletti
- Laboratory for Macromolecular Analysis and Proteomics Facility, Albert Einstein College of Medicine, New York, 10461, USA
| | - Louis M Weiss
- Department of Pathology, Albert Einstein College of Medicine, New York, 10461, USA
- Montefiore Medical Center, Moses and Weiler Campus, New York, 10461, USA
| | - Adam Cole
- Montefiore Medical Center, Moses and Weiler Campus, New York, 10461, USA
| | - Michael Prystowsky
- Department of Pathology, Albert Einstein College of Medicine, New York, 10461, USA
- Montefiore Medical Center, Moses and Weiler Campus, New York, 10461, USA
| | - James Pullman
- Montefiore Medical Center, Moses and Weiler Campus, New York, 10461, USA
| | - Simone Sidoli
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, NY, 10461, USA.
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Karam S, Kaushal A, Abu Amer N, Royal V, KItchlu A. Non-Immunoglobulin Amyloidosis-Mediated Kidney Disease: Emerging Understanding of Underdiagnosed Entities. ADVANCES IN KIDNEY DISEASE AND HEALTH 2024; 31:334-345. [PMID: 39084759 DOI: 10.1053/j.akdh.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/24/2024] [Accepted: 02/06/2024] [Indexed: 08/02/2024]
Abstract
Amyloidosis is a complex group of rare disorders characterized by the deposition of misfolded proteins in the extracellular space of various tissues and organs, leading to progressive organ dysfunction. The kidneys constitute a very common site affected, most notably by immunoglobulin-mediated (light chain, heavy chain, and light and heavy chain amyloidosis), but other types that include serum amyloid A (AA) amyloidosis and leukocyte chemotactic factor 2 amyloidosis, along with mutant proteins in several hereditary forms of amyloidosis such as transthyretin, fibrinogen α-chain, gelsolin, lysozyme, and apolipoproteins AI/AII/AIV/CII/CIII amyloidosis have been incriminated as well. The clinical presentation is variable and can range from minimal proteinuria for leukocyte chemotactic factor 2 amyloidosis to a full-blown nephrotic syndrome for AA amyloidosis. Clinical correlation, genetic analysis, and adequate tissue typing through a kidney biopsy are essential to make the correct diagnosis, especially when a family history of amyloidosis is absent. Except for AA and transthyretin amyloidosis, the treatment is usually purely supportive. Kidney transplantation is an acceptable form of treatment for end-stage kidney disease in all types of non-Ig-mediated renal amyloidosis.
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Affiliation(s)
- Sabine Karam
- Division of Nephrology and Hypertension, University of Minnesota, Minneapolis.
| | - Amit Kaushal
- Division of Nephrology, West Virginia University, Morgantown, WV
| | - Nabil Abu Amer
- Division of Nephrology, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Virginie Royal
- Division of Pathology, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, Canada
| | - Abhijat KItchlu
- Division of Nephrology, University Health Network, University of Toronto, Toronto, ON, Canada
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Delrue C, Dendooven A, Vandendriessche A, Speeckaert R, De Bruyne S, Speeckaert MM. Advancing Renal Amyloidosis Care: The Role of Modern Diagnostic Techniques with the Potential of Enhancing Patient Outcomes. Int J Mol Sci 2024; 25:5875. [PMID: 38892061 PMCID: PMC11172584 DOI: 10.3390/ijms25115875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/24/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
Renal amyloidosis is a set of complex disorders characterized by the deposition of amyloid proteins in the kidneys, which causes gradual organ damage and potential kidney failure. Recent developments in diagnostic methods, particularly mass spectrometry and proteome profiling, have greatly improved the accuracy of amyloid typing, which is critical for disease management. These technologies provide extensive insights into the specific proteins involved, allowing for more targeted treatment approaches and better patient results. Despite these advances, problems remain, owing to the heterogeneous composition of amyloid proteins and the varying efficacy of treatments based on amyloid type. Access to sophisticated diagnostics and therapy varies greatly, highlighting the global difference in renal amyloidosis management. Future research is needed to investigate next-generation sequencing and gene-editing technologies, like clustered regularly interspaced short palindromic repeats (CRISPR), which promise more profound insights into the genetic basis of amyloidosis.
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Affiliation(s)
- Charlotte Delrue
- Department of Nephrology, Ghent University Hospital, 9000 Ghent, Belgium;
| | - Amélie Dendooven
- Department of Pathology, Ghent University Hospital, 9000 Ghent, Belgium; (A.D.); (A.V.)
- Faculty of Medicine, University of Antwerp, 2610 Wilrijk, Belgium
| | | | | | - Sander De Bruyne
- Department of Laboratory Medicine, Ghent University Hospital, 9000 Ghent, Belgium;
| | - Marijn M. Speeckaert
- Department of Nephrology, Ghent University Hospital, 9000 Ghent, Belgium;
- Research Foundation-Flanders (FWO), 1000 Brussels, Belgium
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Basilisco G, Marchi M, Coletta M. Chronic intestinal pseudo-obstruction in adults: A practical guide to identify patient subgroups that are suitable for more specific treatments. Neurogastroenterol Motil 2024; 36:e14715. [PMID: 37994282 DOI: 10.1111/nmo.14715] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 11/06/2023] [Accepted: 11/10/2023] [Indexed: 11/24/2023]
Abstract
Chronic intestinal pseudo-obstruction is a rare and heterogeneous syndrome characterized by recurrent symptoms of intestinal obstruction with radiological features of dilated small or large intestine with air/fluid levels in the absence of any mechanical occlusive lesion. Several diseases may be associated with chronic intestinal pseudo-obstruction and in these cases, the prognosis and treatment are related to the underlying disease. Also, in its "primary or idiopathic" form, two subgroups of patients should be determined as they require a more specific therapeutic approach: patients whose chronic intestinal pseudo-obstruction is due to sporadic autoimmune/inflammatory mechanisms and patients whose neuromuscular changes are genetically determined. In a context of a widely heterogeneous adult population presenting chronic intestinal pseudo-obstruction, this review aims to summarize a practical diagnostic workup for identifying definite subgroups of patients who might benefit from more specific treatments, based on the etiology of their underlying condition.
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Affiliation(s)
- Guido Basilisco
- Gastroenterology and Endoscopic Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Margherita Marchi
- Neuroalgology Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - Marina Coletta
- Gastroenterology and Endoscopic Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Anand SK, Sanchorawala V, Verma A. Systemic Amyloidosis and Kidney Transplantation: An Update. Semin Nephrol 2024; 44:151496. [PMID: 38490903 DOI: 10.1016/j.semnephrol.2024.151496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
Amyloidosis is a heterogeneous disorder characterized by abnormal protein aggregate deposition that often leads to kidney involvement and end-stage kidney disease. With advancements in diagnostic techniques and treatment options, the prevalence of patients with amyloidosis requiring chronic dialysis has increased. Kidney transplantation is a promising avenue for extending survival and enhancing quality of life in these patients. However, the complex and heterogeneous nature of amyloidosis presents challenges in determining optimal referral timing for transplantation and managing post-transplantation course. This review focuses on recent developments and outcomes of kidney transplantation for amyloidosis-related end-stage kidney disease. This review also aims to guide clinical decision-making and improve management of patients with amyloidosis-associated kidney disease, offering insights into optimizing patient selection and post-transplant care for favorable outcomes.
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Affiliation(s)
- Shankara K Anand
- Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center, Boston, MA
| | - Vaishali Sanchorawala
- Amyloidosis Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA; Section of Hematology and Oncology, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA
| | - Ashish Verma
- Renal Section, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA; Amyloidosis Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA; Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center, Boston, MA.
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Khaja T, Truong L, Nassar G. De Novo Fibrinogen A Alpha Chain Amyloidosis in a Kidney Transplant Patient: Case Report and Literature Review. Can J Kidney Health Dis 2023; 10:20543581231209207. [PMID: 37920778 PMCID: PMC10619347 DOI: 10.1177/20543581231209207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 09/21/2023] [Indexed: 11/04/2023] Open
Abstract
Rationale De Novo transplant amyloidosis denotes the condition when a patient develops amyloidosis after transplantation but had not been diagnosed with the disease prior to transplantation. The incidence of de novo amyloidosis in kidney transplants is rare, but few published case reports have described the occurrence of de novo Amyloid A protein (AA) and Light Chain (AL) amyloidosis. However, de novo hereditary fibrinogen A alpha chain (AFib) has not been previously reported. Patient Presentation We present a 72-year-old man, a kidney transplant recipient, who developed progressive rise in his creatinine about 3 years after transplantation. He has long-standing diabetes mellitus type 2, obesity, and hypertension, so he did not have a kidney biopsy of his native kidneys prior to transplantation. Diagnosis A kidney transplant biopsy was done that showed amyloidosis. Mass spectrophotometry confirmed it as AFib amyloidosis. Genetic testing of the patient revealed that he has fibrinogen A alpha gene (FGA) point mutation with a p.E545V variant. Interventions Cardiac evaluation showed normal transthoracic echocardiogram. Cardiac magnetic resonance imaging (MRI) showed no involvement by amyloidosis. A peripheral nerve biopsy showed diabetic neuropathy. Thus, the kidney was the only organ involved by the disease. The kidney transplant was managed conservatively with blood pressure and diabetes control in addition to his usual immunosuppression regimen which was not altered. He is being treated with diuretics, angiotensin receptor inhibitors, and sodium glucose transport 2 inhibitors. Outcomes Kidney transplant function exhibited only slow progression over 18 months since the diagnosis was confirmed. This slow progression is likely because the p.E545V point mutation variant is less aggressive than other gene deletion mutations and because our patient was judged to have been diagnosed early in the course of his disease. Teaching Points In this case report, we illustrate the findings and testing that confirmed the diagnosis of AFib amyloidosis. We summarize the clinical aspects, outcomes of the disease, and treatment options. We believe this case report is interesting because it is the first reported case of AFib amyloidosis in a kidney transplant recipient who was not known to have the disease prior to kidney transplantation.
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Affiliation(s)
- Taqui Khaja
- Division of Nephrology, Department of Internal Medicine, Houston Methodist Hospital, Weill Cornell Medicine, TX, USA
| | - Luan Truong
- Department of Pathology, Houston Methodist Hospital, Weill Cornell Medicine, TX, USA
| | - George Nassar
- Division of Nephrology, Department of Internal Medicine, Houston Methodist Hospital, Weill Cornell Medicine, TX, USA
- Nephrology, Dialysis & Transplantation Associates, Houston, TX, USA
- Panoramic Health, Tempe, AZ, USA
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Ceglarz K, Gozdowska J, Świder R, Kosieradzki M, Zduńczyk D, Durlik M. Difficulties in the Diagnosis of Fibrinogen Aα-Chain Amyloidosis-Literature Review and Case Report of a Patient After Kidney Transplantation. Transplant Proc 2023; 55:644-648. [PMID: 36966081 DOI: 10.1016/j.transproceed.2023.02.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 02/19/2023] [Indexed: 03/27/2023]
Abstract
BACKGROUND Amyloidosis is a very heterogeneous disease. Correct diagnosis is extremely important because of the various treatment options for different types of amyloidosis. This study presents a case report and literature review of the misdiagnosis of fibrinogen Aα-chain amyloidosis (AFib amyloidosis). CASE PRESENTATION We report a 65-year-old man diagnosed with proteinuria in 2009. The kidney biopsy revealed the presence of Congo red-stained amyloid deposits. During differential diagnosis, amyloid deposits were discovered in adipose tissue and gingiva. Bone marrow trephine biopsy showed a predominance of lambda chains presenting plasmocytes. Based on performed medical examination, light chain amyloidosis was identified. Therefore, the patient received high-dose melphalan and underwent successful autologous peripheral blood stem cell transplantation. However, proteinuria, worsening of the kidneys' function, and incorrect levels of free light chains were still observed. In 2019, due to continuous treatment failure, a previously acquired kidney biopsy was examined by mass spectrometry, and numerous fibrinogen deposits were identified. Recommended DNA analysis revealed that the patient had AFib amyloidosis. Therefore, chemotherapy treatment was abandoned, and successful kidney transplantation was performed. CONCLUSION Today, it is essential for medical practitioners to remember the possibility of rare and hereditary types of amyloidosis. There are multiple cases where a diagnosis was wrong or delayed because of the atypical course of the disease, the coexistence of another disease, and the rarity of AFib amyloidosis, and all of these reasons may result in the wrong treatment that will delay the right therapy. However, with the new, more precise diagnostics methods, such situations will become rare.
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Affiliation(s)
- Katarzyna Ceglarz
- Department of Transplantation Medicine, Nephrology and Internal Medicine, Medical University of Warsaw, Poland
| | - Jolanta Gozdowska
- Department of Transplantation Medicine, Nephrology and Internal Medicine, Medical University of Warsaw, Poland.
| | - Robert Świder
- Department of Transplantation Medicine, Nephrology and Internal Medicine, Medical University of Warsaw, Poland
| | - Maciej Kosieradzki
- Department of General and Transplantation Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Dorota Zduńczyk
- Department of Hematology, Oncology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Magdalena Durlik
- Department of Transplantation Medicine, Nephrology and Internal Medicine, Medical University of Warsaw, Poland
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Pande M, Kundu D, Srivastava R. Selective vitamins as potential options for dietary therapeutic interventions: In silico and In vitro insights from mutant C terminal fragment of FGA. J Steroid Biochem Mol Biol 2023; 230:106290. [PMID: 36907427 DOI: 10.1016/j.jsbmb.2023.106290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/18/2023] [Accepted: 03/09/2023] [Indexed: 03/12/2023]
Abstract
We have used an integrated computational approach to explore the role of vitamin C and vitamin D in preventing aggregation of Fibrinogen A alpha-chain (FGActer) protein responsible for renal amyloidosis. We modelled structures of E524K / E526K mutants of FGActer protein and examined the potential interactions of these mutants with vitamin C and vitamin D3. Interaction of these vitamins at the amyloidogenic site may prevent the intermolecular interaction required for amyloid formation. The binding free energy values of vitamin C and vitamin D3 for E524K FGActer and E526K FGActer are - 67.12 ± 30.46 kJ/mole and - 79.45 ± 26.12 kJ/mol, respectively. Experimental studies using Congo red absorption, aggregation index studies and AFM imaging show encouraging results. The AFM images of E526K FGActer contained more extensive and higher protofibril aggregates, whereas, in the presence of vitamin D3, small monomeric and oligomeric aggregates were observed. Overall, the works provide interesting results about vitamin C and D role in preventing renal amyloidosis.
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Affiliation(s)
- Monu Pande
- Department of Biochemistry, Institute of Medical Science, Banaras Hindu University, Varanasi 221005, India
| | - Debanjan Kundu
- School of Biochemical Engineering, Indian Institute of Technology (BHU), Varanasi 221005, India
| | - Ragini Srivastava
- Department of Biochemistry, Institute of Medical Science, Banaras Hindu University, Varanasi 221005, India.
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11
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Khan A, Alam MT, Iqbal A, Siddiqui T, Ali A. Microwave-assisted one-pot multicomponent synthesis of steroidal pyrido[2,3-d]pyrimidines and their possible implications in drug development. Steroids 2023; 190:109154. [PMID: 36521632 DOI: 10.1016/j.steroids.2022.109154] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/05/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022]
Abstract
Protein misfolding can lead to fibrillar and non-fibrillar deposits which are the signs of countless human diseases. A promising strategy for the prevention of such diseases is the inhibition of protein aggregation, and the most crucial step toward effective prevention is the development of small molecules having the potential for protein-aggregation inhibition. In this search, a series of novel steroidal pyrido[2,3-d]pyrimidines have been synthesized employing steroidal ketone, substituted aldehydes, and 2,6-diaminopyrimidin-4(3H)-one through the microwave-assisted one-pot multicomponent methodology. The aggregation inhibition potential of newly synthesized compounds was evaluated on human lysozyme (HLZ). All the synthesized compounds were found to be efficient in the inhibition of protein aggregation in carefully designed in vitro experiments. Moreover, molecular docking studies also determine the binding interactions between all the synthesized compounds and native HLZ through hydrogen bonding. The structures of synthesized compounds were also elucidated using various spectroscopic techniques.
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Affiliation(s)
- Asna Khan
- Department of Chemistry, Faculty of Science, Aligarh Muslim University, Aligarh 202 002, UP, India
| | - Md Tauqir Alam
- Department of Biochemistry, Faculty of Life Science, Aligarh Muslim University, Aligarh 202 002, UP, India
| | - Arfeen Iqbal
- Department of Chemistry, Faculty of Science, Aligarh Muslim University, Aligarh 202 002, UP, India
| | - Tabassum Siddiqui
- Department of Chemistry, Faculty of Science, Aligarh Muslim University, Aligarh 202 002, UP, India
| | - Abad Ali
- Department of Chemistry, Faculty of Science, Aligarh Muslim University, Aligarh 202 002, UP, India.
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12
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Biederman LE, Dasgupta AD, Dreyfus DE, Nadasdy T, Satoskar AA, Brodsky SV. Kidney Biopsy Corner: Amyloidosis. GLOMERULAR DISEASES 2023; 3:165-177. [PMID: 37901698 PMCID: PMC10601942 DOI: 10.1159/000533195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/17/2023] [Indexed: 10/31/2023]
Abstract
Amyloidosis is an infiltrative disease caused by misfolded proteins depositing in tissues. Amyloid infiltrates the kidney in several patterns. There are, as currently described by the International Society of Amyloidosis, 14 types of amyloid that can involve the kidney, and these types may have different locations or clinical settings. Herein we report a case of AA amyloidosis occurring in a 24-year-old male with a history of intravenous drug abuse and provide a comprehensive review of different types of amyloids involving the kidney.
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Affiliation(s)
- Laura E. Biederman
- Department of Pathology, Ohio State Wexner Medical Center, Columbus, OH, USA
- Department of Pathology, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Alana D. Dasgupta
- Department of Pathology, Ohio State Wexner Medical Center, Columbus, OH, USA
| | | | - Tibor Nadasdy
- Department of Pathology, Ohio State Wexner Medical Center, Columbus, OH, USA
| | - Anjali A. Satoskar
- Department of Pathology, Ohio State Wexner Medical Center, Columbus, OH, USA
| | - Sergey V. Brodsky
- Department of Pathology, Ohio State Wexner Medical Center, Columbus, OH, USA
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Li ZY, Wang S, Li DY, Liu D, Wang SX, Yu XJ, Liu G, Zhou FD, Zhao MH. Fibrinogen A Alpha-Chain Amyloidosis in Two Chinese Patients. Front Med (Lausanne) 2022; 9:869409. [PMID: 35572989 PMCID: PMC9096909 DOI: 10.3389/fmed.2022.869409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/06/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives Fibrinogen A alpha-chain amyloidosis (AFib amyloidosis) is the most common form of hereditary renal amyloidosis in the United Kingdom and Europe, but has rarely been reported in Asia. In this study, we reported two AFib amyloidosis patients in China, reviewing the literature and summarizing main characteristics of AFib amyloidosis in Asia. Methods Two unrelated Chinese patients were diagnosed with AFib amyloidosis by clinical presentation, renal biopsy, mass spectrometry and DNA sequencing in Peking University First Hospital of China from 2014 to 2016. Results Both of the patients presented with proteinuria, edema and hypertension. Renal biopsies of two patients showed extensive amyloid deposits (Congo red positive) in glomeruli, and focal tubulointerstitial amyloid deposits was also found in patient 1. Besides, hepatic involvement of amyloidosis has been detected by liver biopsy in patient 1. By electron microscopy, randomly arranged fibrils in a diameter of 8–12 nm was identified in mesangial matrix and subendothelial area of glomeruli. Immunohistochemistry demonstrated amyloid deposits were strongly positive for fibrinogen Aα in glomeruli and positive for LECT2 in the interstitium of renal medulla and the liver in Patient 1. Unevenly positive staining for both fibrinogen Aα and ApoA-I were found in Patient 2. Fibrinogen Aα was the most abundant amyloidogenic protein in both patients identified by laser microdissection and mass spectrometry-based proteomic analysis. Genetic analysis revealed the fibrinogen A a-chain gene (FGA) mutation in both patients, including a new deletion mutation [c.1639delA (p.Arg547Glyfs*21; NM_000508)] in Patient 2. Genetic analysis of the LECT2 gene in patient 1 revealed a codon change from ATC to GTC at position 172 [c.172A>G (p.Ile58Val; NM_002302)], which is a common polymorphism (SNP rs31517) in all ALECT2 amyloidosis patients. Conclusions We reported two AFib amyloidosis patients in China, one of them coexisted with ALECT2 amyloidosis simultaneously.
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Affiliation(s)
- Zhen-Yu Li
- Laboratory of Electron Microscopy, Pathological Center, Peking University First Hospital, Beijing, China.,Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.,Renal Pathological Center, Institute of Nephrology, Peking University, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China
| | - Shuang Wang
- Laboratory of Electron Microscopy, Pathological Center, Peking University First Hospital, Beijing, China.,Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.,Renal Pathological Center, Institute of Nephrology, Peking University, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China
| | - Dan-Yang Li
- Laboratory of Electron Microscopy, Pathological Center, Peking University First Hospital, Beijing, China.,Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.,Renal Pathological Center, Institute of Nephrology, Peking University, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China
| | - Dan Liu
- Proteomics Laboratory, Medical and Healthy Analytical Center, Peking University Health Science Center, Beijing, China
| | - Su-Xia Wang
- Laboratory of Electron Microscopy, Pathological Center, Peking University First Hospital, Beijing, China.,Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.,Renal Pathological Center, Institute of Nephrology, Peking University, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China
| | - Xiao-Juan Yu
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.,Renal Pathological Center, Institute of Nephrology, Peking University, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China
| | - Gang Liu
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.,Renal Pathological Center, Institute of Nephrology, Peking University, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China
| | - Fu-De Zhou
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.,Renal Pathological Center, Institute of Nephrology, Peking University, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China
| | - Ming-Hui Zhao
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.,Renal Pathological Center, Institute of Nephrology, Peking University, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China
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14
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Ji A, Shaukat A, Takei R, Bixley M, Cadzow M, Topless RK, Major TJ, Phipps-Green A, Merriman ME, Harré Hindmarsh J, Stamp LK, Dalbeth N, Li C, Merriman TR. Aotearoa New Zealand Māori and Pacific Population-amplified Gout Risk Variants: CLNK Is a Separate Risk Gene at the SLC2A9 Locus. J Rheumatol 2021; 48:1736-1744. [PMID: 34210831 DOI: 10.3899/jrheum.201684] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The Māori and Pacific (Polynesian) population of Aotearoa New Zealand has a high prevalence of gout. Our aim was to identify potentially functional missense genetic variants in candidate inflammatory genes amplified in frequency that may underlie the increased prevalence of gout in Polynesian populations. METHODS A list of 712 inflammatory disease-related genes was generated. An in silico targeted exome set was extracted from whole genome sequencing data in people with gout of various ancestral groups (Polynesian, European, East Asian; n = 55, 780, 135, respectively) to identify Polynesian-amplified common missense variants (minor allele frequency > 0.05). Candidate functional variants were tested for association with gout by multivariable-adjusted regression analysis in 2528 individuals of Polynesian ancestry. RESULTS We identified 26 variants common in the Polynesian population and uncommon in the European and East Asian populations. Three of the 26 population-amplified variants were nominally associated with the risk of gout (rs1635712 [KIAA0319], ORmeta = 1.28, P meta = 0.03; rs16869924 [CLNK], ORmeta = 1.37, P meta = 0.002; rs2070025 [fibrinogen A alpha chain (FGA)], ORmeta = 1.34, P meta = 0.02). The CLNK variant, within the established SLC2A9 gout locus, was genetically independent of the association signal at SLC2A9. CONCLUSION We provide nominal evidence for the existence of population-amplified genetic variants conferring risk of gout in Polynesian populations. Polymorphisms in CLNK have previously been associated with gout in other populations, supporting our evidence for the association of this gene with gout.
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Affiliation(s)
- Aichang Ji
- This research was supported by the Health Research Council of New Zealand (Grant 14/527). 1A. Ji, PhD, Research Fellow, C. Li, PhD, Professor, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China; 2A. Shaukat, MSc, Doctoral Student, M. Bixley, MSc, Assistant Research Fellow, M. Cadzow, PhD, Research Fellow, R.K. Topless, BSc, Assistant Research Fellow, T.J. Major, PhD, Research Fellow, A. Phipps-Green, MSc, Assistant Research Fellow, M.E. Merriman, BSc, Research Assistant, Department of Biochemistry, University of Otago, Dunedin, New Zealand; 3R. Takei, MSc, Scientist, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA; 4J. Harré Hindmarsh, PhD, Research Coordinator, Ngāti Porou Hauora Charitable Trust, Te Puia Springs, Tairāwhiti East Coast, New Zealand; 5L.K. Stamp, PhD, Professor, Department of Medicine, University of Otago, Christchurch, New Zealand; 6N. Dalbeth, MD, Professor, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; 7T.R. Merriman, BSc, Research Assistant, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China, Department of Biochemistry, University of Otago, Dunedin, New Zealand, and Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA. A. Ji and A. Shaukat contributed equally to this work. The authors declare no conflict of interest relevant to this article. Address correspondence to T.R. Merriman, School of Biomedical Sciences, Department of Biochemistry, 710 Cumberland Street, Dunedin, Otago 9054, New Zealand. . Accepted for publication June 11, 2021
| | - Amara Shaukat
- This research was supported by the Health Research Council of New Zealand (Grant 14/527). 1A. Ji, PhD, Research Fellow, C. Li, PhD, Professor, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China; 2A. Shaukat, MSc, Doctoral Student, M. Bixley, MSc, Assistant Research Fellow, M. Cadzow, PhD, Research Fellow, R.K. Topless, BSc, Assistant Research Fellow, T.J. Major, PhD, Research Fellow, A. Phipps-Green, MSc, Assistant Research Fellow, M.E. Merriman, BSc, Research Assistant, Department of Biochemistry, University of Otago, Dunedin, New Zealand; 3R. Takei, MSc, Scientist, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA; 4J. Harré Hindmarsh, PhD, Research Coordinator, Ngāti Porou Hauora Charitable Trust, Te Puia Springs, Tairāwhiti East Coast, New Zealand; 5L.K. Stamp, PhD, Professor, Department of Medicine, University of Otago, Christchurch, New Zealand; 6N. Dalbeth, MD, Professor, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; 7T.R. Merriman, BSc, Research Assistant, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China, Department of Biochemistry, University of Otago, Dunedin, New Zealand, and Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA. A. Ji and A. Shaukat contributed equally to this work. The authors declare no conflict of interest relevant to this article. Address correspondence to T.R. Merriman, School of Biomedical Sciences, Department of Biochemistry, 710 Cumberland Street, Dunedin, Otago 9054, New Zealand. . Accepted for publication June 11, 2021
| | - Riku Takei
- This research was supported by the Health Research Council of New Zealand (Grant 14/527). 1A. Ji, PhD, Research Fellow, C. Li, PhD, Professor, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China; 2A. Shaukat, MSc, Doctoral Student, M. Bixley, MSc, Assistant Research Fellow, M. Cadzow, PhD, Research Fellow, R.K. Topless, BSc, Assistant Research Fellow, T.J. Major, PhD, Research Fellow, A. Phipps-Green, MSc, Assistant Research Fellow, M.E. Merriman, BSc, Research Assistant, Department of Biochemistry, University of Otago, Dunedin, New Zealand; 3R. Takei, MSc, Scientist, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA; 4J. Harré Hindmarsh, PhD, Research Coordinator, Ngāti Porou Hauora Charitable Trust, Te Puia Springs, Tairāwhiti East Coast, New Zealand; 5L.K. Stamp, PhD, Professor, Department of Medicine, University of Otago, Christchurch, New Zealand; 6N. Dalbeth, MD, Professor, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; 7T.R. Merriman, BSc, Research Assistant, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China, Department of Biochemistry, University of Otago, Dunedin, New Zealand, and Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA. A. Ji and A. Shaukat contributed equally to this work. The authors declare no conflict of interest relevant to this article. Address correspondence to T.R. Merriman, School of Biomedical Sciences, Department of Biochemistry, 710 Cumberland Street, Dunedin, Otago 9054, New Zealand. . Accepted for publication June 11, 2021
| | - Matthew Bixley
- This research was supported by the Health Research Council of New Zealand (Grant 14/527). 1A. Ji, PhD, Research Fellow, C. Li, PhD, Professor, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China; 2A. Shaukat, MSc, Doctoral Student, M. Bixley, MSc, Assistant Research Fellow, M. Cadzow, PhD, Research Fellow, R.K. Topless, BSc, Assistant Research Fellow, T.J. Major, PhD, Research Fellow, A. Phipps-Green, MSc, Assistant Research Fellow, M.E. Merriman, BSc, Research Assistant, Department of Biochemistry, University of Otago, Dunedin, New Zealand; 3R. Takei, MSc, Scientist, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA; 4J. Harré Hindmarsh, PhD, Research Coordinator, Ngāti Porou Hauora Charitable Trust, Te Puia Springs, Tairāwhiti East Coast, New Zealand; 5L.K. Stamp, PhD, Professor, Department of Medicine, University of Otago, Christchurch, New Zealand; 6N. Dalbeth, MD, Professor, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; 7T.R. Merriman, BSc, Research Assistant, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China, Department of Biochemistry, University of Otago, Dunedin, New Zealand, and Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA. A. Ji and A. Shaukat contributed equally to this work. The authors declare no conflict of interest relevant to this article. Address correspondence to T.R. Merriman, School of Biomedical Sciences, Department of Biochemistry, 710 Cumberland Street, Dunedin, Otago 9054, New Zealand. . Accepted for publication June 11, 2021
| | - Murray Cadzow
- This research was supported by the Health Research Council of New Zealand (Grant 14/527). 1A. Ji, PhD, Research Fellow, C. Li, PhD, Professor, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China; 2A. Shaukat, MSc, Doctoral Student, M. Bixley, MSc, Assistant Research Fellow, M. Cadzow, PhD, Research Fellow, R.K. Topless, BSc, Assistant Research Fellow, T.J. Major, PhD, Research Fellow, A. Phipps-Green, MSc, Assistant Research Fellow, M.E. Merriman, BSc, Research Assistant, Department of Biochemistry, University of Otago, Dunedin, New Zealand; 3R. Takei, MSc, Scientist, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA; 4J. Harré Hindmarsh, PhD, Research Coordinator, Ngāti Porou Hauora Charitable Trust, Te Puia Springs, Tairāwhiti East Coast, New Zealand; 5L.K. Stamp, PhD, Professor, Department of Medicine, University of Otago, Christchurch, New Zealand; 6N. Dalbeth, MD, Professor, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; 7T.R. Merriman, BSc, Research Assistant, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China, Department of Biochemistry, University of Otago, Dunedin, New Zealand, and Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA. A. Ji and A. Shaukat contributed equally to this work. The authors declare no conflict of interest relevant to this article. Address correspondence to T.R. Merriman, School of Biomedical Sciences, Department of Biochemistry, 710 Cumberland Street, Dunedin, Otago 9054, New Zealand. . Accepted for publication June 11, 2021
| | - Ruth K Topless
- This research was supported by the Health Research Council of New Zealand (Grant 14/527). 1A. Ji, PhD, Research Fellow, C. Li, PhD, Professor, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China; 2A. Shaukat, MSc, Doctoral Student, M. Bixley, MSc, Assistant Research Fellow, M. Cadzow, PhD, Research Fellow, R.K. Topless, BSc, Assistant Research Fellow, T.J. Major, PhD, Research Fellow, A. Phipps-Green, MSc, Assistant Research Fellow, M.E. Merriman, BSc, Research Assistant, Department of Biochemistry, University of Otago, Dunedin, New Zealand; 3R. Takei, MSc, Scientist, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA; 4J. Harré Hindmarsh, PhD, Research Coordinator, Ngāti Porou Hauora Charitable Trust, Te Puia Springs, Tairāwhiti East Coast, New Zealand; 5L.K. Stamp, PhD, Professor, Department of Medicine, University of Otago, Christchurch, New Zealand; 6N. Dalbeth, MD, Professor, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; 7T.R. Merriman, BSc, Research Assistant, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China, Department of Biochemistry, University of Otago, Dunedin, New Zealand, and Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA. A. Ji and A. Shaukat contributed equally to this work. The authors declare no conflict of interest relevant to this article. Address correspondence to T.R. Merriman, School of Biomedical Sciences, Department of Biochemistry, 710 Cumberland Street, Dunedin, Otago 9054, New Zealand. . Accepted for publication June 11, 2021
| | - Tanya J Major
- This research was supported by the Health Research Council of New Zealand (Grant 14/527). 1A. Ji, PhD, Research Fellow, C. Li, PhD, Professor, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China; 2A. Shaukat, MSc, Doctoral Student, M. Bixley, MSc, Assistant Research Fellow, M. Cadzow, PhD, Research Fellow, R.K. Topless, BSc, Assistant Research Fellow, T.J. Major, PhD, Research Fellow, A. Phipps-Green, MSc, Assistant Research Fellow, M.E. Merriman, BSc, Research Assistant, Department of Biochemistry, University of Otago, Dunedin, New Zealand; 3R. Takei, MSc, Scientist, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA; 4J. Harré Hindmarsh, PhD, Research Coordinator, Ngāti Porou Hauora Charitable Trust, Te Puia Springs, Tairāwhiti East Coast, New Zealand; 5L.K. Stamp, PhD, Professor, Department of Medicine, University of Otago, Christchurch, New Zealand; 6N. Dalbeth, MD, Professor, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; 7T.R. Merriman, BSc, Research Assistant, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China, Department of Biochemistry, University of Otago, Dunedin, New Zealand, and Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA. A. Ji and A. Shaukat contributed equally to this work. The authors declare no conflict of interest relevant to this article. Address correspondence to T.R. Merriman, School of Biomedical Sciences, Department of Biochemistry, 710 Cumberland Street, Dunedin, Otago 9054, New Zealand. . Accepted for publication June 11, 2021
| | - Amanda Phipps-Green
- This research was supported by the Health Research Council of New Zealand (Grant 14/527). 1A. Ji, PhD, Research Fellow, C. Li, PhD, Professor, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China; 2A. Shaukat, MSc, Doctoral Student, M. Bixley, MSc, Assistant Research Fellow, M. Cadzow, PhD, Research Fellow, R.K. Topless, BSc, Assistant Research Fellow, T.J. Major, PhD, Research Fellow, A. Phipps-Green, MSc, Assistant Research Fellow, M.E. Merriman, BSc, Research Assistant, Department of Biochemistry, University of Otago, Dunedin, New Zealand; 3R. Takei, MSc, Scientist, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA; 4J. Harré Hindmarsh, PhD, Research Coordinator, Ngāti Porou Hauora Charitable Trust, Te Puia Springs, Tairāwhiti East Coast, New Zealand; 5L.K. Stamp, PhD, Professor, Department of Medicine, University of Otago, Christchurch, New Zealand; 6N. Dalbeth, MD, Professor, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; 7T.R. Merriman, BSc, Research Assistant, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China, Department of Biochemistry, University of Otago, Dunedin, New Zealand, and Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA. A. Ji and A. Shaukat contributed equally to this work. The authors declare no conflict of interest relevant to this article. Address correspondence to T.R. Merriman, School of Biomedical Sciences, Department of Biochemistry, 710 Cumberland Street, Dunedin, Otago 9054, New Zealand. . Accepted for publication June 11, 2021
| | - Marilyn E Merriman
- This research was supported by the Health Research Council of New Zealand (Grant 14/527). 1A. Ji, PhD, Research Fellow, C. Li, PhD, Professor, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China; 2A. Shaukat, MSc, Doctoral Student, M. Bixley, MSc, Assistant Research Fellow, M. Cadzow, PhD, Research Fellow, R.K. Topless, BSc, Assistant Research Fellow, T.J. Major, PhD, Research Fellow, A. Phipps-Green, MSc, Assistant Research Fellow, M.E. Merriman, BSc, Research Assistant, Department of Biochemistry, University of Otago, Dunedin, New Zealand; 3R. Takei, MSc, Scientist, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA; 4J. Harré Hindmarsh, PhD, Research Coordinator, Ngāti Porou Hauora Charitable Trust, Te Puia Springs, Tairāwhiti East Coast, New Zealand; 5L.K. Stamp, PhD, Professor, Department of Medicine, University of Otago, Christchurch, New Zealand; 6N. Dalbeth, MD, Professor, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; 7T.R. Merriman, BSc, Research Assistant, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China, Department of Biochemistry, University of Otago, Dunedin, New Zealand, and Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA. A. Ji and A. Shaukat contributed equally to this work. The authors declare no conflict of interest relevant to this article. Address correspondence to T.R. Merriman, School of Biomedical Sciences, Department of Biochemistry, 710 Cumberland Street, Dunedin, Otago 9054, New Zealand. . Accepted for publication June 11, 2021
| | - Jennie Harré Hindmarsh
- This research was supported by the Health Research Council of New Zealand (Grant 14/527). 1A. Ji, PhD, Research Fellow, C. Li, PhD, Professor, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China; 2A. Shaukat, MSc, Doctoral Student, M. Bixley, MSc, Assistant Research Fellow, M. Cadzow, PhD, Research Fellow, R.K. Topless, BSc, Assistant Research Fellow, T.J. Major, PhD, Research Fellow, A. Phipps-Green, MSc, Assistant Research Fellow, M.E. Merriman, BSc, Research Assistant, Department of Biochemistry, University of Otago, Dunedin, New Zealand; 3R. Takei, MSc, Scientist, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA; 4J. Harré Hindmarsh, PhD, Research Coordinator, Ngāti Porou Hauora Charitable Trust, Te Puia Springs, Tairāwhiti East Coast, New Zealand; 5L.K. Stamp, PhD, Professor, Department of Medicine, University of Otago, Christchurch, New Zealand; 6N. Dalbeth, MD, Professor, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; 7T.R. Merriman, BSc, Research Assistant, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China, Department of Biochemistry, University of Otago, Dunedin, New Zealand, and Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA. A. Ji and A. Shaukat contributed equally to this work. The authors declare no conflict of interest relevant to this article. Address correspondence to T.R. Merriman, School of Biomedical Sciences, Department of Biochemistry, 710 Cumberland Street, Dunedin, Otago 9054, New Zealand. . Accepted for publication June 11, 2021
| | - Lisa K Stamp
- This research was supported by the Health Research Council of New Zealand (Grant 14/527). 1A. Ji, PhD, Research Fellow, C. Li, PhD, Professor, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China; 2A. Shaukat, MSc, Doctoral Student, M. Bixley, MSc, Assistant Research Fellow, M. Cadzow, PhD, Research Fellow, R.K. Topless, BSc, Assistant Research Fellow, T.J. Major, PhD, Research Fellow, A. Phipps-Green, MSc, Assistant Research Fellow, M.E. Merriman, BSc, Research Assistant, Department of Biochemistry, University of Otago, Dunedin, New Zealand; 3R. Takei, MSc, Scientist, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA; 4J. Harré Hindmarsh, PhD, Research Coordinator, Ngāti Porou Hauora Charitable Trust, Te Puia Springs, Tairāwhiti East Coast, New Zealand; 5L.K. Stamp, PhD, Professor, Department of Medicine, University of Otago, Christchurch, New Zealand; 6N. Dalbeth, MD, Professor, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; 7T.R. Merriman, BSc, Research Assistant, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China, Department of Biochemistry, University of Otago, Dunedin, New Zealand, and Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA. A. Ji and A. Shaukat contributed equally to this work. The authors declare no conflict of interest relevant to this article. Address correspondence to T.R. Merriman, School of Biomedical Sciences, Department of Biochemistry, 710 Cumberland Street, Dunedin, Otago 9054, New Zealand. . Accepted for publication June 11, 2021
| | - Nicola Dalbeth
- This research was supported by the Health Research Council of New Zealand (Grant 14/527). 1A. Ji, PhD, Research Fellow, C. Li, PhD, Professor, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China; 2A. Shaukat, MSc, Doctoral Student, M. Bixley, MSc, Assistant Research Fellow, M. Cadzow, PhD, Research Fellow, R.K. Topless, BSc, Assistant Research Fellow, T.J. Major, PhD, Research Fellow, A. Phipps-Green, MSc, Assistant Research Fellow, M.E. Merriman, BSc, Research Assistant, Department of Biochemistry, University of Otago, Dunedin, New Zealand; 3R. Takei, MSc, Scientist, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA; 4J. Harré Hindmarsh, PhD, Research Coordinator, Ngāti Porou Hauora Charitable Trust, Te Puia Springs, Tairāwhiti East Coast, New Zealand; 5L.K. Stamp, PhD, Professor, Department of Medicine, University of Otago, Christchurch, New Zealand; 6N. Dalbeth, MD, Professor, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; 7T.R. Merriman, BSc, Research Assistant, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China, Department of Biochemistry, University of Otago, Dunedin, New Zealand, and Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA. A. Ji and A. Shaukat contributed equally to this work. The authors declare no conflict of interest relevant to this article. Address correspondence to T.R. Merriman, School of Biomedical Sciences, Department of Biochemistry, 710 Cumberland Street, Dunedin, Otago 9054, New Zealand. . Accepted for publication June 11, 2021
| | - Changgui Li
- This research was supported by the Health Research Council of New Zealand (Grant 14/527). 1A. Ji, PhD, Research Fellow, C. Li, PhD, Professor, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China; 2A. Shaukat, MSc, Doctoral Student, M. Bixley, MSc, Assistant Research Fellow, M. Cadzow, PhD, Research Fellow, R.K. Topless, BSc, Assistant Research Fellow, T.J. Major, PhD, Research Fellow, A. Phipps-Green, MSc, Assistant Research Fellow, M.E. Merriman, BSc, Research Assistant, Department of Biochemistry, University of Otago, Dunedin, New Zealand; 3R. Takei, MSc, Scientist, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA; 4J. Harré Hindmarsh, PhD, Research Coordinator, Ngāti Porou Hauora Charitable Trust, Te Puia Springs, Tairāwhiti East Coast, New Zealand; 5L.K. Stamp, PhD, Professor, Department of Medicine, University of Otago, Christchurch, New Zealand; 6N. Dalbeth, MD, Professor, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; 7T.R. Merriman, BSc, Research Assistant, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China, Department of Biochemistry, University of Otago, Dunedin, New Zealand, and Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA. A. Ji and A. Shaukat contributed equally to this work. The authors declare no conflict of interest relevant to this article. Address correspondence to T.R. Merriman, School of Biomedical Sciences, Department of Biochemistry, 710 Cumberland Street, Dunedin, Otago 9054, New Zealand. . Accepted for publication June 11, 2021
| | - Tony R Merriman
- This research was supported by the Health Research Council of New Zealand (Grant 14/527). 1A. Ji, PhD, Research Fellow, C. Li, PhD, Professor, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China; 2A. Shaukat, MSc, Doctoral Student, M. Bixley, MSc, Assistant Research Fellow, M. Cadzow, PhD, Research Fellow, R.K. Topless, BSc, Assistant Research Fellow, T.J. Major, PhD, Research Fellow, A. Phipps-Green, MSc, Assistant Research Fellow, M.E. Merriman, BSc, Research Assistant, Department of Biochemistry, University of Otago, Dunedin, New Zealand; 3R. Takei, MSc, Scientist, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA; 4J. Harré Hindmarsh, PhD, Research Coordinator, Ngāti Porou Hauora Charitable Trust, Te Puia Springs, Tairāwhiti East Coast, New Zealand; 5L.K. Stamp, PhD, Professor, Department of Medicine, University of Otago, Christchurch, New Zealand; 6N. Dalbeth, MD, Professor, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; 7T.R. Merriman, BSc, Research Assistant, Shandong Provincial Key Laboratory of Metabolic Diseases, the Affiliated Hospital of Qingdao University, Qingdao, China, Department of Biochemistry, University of Otago, Dunedin, New Zealand, and Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA. A. Ji and A. Shaukat contributed equally to this work. The authors declare no conflict of interest relevant to this article. Address correspondence to T.R. Merriman, School of Biomedical Sciences, Department of Biochemistry, 710 Cumberland Street, Dunedin, Otago 9054, New Zealand. . Accepted for publication June 11, 2021
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15
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Clotet-Freixas S, McEvoy CM, Batruch I, Pastrello C, Kotlyar M, Van JAD, Arambewela M, Boshart A, Farkona S, Niu Y, Li Y, Famure O, Bozovic A, Kulasingam V, Chen P, Kim SJ, Chan E, Moshkelgosha S, Rahman SA, Das J, Martinu T, Juvet S, Jurisica I, Chruscinski A, John R, Konvalinka A. Extracellular Matrix Injury of Kidney Allografts in Antibody-Mediated Rejection: A Proteomics Study. J Am Soc Nephrol 2020; 31:2705-2724. [PMID: 32900843 DOI: 10.1681/asn.2020030286] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 07/21/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Antibody-mediated rejection (AMR) accounts for >50% of kidney allograft loss. Donor-specific antibodies (DSA) against HLA and non-HLA antigens in the glomeruli and the tubulointerstitium cause AMR while inflammatory cytokines such as TNFα trigger graft injury. The mechanisms governing cell-specific injury in AMR remain unclear. METHODS Unbiased proteomic analysis of laser-captured and microdissected glomeruli and tubulointerstitium was performed on 30 for-cause kidney biopsy specimens with early AMR, acute cellular rejection (ACR), or acute tubular necrosis (ATN). RESULTS A total of 107 of 2026 glomerular and 112 of 2399 tubulointerstitial proteins was significantly differentially expressed in AMR versus ACR; 112 of 2026 glomerular and 181 of 2399 tubulointerstitial proteins were significantly dysregulated in AMR versus ATN (P<0.05). Basement membrane and extracellular matrix (ECM) proteins were significantly decreased in both AMR compartments. Glomerular and tubulointerstitial laminin subunit γ-1 (LAMC1) expression decreased in AMR, as did glomerular nephrin (NPHS1) and receptor-type tyrosine-phosphatase O (PTPRO). The proteomic analysis revealed upregulated galectin-1, which is an immunomodulatory protein linked to the ECM, in AMR glomeruli. Anti-HLA class I antibodies significantly increased cathepsin-V (CTSV) expression and galectin-1 expression and secretion in human glomerular endothelial cells. CTSV had been predicted to cleave ECM proteins in the AMR glomeruli. Glutathione S-transferase ω-1, an ECM-modifying enzyme, was significantly increased in the AMR tubulointerstitium and in TNFα-treated proximal tubular epithelial cells. CONCLUSIONS Basement membranes are often remodeled in chronic AMR. Proteomic analysis performed on laser-captured and microdissected glomeruli and tubulointerstitium identified early ECM remodeling, which may represent a new therapeutic opportunity.
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Affiliation(s)
- Sergi Clotet-Freixas
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Caitriona M McEvoy
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada.,Division of Nephrology, Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Ihor Batruch
- Department of Laboratory Medicine and Pathobiology, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Chiara Pastrello
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Max Kotlyar
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Julie Anh Dung Van
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Madhurangi Arambewela
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Alex Boshart
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Sofia Farkona
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Yun Niu
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Yanhong Li
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Olusegun Famure
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Andrea Bozovic
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Vathany Kulasingam
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Peixuen Chen
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
| | - S Joseph Kim
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada.,Division of Nephrology, Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Emilie Chan
- Division of Nephrology, Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Sajad Moshkelgosha
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada.,Division of Respirology, Toronto Lung Transplant Program, University Health Network, Toronto, Ontario, Canada
| | - Syed Ashiqur Rahman
- Center for Systems Immunology, Department of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.,Center for Systems Immunology, Department of Computational and Systems Biology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jishnu Das
- Center for Systems Immunology, Department of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.,Center for Systems Immunology, Department of Computational and Systems Biology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Tereza Martinu
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada.,Division of Respirology, Toronto Lung Transplant Program, University Health Network, Toronto, Ontario, Canada.,Soham and Shaila Ajmera Family Transplant Centre, University Health Network, Toronto, Ontario, Canada
| | - Stephen Juvet
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada.,Division of Respirology, Toronto Lung Transplant Program, University Health Network, Toronto, Ontario, Canada.,Soham and Shaila Ajmera Family Transplant Centre, University Health Network, Toronto, Ontario, Canada
| | - Igor Jurisica
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.,Department of Computer Science, University of Toronto, Toronto, Ontario, Canada.,Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Andrzej Chruscinski
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada.,Soham and Shaila Ajmera Family Transplant Centre, University Health Network, Toronto, Ontario, Canada
| | - Rohan John
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Ana Konvalinka
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada .,Division of Nephrology, Department of Medicine, University Health Network, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Soham and Shaila Ajmera Family Transplant Centre, University Health Network, Toronto, Ontario, Canada
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16
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Gupta N, Kaur H, Wajid S. Renal amyloidosis: an update on diagnosis and pathogenesis. PROTOPLASMA 2020; 257:1259-1276. [PMID: 32447467 DOI: 10.1007/s00709-020-01513-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 05/11/2020] [Indexed: 06/11/2023]
Abstract
Amyloidosis is a diverse group of protein conformational disorder which is caused by accumulation and deposition of insoluble protein fibrils in vital tissues or organs, instigating organ dysfunction. Renal amyloidosis is characterized by the acellular Congo red-positive pathologic deposition of amyloid fibrils within glomeruli and/or the interstitium. It is generally composed of serum amyloid A-related protein or an immunoglobulin light chain; other rare forms lysozyme, gelsolin, fibrinogen alpha chain, transthyretin, apolipoproteins AI/AII/AIV/CII/CIII; and the recently identified form ALECT2. This disease typically manifests with heavy proteinuria, nephrotic syndrome, and finally progression to end-stage renal failure. Early diagnosis of renal amyloidosis is arduous as its symptoms appear in later stages with prominent amyloid deposition. The identification of the correct type of amyloidosis is quite troublesome as it can be confused with another related form. Therefore, the exact typing of amyloid is essential for prognosis, treatment, and correct management of renal amyloidosis. The emanation of new techniques of proteomic analysis, for instance, mass spectroscopy/laser microdissection, has provided greater accuracy in amyloid typing. This in-depth review emphasizes on the clinical features, renal pathological findings, and diagnosis of the AL and non-AL forms of renal amyloidosis.
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Affiliation(s)
- Nimisha Gupta
- Department of Biotechnology, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi, 110062, India
| | - Harshdeep Kaur
- Department of Biotechnology, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi, 110062, India
| | - Saima Wajid
- Department of Biotechnology, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi, 110062, India.
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17
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Meyer L, Ulrich M, Ducloux D, Garrigue V, Vigneau C, Nochy D, Bobrie G, Ferlicot S, Colombat M, Boffa JJ, Clabault K, Mansour J, Mousson C, Azar R, Bacri JL, Dürrbach A, Duvic C, El Karoui K, Hoffmann M, Lionet A, Panescu V, Plaisier E, Ratsimbazafy A, Guerrot D, Vrigneaud L, Valleix S, François H. Organ Transplantation in Hereditary Fibrinogen A α-Chain Amyloidosis: A Case Series of French Patients. Am J Kidney Dis 2020; 76:384-391. [PMID: 32660897 DOI: 10.1053/j.ajkd.2020.02.445] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 02/04/2020] [Indexed: 11/11/2022]
Abstract
RATIONALE & OBJECTIVE Fibrinogen A α-chain amyloidosis (AFib amyloidosis) is a form of amyloidosis resulting from mutations in the fibrinogen A α-chain gene (FGA), causing progressive kidney disease leading to kidney failure. Treatment may include kidney transplantation (KT) or liver-kidney transplantation (LKT), but it is not clear what factors should guide this decision. The aim of this study was to characterize the natural history and long-term outcomes of this disease, with and without organ transplantation, among patients with AFib amyloidosis and various FGA variants. STUDY DESIGN Case series. SETTING & PARTICIPANTS 32 patients with AFib amyloidosis diagnosed by genetic testing in France between 1983 and 2014, with a median follow-up of 93 (range, 4-192) months, were included. RESULTS Median age at diagnosis was 51.5 (range, 12-77) years. Clinical presentation consisted of proteinuria (93%), hypertension (83%), and kidney failure (68%). Manifestations of kidney disease appeared on average at age 57 (range, 36-77) years in patients with the E526V variant, at age 45 (range, 12-59) years in those with the R554L variant (P<0.001), and at age 24.5 (range, 12-31) years in those with frameshift variants (P<0.001). KT was performed in 15 patients and LKT was performed in 4. In KT patients with the E526V variant, recurrence of AFib amyloidosis in the kidney graft was less common than with a non-E526V (R554L or frameshift) variant (22% vs 83%; P=0.03) and led to graft loss less frequently (33% vs 100%). Amyloid recurrence was not observed in patients after LKT. LIMITATIONS Analyses were based on clinically available historical data. Small number of patients with non-E526V and frameshift variants. CONCLUSIONS Our study suggests phenotypic variability in the natural history of AFib amyloidosis, depending on the FGA mutation type. KT appears to be a viable option for patients with the most common E526V variant, whereas LKT may be a preferred option for patients with frameshift variants.
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Affiliation(s)
- Lara Meyer
- Department of Nephrology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Nephrology, Université Paris Descartes, Paris
| | - Marc Ulrich
- Department of Nephrology, Hôpital Jean Bernard, Valenciennes, France
| | - Didier Ducloux
- Department of Nephrology, Centre Hospitalier Universitaire de Besançon, France
| | - Valérie Garrigue
- Department of Nephrology, Hôpital Lapeyronie, Montpellier, France
| | - Cécile Vigneau
- Department of Nephrology, Centre Hospitalier Universitaire de Rennes, France
| | - Dominique Nochy
- Departments of Pathology, Hôpital Européen Georges Pompidou, AP-HP, Université Paris Descartes, Paris, France
| | - Guillaume Bobrie
- Departments of Hypertension, Hôpital Européen Georges Pompidou, AP-HP, Université Paris Descartes, France
| | - Sophie Ferlicot
- Hôpital Européen Georges Pompidou, AP-HP, Université Paris Descartes, Paris, Department of Pathology, Hôpital Bicêtre, AP-HP, Université Paris-Sud, Le Kremlin-Bicêtre, France
| | - Magalie Colombat
- Department of Pathology, Centre Hospitalier Universitaire de Toulouse, France
| | - Jean-Jacques Boffa
- Department of Nephrology and Dialysis, Hôpital Tenon, AP-HP, Sorbonne Université, Paris, France
| | | | | | - Christiane Mousson
- Department of Nephrology, Centre Hospitalier Unversitaire de Dijon, France
| | - Raymond Azar
- Department of Nephrology, Centre Hospitalier de Dunkerque, France
| | - Jean-Louis Bacri
- Department of Nephrology, Hôpital Jean Bernard, Valenciennes, France
| | - Antoine Dürrbach
- Department of Nephrology, Dialysis and Transplantation, Hôpital Bicêtre, AP-HP, Université Paris-Sud, Le Kremlin-Bicêtre
| | - Christian Duvic
- Department of Hemodialysis Clinique de Choisy, Le Gosier, Guadeloupe
| | | | - Maxime Hoffmann
- Department of Nephrology and Dialysis, Hôpital Privé La Louvière, Groupe Ramsay Générale de Santé, Lille
| | - Arnaud Lionet
- Department of Nephrology, and Transplantation, Centre Hospitalier Régional et Universitaire de Lille, France
| | - Victor Panescu
- Department of Nephrology and Hemodialysis, Polyclinique de Gentilly, Gentilly, France
| | - Emmanuelle Plaisier
- Department of Nephrology and Dialysis, Hôpital Tenon, AP-HP, Sorbonne Université, Paris, France
| | | | - Dominique Guerrot
- Department of Nephrology and Dialysis, Centre Hospitalier Bois Guillaume, Rouen
| | - Laurence Vrigneaud
- Department of Nephrology and Dialysis, Hôpital Privé La Louvière, Groupe Ramsay Générale de Santé, Lille
| | - Sophie Valleix
- Department of Genetic Necker Hospital, AP-HP, Université Paris Descartes, Paris AP-HP, France.
| | - Hélène François
- Department of Nephrology and Transplantation, Hôpital Tenon, Sorbonne Université, Paris, France.
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18
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Canetti D, Rendell NB, Gilbertson JA, Botcher N, Nocerino P, Blanco A, Di Vagno L, Rowczenio D, Verona G, Mangione PP, Bellotti V, Hawkins PN, Gillmore JD, Taylor GW. Diagnostic amyloid proteomics: experience of the UK National Amyloidosis Centre. Clin Chem Lab Med 2020; 58:948-957. [PMID: 32069225 DOI: 10.1515/cclm-2019-1007] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 01/16/2020] [Indexed: 11/15/2022]
Abstract
Systemic amyloidosis is a serious disease which is caused when normal circulating proteins misfold and aggregate extracellularly as insoluble fibrillary deposits throughout the body. This commonly results in cardiac, renal and neurological damage. The tissue target, progression and outcome of the disease depends on the type of protein forming the fibril deposit, and its correct identification is central to determining therapy. Proteomics is now used routinely in our centre to type amyloid; over the past 7 years we have examined over 2000 clinical samples. Proteomics results are linked directly to our patient database using a simple algorithm to automatically highlight the most likely amyloidogenic protein. Whilst the approach has proved very successful, we have encountered a number of challenges, including poor sample recovery, limited enzymatic digestion, the presence of multiple amyloidogenic proteins and the identification of pathogenic variants. Our proteomics procedures and approaches to resolving difficult issues are outlined.
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Affiliation(s)
- Diana Canetti
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Nigel B Rendell
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Janet A Gilbertson
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Nicola Botcher
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Paola Nocerino
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Angel Blanco
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Lucia Di Vagno
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Dorota Rowczenio
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Guglielmo Verona
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - P Patrizia Mangione
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK.,Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy
| | - Vittorio Bellotti
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK.,Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy
| | - Philip N Hawkins
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Julian D Gillmore
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
| | - Graham W Taylor
- Wolfson Drug Discovery Unit and National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, University College London, London, UK
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19
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Gaddi GM, Gisonno RA, Rosú SA, Curto LM, Prieto ED, Schinella GR, Finarelli GS, Cortez MF, Bauzá L, Elías EE, Ramella NA, Tricerri MA. Structural analysis of a natural apolipoprotein A-I variant (L60R) associated with amyloidosis. Arch Biochem Biophys 2020; 685:108347. [DOI: 10.1016/j.abb.2020.108347] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 03/12/2020] [Accepted: 03/14/2020] [Indexed: 01/11/2023]
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20
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Abildgaard N, Rojek AM, Møller HE, Palstrøm NB, Nyvold CG, Rasmussen LM, Hansen CT, Beck HC, Marcussen N. Immunoelectron microscopy and mass spectrometry for classification of amyloid deposits. Amyloid 2020; 27:59-66. [PMID: 31752543 DOI: 10.1080/13506129.2019.1688289] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Amyloidosis is a shared name for several rare, complex and serious diseases caused by extra-cellular deposits of different misfolded proteins. Accurate characterization of the amyloid protein is essential for patient care. Immunoelectron microscopy (IEM) and laser microdissection followed by tandem mass spectrometry (LMD-MS) are new gold standards for molecular subtyping. Both methods perform superiorly to immunohistochemistry, but their complementarities, strengths and weaknesses across amyloid subtypes and organ biopsy origin remain undefined. Therefore, we performed a retrospective study of 106 Congo Red positive biopsies from different involved organs; heart, kidney, lung, gut mucosa, skin and bone marrow. IEM, performed with gold-labelled antibodies against kappa light chains, lambda light chains, transthyretin and amyloid A, identified specific staining of amyloid fibrils in 91.6%; in six biopsies amyloid fibrils were not identified, and in two, the fibril subtype could not be established. LMD-MS identified amyloid protein signature in 98.1%, but in nine the amyloid protein could not be clearly identified. MS identified protein subtype in 89.6%. Corresponding specificities ranged at organ level from 94-100%. Concordance was 89.6-100% for different amyloid subtypes. Importantly, combined use of both methods increased the diagnostic classification to 100%. Some variety in performances at organ level was observed.
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Affiliation(s)
- Niels Abildgaard
- Odense Amyloidosis Centre, Odense, Denmark.,Department of Haematology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Odense Patient Explorative Network (OPEN), Odense, Denmark
| | - Aleksandra M Rojek
- Odense Amyloidosis Centre, Odense, Denmark.,Department of Pathology, Odense University Hospital, Odense, Denmark
| | - Hanne Eh Møller
- Odense Amyloidosis Centre, Odense, Denmark.,Department of Pathology, Odense University Hospital, Odense, Denmark
| | - Nicolai Bjødstrup Palstrøm
- Odense Amyloidosis Centre, Odense, Denmark.,Department of Clinical Biochemistry and Pharmacology, Centre for Clinical Proteomics, Odense, Denmark
| | - Charlotte Guldborg Nyvold
- Odense Amyloidosis Centre, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Haematology Pathology Research Laboratory, Department of Haematology, Odense University Hospital, Odense, Denmark
| | - Lars Melholt Rasmussen
- Odense Amyloidosis Centre, Odense, Denmark.,Department of Clinical Biochemistry and Pharmacology, Centre for Clinical Proteomics, Odense, Denmark
| | - Charlotte Toftmann Hansen
- Odense Amyloidosis Centre, Odense, Denmark.,Department of Haematology, Odense University Hospital, Odense, Denmark
| | - Hans Christian Beck
- Odense Amyloidosis Centre, Odense, Denmark.,Department of Clinical Biochemistry and Pharmacology, Centre for Clinical Proteomics, Odense, Denmark
| | - Niels Marcussen
- Odense Amyloidosis Centre, Odense, Denmark.,Department of Pathology, Odense University Hospital, Odense, Denmark
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21
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22
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Novel apolipoprotein AII mutation associated renal amyloidosis and fibrillary/immunotactoid cardiomyopathy. Pathology 2019; 51:759-762. [DOI: 10.1016/j.pathol.2019.07.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 06/23/2019] [Accepted: 07/09/2019] [Indexed: 11/21/2022]
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23
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Chapman J, Dogan A. Fibrinogen alpha amyloidosis: insights from proteomics. Expert Rev Proteomics 2019; 16:783-793. [PMID: 31443619 PMCID: PMC6788741 DOI: 10.1080/14789450.2019.1659137] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 08/20/2019] [Indexed: 12/17/2022]
Abstract
Introduction: Systemic amyloidosis is a diverse group of diseases that, although rare, pose a serious health issue and can lead to organ failure and death. Amyloid typing is essential in determining the causative protein and initiating proper treatment. Mass spectrometry-based proteomics is currently the most sensitive and accurate means of typing amyloid. Areas covered: Amyloidosis can be systemic or localized, acquired or hereditary, and can affect any organ or tissue. Diagnosis requires biopsy, histological analysis, and typing of the causative protein to determine treatment. The kidneys are the most commonly affected organ in systemic disease. Fibrinogen alpha chain amyloidosis (AFib) is the most prevalent form of hereditary renal amyloidosis. Select mutations in the fibrinogen Aα (FGA) gene lead to AFib. Expert commentary: Mass spectrometry is currently the most specific and sensitive method for amyloid typing. Identification of the mutated fibrinogen alpha chain can be difficult in the case of 'private' frameshift mutations, which dramatically change the sequences of the expressed fibrinogen alpha chain. A combination of expert pathologist review, mass spectrometry, and gene sequencing can allow for confident diagnosis and determination of the fibrinogen alpha chain mutated sequence.
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Affiliation(s)
- Jessica Chapman
- Hematopathology Service, Memorial Sloan Kettering Cancer Center , New York , NY , USA
| | - Ahmet Dogan
- Hematopathology Service, Memorial Sloan Kettering Cancer Center , New York , NY , USA
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Taylor GW, Gilbertson JA, Sayed R, Blanco A, Rendell NB, Rowczenio D, Rezk T, Mangione PP, Canetti D, Bass P, Hawkins PN, Gillmore JD. Proteomic Analysis for the Diagnosis of Fibrinogen Aα-chain Amyloidosis. Kidney Int Rep 2019; 4:977-986. [PMID: 31317119 PMCID: PMC6612008 DOI: 10.1016/j.ekir.2019.04.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 03/22/2019] [Accepted: 04/08/2019] [Indexed: 01/09/2023] Open
Abstract
Introduction Hereditary fibrinogen Aα-chain (AFib) amyloidosis is a relatively uncommon renal disease associated with a small number of pathogenic fibrinogen Aα (FibA) variants; wild-type FibA normally does not result in amyloid deposition. Proteomics is now routinely used to identify the amyloid type in clinical samples, and we report here our algorithm for identification of FibA in amyloid. Methods Proteomics data from 1001 Congo red–positive patient samples were examined using the Mascot search engine to interrogate the Swiss-Prot database and generate protein identity scores. An algorithm was applied to identify FibA as the amyloid protein based on Mascot scores. FibA variants were identified by appending the known amyloidogenic variant sequences to the Swiss-Prot database. Results AFib amyloid was identified by proteomics in 64 renal samples based on the Mascot scores relative to other amyloid proteins, the presence of a pathogenic variant, and coverage of the p.449-621 sequence. Contamination by blood could be excluded from a comparison of the FibA score with that of the fibrinogen β and γ chains. The proteomics results were consistent with the clinical diagnosis. Four additional renal samples did not fulfill all the criteria using the algorithm but were adjudged as AFib amyloid based on a full assessment of the clinical and biochemical results. Conclusion AFib amyloid can be identified reliably in glomerular amyloid by proteomics using a score-based algorithm. Proteomics data should be used as a guide to AFib diagnosis, with the results considered together with all available clinical and laboratory information.
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Affiliation(s)
- Graham W Taylor
- National Amyloidosis Centre and Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, University College London, London, UK
| | - Janet A Gilbertson
- National Amyloidosis Centre and Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, University College London, London, UK
| | - Rabya Sayed
- National Amyloidosis Centre and Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, University College London, London, UK.,Centre for Nephrology, Division of Medicine, Royal Free Campus, University College London, London, UK
| | - Angel Blanco
- National Amyloidosis Centre and Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, University College London, London, UK
| | - Nigel B Rendell
- National Amyloidosis Centre and Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, University College London, London, UK
| | - Dorota Rowczenio
- National Amyloidosis Centre and Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, University College London, London, UK
| | - Tamer Rezk
- National Amyloidosis Centre and Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, University College London, London, UK.,Centre for Nephrology, Division of Medicine, Royal Free Campus, University College London, London, UK
| | - P Patrizia Mangione
- National Amyloidosis Centre and Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, University College London, London, UK
| | - Diana Canetti
- National Amyloidosis Centre and Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, University College London, London, UK
| | - Paul Bass
- Centre for Nephrology, Division of Medicine, Royal Free Campus, University College London, London, UK
| | - Philip N Hawkins
- National Amyloidosis Centre and Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, University College London, London, UK
| | - Julian D Gillmore
- National Amyloidosis Centre and Wolfson Drug Discovery Unit, Centre for Amyloidosis and Acute Phase Proteins, University College London, London, UK.,Centre for Nephrology, Division of Medicine, Royal Free Campus, University College London, London, UK
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Soria J, Mirshahi S, Mirshahi SQ, Varin R, Pritchard LL, Soria C, Mirshahi M. Fibrinogen αC domain: Its importance in physiopathology. Res Pract Thromb Haemost 2019; 3:173-183. [PMID: 31011701 PMCID: PMC6462745 DOI: 10.1002/rth2.12183] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 11/22/2018] [Indexed: 12/17/2022] Open
Abstract
ABSTRACT Fibrinogen, involved in coagulation, is a soluble protein composed of two sets of disulfide-bridged Aα, Bβ, and γ-chains. In this review, we present the clinical implications of the αC domain of the molecule in Alzheimer's disease, hereditary renal amyloidosis and a number of thrombotic and hemorrhagic disorders. In Alzheimer's disease, amyloid beta peptide (Aβ) is increased and binds to the αC domain of normal fibrinogen, triggering increased fibrin(ogen) deposition in patients' brain parenchyma. In hereditary renal amyloidosis, fibrinogen is abnormal, with mutations located in the fibrinogen αC domain. The mutant αC domain derived from fibrinogen degradation folds incorrectly so that, in time, aggregates form, leading to amyloid deposits in the kidneys. In these patients, no thrombotic tendency has been observed. Abnormal fibrinogens with either a point mutation in the αC domain or a frameshift mutation resulting in absence of a part of the αC domain are often associated with either thrombotic events or bleeding. Mutation of an amino acid into cysteine (as in fibrinogens Dusart and Caracas V) or a frameshift mutation yielding an unpaired cysteine in the αC domain is often responsible for thrombotic events. Covalent binding of albumin to the unpaired cysteine via a disulphide bridge leads to decreased accessibility to the fibrinolytic enzymes, hence formation of poorly degradable fibrin clots, which explains the high incidence of thrombosis. In contrast, anomalies due to a frameshift mutation in the αC connector of the molecule, provoking deletion of a great part of the αC domain, are associated with bleeding.
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Affiliation(s)
- Jeannette Soria
- Laboratoire de recherche en Onco‐HématologieHôtel Dieu de ParisParisFrance
- INSERM U 965‐ CARTHôpital LariboisièreParisFrance
| | - Shahsoltan Mirshahi
- INSERM U 965‐ CARTHôpital LariboisièreParisFrance
- Diagnostica StagoGennevilliersFrance
| | | | - Remi Varin
- Faculté de Médecine et de PharmacieRouenFrance
| | - Linda L. Pritchard
- Laboratoire de recherche en Onco‐HématologieHôtel Dieu de ParisParisFrance
| | - Claudine Soria
- Laboratoire de recherche en Onco‐HématologieHôtel Dieu de ParisParisFrance
| | - Massoud Mirshahi
- Laboratoire de recherche en Onco‐HématologieHôtel Dieu de ParisParisFrance
- INSERM U 965‐ CARTHôpital LariboisièreParisFrance
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Rowczenio D, Quarta CC, Fontana M, Whelan CJ, Martinez-Naharro A, Trojer H, Baginska A, Ferguson SM, Gilbertson J, Rezk T, Sachchithanantham S, Mahmood S, Manwani R, Sharpley F, Wechalekar AD, Hawkins PN, Gillmore JD, Lachmann HJ. Analysis of the TTR gene in the investigation of amyloidosis: A 25-year single UK center experience. Hum Mutat 2018; 40:90-96. [PMID: 30328212 DOI: 10.1002/humu.23669] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/08/2018] [Accepted: 10/15/2018] [Indexed: 01/12/2023]
Abstract
Transthyretin amyloidosis (ATTR) is caused by deposition of either wild-type (ATTRwt) or variant (ATTRm) transthyretin. ATTRwt presents with restrictive cardiomyopathy, while ATTRm displays a range of organ involvement. This retrospective analysis includes all patients referred to a single UK center in the last 25 years for clinical and laboratory assessment of known or suspected amyloidosis who underwent TTR gene sequencing. A total of 4459 patients were included in this study; 37% had final diagnosis of ATTR amyloidosis; 27% light chain amyloidosis; 0.7% other types of amyloidosis; 21.3% had no amyloid and 14% had no data. TTR variants were found in 770 (17%) cases; the most prevalent were p.V142I, p.T80A, and p.V50M identified in 42, 25, and 16%, respectively. The median age at referral in each group was: 76 (range 47-93), 66 (40-81), and 45 years (21-86), respectively. Overall 42 rare or novel variants were identified. Forty-two percent patients with ATTRm died at a median age of 73 years (33-89) with a median survival from diagnosis of 50 months. ATTRwt was the final diagnosis in 20% of patients undergoing genetic testing. Our findings of TTR variants in 17% of screened patients highlight the need for routine genetic testing in the evaluation of suspected ATTR amyloidosis.
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Affiliation(s)
- Dorota Rowczenio
- National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, Royal Free Campus, UCL, London, UK
| | - Candida C Quarta
- National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, Royal Free Campus, UCL, London, UK
| | - Marianna Fontana
- National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, Royal Free Campus, UCL, London, UK
| | - Carol J Whelan
- National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, Royal Free Campus, UCL, London, UK
| | - Ana Martinez-Naharro
- National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, Royal Free Campus, UCL, London, UK
| | - Hadija Trojer
- National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, Royal Free Campus, UCL, London, UK
| | - Anna Baginska
- National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, Royal Free Campus, UCL, London, UK
| | - Stuart M Ferguson
- National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, Royal Free Campus, UCL, London, UK
| | - Janet Gilbertson
- National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, Royal Free Campus, UCL, London, UK
| | - Tamer Rezk
- National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, Royal Free Campus, UCL, London, UK
| | - Sajitha Sachchithanantham
- National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, Royal Free Campus, UCL, London, UK
| | - Shameem Mahmood
- National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, Royal Free Campus, UCL, London, UK
| | - Richa Manwani
- National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, Royal Free Campus, UCL, London, UK
| | - Faye Sharpley
- National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, Royal Free Campus, UCL, London, UK
| | - Ashutosh D Wechalekar
- National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, Royal Free Campus, UCL, London, UK
| | - Philip N Hawkins
- National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, Royal Free Campus, UCL, London, UK
| | - Julian D Gillmore
- National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, Royal Free Campus, UCL, London, UK
| | - Helen J Lachmann
- National Amyloidosis Centre, Centre for Amyloidosis and Acute Phase Proteins, Division of Medicine, Royal Free Campus, UCL, London, UK
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Hereditary Fibrinogen Aα-Chain Amyloidosis in Asia: Clinical and Molecular Characteristics. Int J Mol Sci 2018; 19:ijms19010320. [PMID: 29361747 PMCID: PMC5796263 DOI: 10.3390/ijms19010320] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 01/18/2018] [Accepted: 01/19/2018] [Indexed: 02/07/2023] Open
Abstract
Hereditary fibrinogen Aα-chain amyloidosis (Aα-chain amyloidosis) is a type of autosomal dominant systemic amyloidosis caused by mutations in fibrinogen Aα-chain gene (FGA). Patients with Aα-chain amyloidosis have been mainly reported in Western countries but have been rarely reported in Asia, with only five patients with Aα-chain amyloidosis being reported in Korea, China, and Japan. Clinically, the most prominent manifestation in Asian patients with Aα-chain amyloidosis is progressive nephropathy caused by excessive amyloid deposition in the glomeruli, which is similar to that observed in patients with Aα-chain amyloidosis in Western countries. In molecular features in Asian Aα-chain amyloidosis, the most common variant, E526V, was found in only one Chinese kindred, and other four kindred each had a different variant, which have not been identified in other countries. These variants are located in the C-terminal region (amino acid residues 517–555) of mature Aα-chain, which was similar to that observed in patients with Aα-chain amyloidosis in other countries. The precise number of Asian patients with Aα-chain amyloidosis is unclear. However, patients with Aα-chain amyloidosis do exist in Asian countries, and the majority of these patients may be diagnosed with other types of systemic amyloidosis.
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