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Cohen OC, Blakeney IJ, Law S, Ravichandran S, Gilbertson J, Rowczenio D, Mahmood S, Sachchithanantham S, Wisniowski B, Lachmann HJ, Whelan CJ, Martinez-Naharro A, Fontana M, Hawkins PN, Gillmore JD, Wechalekar AD. The experience of hereditary apolipoprotein A-I amyloidosis at the UK National Amyloidosis Centre. Amyloid 2022; 29:237-244. [PMID: 35502644 DOI: 10.1080/13506129.2022.2070741] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 04/06/2022] [Accepted: 04/10/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Hereditary apolipoprotein A-I (AApoAI) amyloidosis is a rare heterogeneous disease with variable age of onset and organ involvement. There are few series detailing the natural history and outcomes of solid organ transplantation across a range of causative APOA1 gene mutations. METHODS We identified all patients with AApoAI amyloidosis who presented to the National Amyloidosis Centre (NAC) between 1986 and 2019. RESULTS In total, 57 patients with 14 different APOA1 mutations were identified including 18 patients who underwent renal transplantation (5 combined liver-kidney (LKT) and 2 combined heart-kidney (HKT) transplants). Median age of presentation was 43 years and median time from presentation to referral was 3 (0-31 years). Involvement of the kidneys, liver and heart by amyloid was detected in 81%, 67% and 28% of patients, respectively. Renal amyloidosis was universal in association with the most commonly identified variant (Gly26Arg, n = 28). Across all variants, patients with renal amyloidosis had a median creatinine of 159 µmol/L and median urinary protein of 0.3 g/24 h at the time of diagnosis of AApoAI amyloidosis and median time from diagnosis to end-stage renal disease was 15.0 (95% CI: 10.0-20.0) years. Post-renal transplantation, median allograft survival was 22.0 (13.0-31.0) years. There was one early death following transplantation (infection-related at 2 months post-renal transplant) and no episodes of early rejection leading to graft failure. Liver transplantation led to regression of amyloid in all four cases in whom serial 123I-SAP scintigraphy was performed. CONCLUSIONS AApoAI amyloidosis is a slowly progressive disease that is challenging to diagnose. The outcomes of transplantation are encouraging and graft survival is excellent.
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Affiliation(s)
- Oliver C Cohen
- National Amyloidosis Centre, University College London, London, United Kingdom
| | - Iona J Blakeney
- National Amyloidosis Centre, University College London, London, United Kingdom
| | - Steven Law
- National Amyloidosis Centre, University College London, London, United Kingdom
| | - Sriram Ravichandran
- National Amyloidosis Centre, University College London, London, United Kingdom
| | - Janet Gilbertson
- National Amyloidosis Centre, University College London, London, United Kingdom
| | - Dorota Rowczenio
- National Amyloidosis Centre, University College London, London, United Kingdom
| | - Shameem Mahmood
- National Amyloidosis Centre, University College London, London, United Kingdom
- University College Hospital, London, United Kingdom
| | - Sajitha Sachchithanantham
- National Amyloidosis Centre, University College London, London, United Kingdom
- University College Hospital, London, United Kingdom
| | - Brendan Wisniowski
- National Amyloidosis Centre, University College London, London, United Kingdom
| | - Helen J Lachmann
- National Amyloidosis Centre, University College London, London, United Kingdom
| | - Carol J Whelan
- National Amyloidosis Centre, University College London, London, United Kingdom
| | | | - Marianna Fontana
- National Amyloidosis Centre, University College London, London, United Kingdom
| | - Philip N Hawkins
- National Amyloidosis Centre, University College London, London, United Kingdom
| | - Julian D Gillmore
- National Amyloidosis Centre, University College London, London, United Kingdom
| | - Ashutosh D Wechalekar
- National Amyloidosis Centre, University College London, London, United Kingdom
- University College Hospital, London, United Kingdom
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Mikec Š, Kolenc Ž, Peterlin B, Horvat S, Pogorevc N, Kunej T. Syndromic male subfertility: a network view of genome-phenome associations. Andrology 2022; 10:720-732. [PMID: 35218153 PMCID: PMC9314622 DOI: 10.1111/andr.13167] [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: 08/14/2020] [Revised: 01/18/2022] [Accepted: 02/11/2022] [Indexed: 11/26/2022]
Abstract
Background Male infertility is a disorder of the reproductive system with a highly complex genetic landscape. In most cases, the reason for male infertility remains unknown; however, the importance of genetic abnormalities in the diagnosis of subfertility/infertility is becoming increasingly recognized. Several syndromes include impaired male fertility in the clinical picture, although a comprehensive analysis of genetic causes of the syndromology perspective of male reproduction is not yet available. Objectives (1) To develop a catalog of syndromes and corresponding genes associated with impaired male fertility and (2) to visualize an up‐to‐date genome–phenome network of syndromic male subfertility. Materials and methods Published literature was retrieved from the Online Mendelian Inheritance in Man, Orphanet, Human Phenotype Ontology and PubMed databases using keywords “male infertility,” “syndrome,” “gene,” and “case report”; time period from 1980 to September, 2021. Retrieved data were organized as a catalog and complemented with identification numbers of syndromes (MIM ID) and genes (Gene ID). The genome–phenome network and the phenome network were visualized using Cytoscape and Gephi software platforms. Protein–protein interaction analysis was performed using STRING tool. Results Retrieved syndromes were presented as (1) a catalog containing 63 syndromes and 93 associated genes, (2) a genome–phenome network including CHD7 and WT1 genes and Noonan and Kartagener syndromes, and (3) a phenome network including 63 syndromes, and 25 categories of clinical features. Discussion The developed catalog will contribute to the advances and translational impact toward understanding the factors of syndromic male infertility. Visualized networks provide simple, flexible tools for clinicians and researchers to quickly generate hypotheses and gain a deeper understanding of underlying mechanisms affecting male reproduction. Conclusion Recognition of the significance of genome–phenome visualization as part of network medicine can help expedite efforts toward unravelling molecular mechanisms and enable advances personal/precision medicine of male reproduction and other complex traits.
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Affiliation(s)
- Špela Mikec
- University of Ljubljana, Biotechnical Faculty, Department of Animal Science, Domžale, Slovenia
| | - Živa Kolenc
- University of Ljubljana, Biotechnical Faculty, Department of Animal Science, Domžale, Slovenia
| | - Borut Peterlin
- University Medical Center Ljubljana, Clinical Institute of Medical Genetics, Ljubljana, Slovenia
| | - Simon Horvat
- University of Ljubljana, Biotechnical Faculty, Department of Animal Science, Domžale, Slovenia
| | - Neža Pogorevc
- University of Ljubljana, Biotechnical Faculty, Department of Animal Science, Domžale, Slovenia
| | - Tanja Kunej
- University of Ljubljana, Biotechnical Faculty, Department of Animal Science, Domžale, Slovenia
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Chi X, Xiang D, Sha Y, Liang S, Wang C. Inhibition of human sperm function by an antibody against apolipoprotein A1: A protein located in human spermatozoa. Andrologia 2022; 54:e14365. [DOI: 10.1111/and.14365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 12/12/2021] [Accepted: 12/22/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- Xiuping Chi
- Department of Laboratory Medicine the First Medical Centre, Chinese PLA General Hospita Beijing China
| | - Daijun Xiang
- Department of Laboratory Medicine the First Medical Centre, Chinese PLA General Hospita Beijing China
| | - Yingjiao Sha
- Department of Laboratory Medicine the First Medical Centre, Chinese PLA General Hospita Beijing China
| | - Shuang Liang
- Department of Medical Laboratory Maternal and Child Health Hospital Tangshan China
| | - Chengbin Wang
- Department of Laboratory Medicine the First Medical Centre, Chinese PLA General Hospita Beijing China
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Amyloidosis of the Urinary Bladder: A Systematic Review and a Proposed Management Algorithm. Urology 2021; 156:e12-e19. [PMID: 34314752 DOI: 10.1016/j.urology.2021.07.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/19/2021] [Accepted: 07/15/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To propose an algorithm for the management of bladder amyloidosis based on a systematic review of the literature, given that the bladder is the second most commonly affected organ of the urinary tract in the course of systemic or localized amyloidosis. METHODS We searched PubMed, Cochrane Library and Scopus databases utilizing PRISMA methodology from inception to November 30, 2020 (PROSPERO: CRD42020207855). RESULTS We included 76 studies with 184 patients (9 case series and 67 case reports). Presenting symptoms of bladder amyloidosis comprised of hematuria, irritative or obstructive urinary symptoms, and cystitis-like symptoms. The diagnosis of amyloidosis was established by histologic examination of specimens retrieved during transurethral resection of bladder lesions. Complete endoscopic resection, the cornerstone of management of localized disease, was feasible in 89.1% cases. The included patients were followed up for a mean of 54 months, within which 65 patients (35.3%) recurred. The time to first amyloidosis recurrence was 20 months (range: 1-168). Additionally, 16 individuals presented with concomitant bladder amyloidosis and bladder cancer, while 4 developed bladder malignancy during follow-up. Due to the frequent and early recurrences of patients with bladder amyloidosis, a check-up cystoscopy at 3, 12, and 24 months' after initial resection is recommended. Recurrences should be managed with transurethral resection, while intravesical instillations of dimethyl sulfoxide (DMSO) and cystectomy should be reserved for refractory cases. CONCLUSION We propose a management algorithm for bladder amyloidosis based on the available evidence for this rare benign entity that mimics bladder cancer.
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Delbarba A, Facondo P, Fisogni S, Izzi C, Maffezzoni F, Pezzaioli LC, Di Lodovico E, Facchetti F, Cappelli C, Scolari F, Ferlin A. Testicular Involvement is a Hallmark of Apo A-I Leu75Pro Mutation Amyloidosis. J Clin Endocrinol Metab 2020; 105:5897040. [PMID: 32841328 DOI: 10.1210/clinem/dgaa587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/19/2020] [Indexed: 01/19/2023]
Abstract
CONTEXT Apo A-I Leu75Pro is a rare hereditary form of amyloidosis that mainly involves the kidney, the liver, and the testis. OBJECTIVE To define the characteristics of organ damage and testis impairment in the largest cohort collected to date of men with Apo A-I Leu75Pro amyloidosis. DESIGN, SETTING, AND PATIENTS Retrospective study from a prospectively collected database of 129 male subjects >18 years with Apo A-I Leu75Pro amyloidosis from a reference center at the University Hospital of Brescia, Italy. MAIN OUTCOME MEASURES We evaluated liver and renal function, scrotal ultrasound, reproductive hormone levels, testis biopsy, hypogonadal symptoms, and fertility. RESULTS Progressive involvement of testis, kidney, and liver was observed in 96/129 (74.4%) cases. Testis impairment was found in 88/129 patients (68.2%), liver in 59 (45.7%) and renal in 50 (38.8%). Testis damage was often the first manifestation of the disease and the only dysfunction in 30% of younger patients (<38 years). Testicular involvement was characterized mainly by primary (73/88 patients, 83.0%) and subclinical (8/88, 9.1%) hypogonadism. Almost all (85/88, 96.6%) also had high follicle-stimulating hormone, suggesting a primary global damage of endocrine and spermatogenic functions, and 30% of them did not conceive. Macroorchidism was found in 53/88 (60.2%) patients, especially in men <54 years (30/33, 90.9%). Apo A-I amyloid deposits were found in Sertoli cells, germinal epithelium, and vessel walls. CONCLUSION In men with Apo A-I Leu75Pro amyloidosis, testicular involvement is the hallmark of the disease, characterized by global primary testicular dysfunction and macroorchidism due to amyloid deposits.
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Affiliation(s)
- Andrea Delbarba
- Unit of Endocrinology and Metabolism, ASST Spedali Civili Brescia, Brescia, Italy
| | - Paolo Facondo
- Department of Clinical and Experimental Sciences, Unit of Endocrinology and Metabolism, University of Brescia and ASST Spedali Civili Brescia, Brescia, Italy
| | - Simona Fisogni
- Department of Molecular and Translational Medicine, Pathology Unit, University of Brescia and ASST Spedali Civili Brescia, Brescia, Italy
| | - Claudia Izzi
- Prenatal Diagnosis Unit, Department of Obstetrics and Gynecology, ASST Spedali Civili, Brescia, Italy
- Division of Nephrology and Dialysis, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia and ASST Spedali Civili Brescia, Brescia, Italy
| | - Filippo Maffezzoni
- Unit of Endocrinology and Metabolism, ASST Spedali Civili Brescia, Brescia, Italy
| | - Letizia Chiara Pezzaioli
- Department of Clinical and Experimental Sciences, Unit of Endocrinology and Metabolism, University of Brescia and ASST Spedali Civili Brescia, Brescia, Italy
| | - Elena Di Lodovico
- Department of Clinical and Experimental Sciences, Unit of Endocrinology and Metabolism, University of Brescia and ASST Spedali Civili Brescia, Brescia, Italy
| | - Fabio Facchetti
- Department of Molecular and Translational Medicine, Pathology Unit, University of Brescia and ASST Spedali Civili Brescia, Brescia, Italy
| | - Carlo Cappelli
- Department of Clinical and Experimental Sciences, Unit of Endocrinology and Metabolism, University of Brescia and ASST Spedali Civili Brescia, Brescia, Italy
| | - Francesco Scolari
- Division of Nephrology and Dialysis, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia and ASST Spedali Civili Brescia, Brescia, Italy
| | - Alberto Ferlin
- Department of Clinical and Experimental Sciences, Unit of Endocrinology and Metabolism, University of Brescia and ASST Spedali Civili Brescia, Brescia, Italy
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Moutafi M, Ziogas DC, Michopoulos S, Bagratuni T, Vasileiou V, Verga L, Merlini G, Palladini G, Matsouka C, Dimopoulos MA, Kastritis E. A new genetic variant of hereditary apolipoprotein A-I amyloidosis: a case-report followed by discussion of diagnostic challenges and therapeutic options. BMC MEDICAL GENETICS 2019; 20:23. [PMID: 30665372 PMCID: PMC6341640 DOI: 10.1186/s12881-019-0755-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 01/15/2019] [Indexed: 11/14/2022]
Abstract
Background Hereditary amyloidosis refers to a wide spectrum of rare diseases with different causative mutations in the genes of various proteins including transthyretin, apolipoprotein AI and AII, gelsolin, lysozyme, cystatin C, fibrinogen Aα-chain, β2-microglobulin, apolipoprotein CII and CIII. Case presentation Among hereditary amyloidosis subtypes, we describe here a specific case of Apolipoprotein AI amyloidosis (AApoAI), where the diagnosis began from an almost asymptomatic hepatomegaly followed by the development of primary hypogonadism. Baseline laboratory tests showed increased liver enzymes, while imaging tests revealed a suspected infiltrative liver disease. Patient underwent into liver biopsy and histological examination detected the presence of periodic acid-Schiff (−) and Congo-red (+) amorphous eosinophilic material within normal liver tissue. In the typing of amyloid by immunoelectron microscopy, the liver appeared heavily infiltrated by anti-apoAI (+) amyloid fibrils. Gene sequencing and mutational analysis revealed a single-base mutation at position c.251 T > C resulting in an amino acid substitution from leucine to proline in the mature ApoAI protein. This amino acid change led to lower cleavage and ApoAI deposition into the involved organs. Few years later, our patient remaining without treatment, came with symptoms consistent with primary hypogonadism but testicular involvement with ApoAI deposits could not be proven since the patient refused testicular biopsy. Based on this case, we recap the diagnostic challenges, the clinical manifestations, and the potential treatment options for this indolent hereditary amyloidosis subtype. Conclusions This case-report enlarges the clinical picture of ApoAI-driven disease and its complex genetic background and in parallel suggests for a more systematic approach in any case with strong suspicion of hereditary amyloidosis.
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Affiliation(s)
- Myrto Moutafi
- Department of Clinical Therapeutics, Alexandra General Hospital, National and Kapodistrian University of Athens, School of Medicine, 80 Vas Sofias Avenue, 11528, Athens, Greece
| | - Dimitrios C Ziogas
- Department of Clinical Therapeutics, Alexandra General Hospital, National and Kapodistrian University of Athens, School of Medicine, 80 Vas Sofias Avenue, 11528, Athens, Greece.
| | - Spyros Michopoulos
- Department of Clinical Therapeutics, Alexandra General Hospital, National and Kapodistrian University of Athens, School of Medicine, 80 Vas Sofias Avenue, 11528, Athens, Greece
| | - Tina Bagratuni
- Department of Clinical Therapeutics, Alexandra General Hospital, National and Kapodistrian University of Athens, School of Medicine, 80 Vas Sofias Avenue, 11528, Athens, Greece
| | - Vassiliki Vasileiou
- Department of Clinical Therapeutics, Alexandra General Hospital, National and Kapodistrian University of Athens, School of Medicine, 80 Vas Sofias Avenue, 11528, Athens, Greece
| | - Laura Verga
- Amyloidosis Research and Treatment Center, Foundation Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo and Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Giampaolo Merlini
- Amyloidosis Research and Treatment Center, Foundation Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo and Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Giovanni Palladini
- Amyloidosis Research and Treatment Center, Foundation Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo and Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Charis Matsouka
- Department of Clinical Therapeutics, Alexandra General Hospital, National and Kapodistrian University of Athens, School of Medicine, 80 Vas Sofias Avenue, 11528, Athens, Greece
| | - Meletios A Dimopoulos
- Department of Clinical Therapeutics, Alexandra General Hospital, National and Kapodistrian University of Athens, School of Medicine, 80 Vas Sofias Avenue, 11528, Athens, Greece
| | - Efstathios Kastritis
- Department of Clinical Therapeutics, Alexandra General Hospital, National and Kapodistrian University of Athens, School of Medicine, 80 Vas Sofias Avenue, 11528, Athens, Greece
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Pané A, Ruiz S, Orois A, Martínez D, Squarcia M, Sastre L, Ruiz P, Caballería J, Mora M, Hanzu FA, Halperin I. Primary adrenal insufficiency due to hereditary apolipoprotein AI amyloidosis: endocrine involvement beyond hypogonadism. Amyloid 2018; 25:75-78. [PMID: 29446975 DOI: 10.1080/13506129.2018.1438390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Several mutations in the gene encoding apolipoprotein AI (apoAI) have been described as a cause of familial amyloidosis. Individuals with apoAI-derived (AApoAI) amyloidosis frequently manifest with liver, kidney, laryngeal, skin and myocardial involvement. Although primary hypogonadism (PH) is considered almost pathognomonic of this disease, until now, primary adrenal insufficiency (PAI) has not been described as a common clinical feature. Here, we report the first kindred with AApoAI amyloidosis in which PAI is well-documented. All family members with the Leu60_Phe71delins60Val_61Thr heterozygous mutation who were regularly followed-up at our centre were considered. Nineteen individuals had the confirmed APOA1 deletion/insertion mutation, with detailed medical records available in 11 cases. Of these, 6 had PAI and 3 (all males) had PH. Among them, one 47-year-old man, not previously diagnosed with PAI, developed adrenal crisis after liver transplantation, precipitated by an opportunistic infection. Transplantation due to organ failure, which necessitates use of immunosuppressive medication such as corticosteroids, is frequently required during the course of hereditary amyloidosis. Consequently, PAI can remain masked, being discovered only when an adrenal crisis develops. Therefore, according to the present evidence, patients with AApoAI amyloidosis should be submitted to regular testing of corticotrophin and cortisol levels in order to avoid delaying corticosteroid replacement.
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Affiliation(s)
- Adriana Pané
- a Department of Endocrinology and Nutrition , Hospital Clínic , Barcelona , Spain
| | - Sabina Ruiz
- a Department of Endocrinology and Nutrition , Hospital Clínic , Barcelona , Spain
| | - Aida Orois
- a Department of Endocrinology and Nutrition , Hospital Clínic , Barcelona , Spain
| | - Daniel Martínez
- b Department of Anatomic Pathology , Hospital Clínic , Barcelona , Spain
| | - Mattia Squarcia
- c Department of Radiology , Hospital Clínic , Barcelona , Spain
| | - Lydia Sastre
- d Department of Hepatology , Hospital Clínic , Barcelona , Spain
| | - Pablo Ruiz
- d Department of Hepatology , Hospital Clínic , Barcelona , Spain
| | - Joan Caballería
- d Department of Hepatology , Hospital Clínic , Barcelona , Spain.,e Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS) , Barcelona , Spain.,f Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD) , Madrid , Spain
| | - Mireia Mora
- a Department of Endocrinology and Nutrition , Hospital Clínic , Barcelona , Spain
| | - Felicia A Hanzu
- a Department of Endocrinology and Nutrition , Hospital Clínic , Barcelona , Spain.,e Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS) , Barcelona , Spain
| | - Irene Halperin
- a Department of Endocrinology and Nutrition , Hospital Clínic , Barcelona , Spain
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Tsukanov J, Fabbro ED. Palliative care and symptom management in amyloidosis: A review. Curr Probl Cancer 2016; 40:220-228. [DOI: 10.1016/j.currproblcancer.2016.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 09/04/2016] [Accepted: 09/14/2016] [Indexed: 12/27/2022]
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Muiesan ML, Salvetti M, Paini A, Agabiti Rosei C, Rubagotti G, Negrinelli A, Gregorini G, Cancarini G, Calabresi L, Franceschini G, Obici L, Perlini S, Merlini G, Agabiti Rosei E. Vascular alterations in apolipoprotein A-I amyloidosis (Leu75Pro). A case-control study. Amyloid 2015; 22:187-93. [PMID: 26193960 DOI: 10.3109/13506129.2015.1066771] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Among hereditary amyloidoses, apolipoprotein A-I (APO A-I) amyloidosis (Leu75Pro) is a rare, autosomal dominant condition in which renal, hepatic, and testicular involvement has been demonstrated. OBJECTIVE To investigate vascular structural as well as functional alterations. METHODS In 131 carriers of the amyloidogenic Leu75Pro APO A-I mutation (mean age 52 + 16 years, 56 women) and in 131 subjects matched for age, sex, body mass index and clinic blood pressure (BP), arterial stiffness (pulse wave velocity, PWV) and carotid intima-media thickness (IMT) were measured. RESULTS By definition no differences for age, sex, body mass index, and BP were observed. Meanmax IMT (Mmax-IMT) in the common (CC), bifurcation (BIF) and internal (ICA) carotid artery were comparable in the two groups. After adjustment for high-density lipoprotein cholesterol and renal function differences between the two groups, a lower meanmax-IMT was observed in APO A-I Leu75Pro mutation carriers than in controls (CC Mmax-IMT 0.87 ± 0.21 versus 0.93 ± 0.2 mm, p = 0.07; BIF Mmax-IMT 1.19 ± 0.48 versus 1.36 ± 0.46 mm, p = 0.025; ICA Mmax-IMT 0.9 ± 0.37 versus 1.02 ± 0.35 mm, p = 0.028). On the other hand, aortic stiffness was significantly greater in patients with APO A-I amyloidosis than controls (PWV 11.5 ± 2.9 and 10.7 ± 2.3 m/s, p < 0.05), even after adjusting for confounders. CONCLUSIONS In carriers of the amyloidogenic Leu75Pro APO A-I mutation, a significant increase in arterial stiffness is observed; on the contrary, carotid artery IMT is comparable to that of control subjects. These results may add significant information to the clinical features of this rare genetic disorder.
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Affiliation(s)
- Maria Lorenza Muiesan
- a Internal Medicine, Department of Clinical and Experimental Sciences , University of Brescia and Spedali Civili , Brescia , Italy
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Petrlova J, Bhattacherjee A, Boomsma W, Wallin S, Lagerstedt JO, Irbäck A. Conformational and aggregation properties of the 1-93 fragment of apolipoprotein A-I. Protein Sci 2014; 23:1559-71. [PMID: 25131953 DOI: 10.1002/pro.2534] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 07/11/2014] [Accepted: 08/04/2014] [Indexed: 11/12/2022]
Abstract
Several disease-linked mutations of apolipoprotein A-I, the major protein in high-density lipoprotein (HDL), are known to be amyloidogenic, and the fibrils often contain N-terminal fragments of the protein. Here, we present a combined computational and experimental study of the fibril-associated disordered 1-93 fragment of this protein, in wild-type and mutated (G26R, S36A, K40L, W50R) forms. In atomic-level Monte Carlo simulations of the free monomer, validated by circular dichroism spectroscopy, we observe changes in the position-dependent β-strand probability induced by mutations. We find that these conformational shifts match well with the effects of these mutations in thioflavin T fluorescence and transmission electron microscopy experiments. Together, our results point to molecular mechanisms that may have a key role in disease-linked aggregation of apolipoprotein A-I.
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Affiliation(s)
- Jitka Petrlova
- Department of Experimental Medical Science, Lund University, BMC Floor C12, SE-221 84, Lund, Sweden
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Khalighi MA, Dean Wallace W, Palma-Diaz MF. Amyloid nephropathy. Clin Kidney J 2014; 7:97-106. [PMID: 25852856 PMCID: PMC4377792 DOI: 10.1093/ckj/sfu021] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Accepted: 02/19/2014] [Indexed: 01/29/2023] Open
Abstract
Amyloidosis is an uncommon disease that is characterized by abnormal extracellular deposition of misfolded protein fibrils leading to organ dysfunction. The deposited proteins display common chemical and histologic properties but can vary dramatically in their origin. Kidney disease is a common manifestation in patients with systemic amyloidosis with a number of amyloidogenic proteins discovered in kidney biopsy specimens. The emergence of mass spectrometry-based proteomics has added to the diagnostic accuracy and overall understanding of amyloidosis. This in-depth review discusses the general histopathologic features of renal amyloidosis and includes an in-depth discussion of specific forms of amyloid affecting the kidney.
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Affiliation(s)
| | - W Dean Wallace
- Department of Pathology and Laboratory Medicine , University of California , Los Angeles, CA , USA
| | - Miguel F Palma-Diaz
- Department of Pathology and Laboratory Medicine , University of California , Los Angeles, CA , USA
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Whelly S, Serobian G, Borchardt C, Powell J, Johnson S, Hakansson K, Lindstrom V, Abrahamson M, Grubb A, Cornwall GA. Fertility defects in mice expressing the L68Q variant of human cystatin C: a role for amyloid in male infertility. J Biol Chem 2014; 289:7718-29. [PMID: 24500719 DOI: 10.1074/jbc.m113.515759] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Hereditary cystatin C amyloid angiopathy is an autosomal dominant disorder in which a variant form of cystatin C (L68Q) readily forms amyloid deposits in cerebral arteries in affected individuals resulting in early death. L68Q protein deposits in human cystatin C amyloid angiopathy patients have also been found in tissues outside of the brain including the testis, suggesting possible effects on fertility. Heterozygous transgenic mice (L68Q) that express the human L68Q variant of cystatin C under the control of the mouse cystatin C promoter were unable to generate offspring, suggesting the presence of L68Q cystatin C amyloid affected sperm function. In vitro studies showed that epididymal spermatozoa from L68Q mice were unable to fertilize oocytes and exhibited poor sperm motility. Furthermore, spermatozoa from L68Q mice exhibited reduced cell viability compared with wild type (WT) spermatozoa and often were detected in large agglutinated clumps. Examination of the epididymal fluid and spermatozoa from L68Q mice showed increased levels and distinct forms of cystatin C amyloid that were not present in WT mice. The addition of epididymal fluid from L68Q mice to WT spermatozoa resulted in a recapitulation of the L68Q phenotype in that WT spermatozoa showed reduced cell viability and motility compared with WT spermatozoa incubated in epididymal fluid from WT mice. L68Q epididymal fluid that was depleted of cystatin C amyloids, however, did not impair the motility of WT spermatozoa. Taken together these studies suggest that amyloids in the epididymal fluid can be cytotoxic to the maturing spermatozoa resulting in male infertility.
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Affiliation(s)
- Sandra Whelly
- From the Department of Cell Biology and Biochemistry, Texas Tech University Health Sciences Center, Lubbock, Texas 79430 and
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Raimondi S, Guglielmi F, Giorgetti S, Gaetano SD, Arciello A, Monti DM, Relini A, Nichino D, Doglia SM, Natalello A, Pucci P, Mangione P, Obici L, Merlini G, Stoppini M, Robustelli P, Tartaglia GG, Vendruscolo M, Dobson CM, Piccoli R, Bellotti V. Effects of the Known Pathogenic Mutations on the Aggregation Pathway of the Amyloidogenic Peptide of Apolipoprotein A-I. J Mol Biol 2011; 407:465-76. [DOI: 10.1016/j.jmb.2011.01.044] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Revised: 12/22/2010] [Accepted: 01/23/2011] [Indexed: 11/30/2022]
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Aitken RJ, Curry BJ. Redox regulation of human sperm function: from the physiological control of sperm capacitation to the etiology of infertility and DNA damage in the germ line. Antioxid Redox Signal 2011; 14:367-81. [PMID: 20522002 DOI: 10.1089/ars.2010.3186] [Citation(s) in RCA: 242] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Defective sperm function is the largest single defined cause of human infertility and one of the major reasons we are witnessing an exponential increase in the uptake of assisted conception therapy in the developed world. A major characteristic of defective human spermatozoa is the presence of large amounts of DNA damage, which is, in turn, associated with reduced fertility, increased rates of miscarriage, and an enhanced risk of disease in the offspring. This DNA damage is largely oxidative and is closely associated with defects in spermiogenesis. To explain the origins of this DNA damage, we postulate that spermiogenesis is disrupted by oxidative stress, leading to the creation of defective gametes with poorly remodeled chromatin that are particularly susceptible to free radical attack. To compound the problem, these defective cells have a tendency to undergo an unusual truncated form of apoptosis associated with high amounts of superoxide generation by the sperm mitochondria. This leads to significant oxidative DNA damage that eventually culminates in the DNA fragmentation we see in infertile patients. In light of the significance of oxidative stress in the etiology of defective sperm function, a variety of antioxidant therapies are now being assessed for their therapeutic potential.
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Affiliation(s)
- Robert J Aitken
- Discipline of Biological Sciences and ARC Centre of Excellence in Biotechnology and Development, School of Environmental and Life Sciences, University of Newcastle, Callaghan, Australia.
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