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Barreca A, Bottasso E, Veneziano F, Giarin M, Nocifora A, Martinetti N, Attanasio A, Biancone L, Benevolo G, Roccatello D, Cassoni P, Papotti MG. Immunohistochemical typing of amyloid in fixed paraffin-embedded samples by an automatic procedure: Comparison with immunofluorescence data on fresh-frozen tissue. PLoS One 2021; 16:e0256306. [PMID: 34428239 PMCID: PMC8384180 DOI: 10.1371/journal.pone.0256306] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 08/03/2021] [Indexed: 11/19/2022] Open
Abstract
Amyloidosis comprises a spectrum of disorders characterized by the extracellular deposition of amorphous material, originating from an abnormal serum protein. The typing of amyloid into its many variants represents a pivotal step for a correct patient management. Several methods are currently used, including mass spectrometry, immunofluorescence, immunohistochemistry, and immunogold labeling. The aim of the present study was to investigate the accuracy and reliability of immunohistochemistry by means of a recently developed amyloid antibody panel applicable on fixed paraffin-embedded tissues in an automated platform. Patients with clinically and pathologically proven amyloidosis were divided into two cohorts: a pilot one, which included selected amyloidosis cases from 2009 to 2018, and a retrospective one (comprising all consecutive amyloidosis cases analyzed between November 2018 and May 2020). The above-referred panel of antibodies for amyloid classification was tested in all cases using an automated immunohistochemistry platform. When fresh-frozen material was available, immunofluorescence was also performed. Among 130 patients, a total of 143 samples from different organs was investigated. They corresponded to 51 patients from the pilot cohort and 79 ones from the retrospective cohort. In 82 cases (63%), fresh-frozen tissue was tested by immunofluorescence, serving to define amyloid subtype only in 30 of them (36.6%). On the contrary, the automated immunohistochemistry procedure using the above-referred new antibodies allowed to establish the amyloid type in all 130 cases (100%). These included: ALλ (n = 60, 46.2%), ATTR (n = 29, 22.3%), AA (n = 19, 14.6%), ALκ (n = 18, 13.8%), ALys (n = 2, 1.5%), and Aβ2M amyloidosis (n = 2, 1.5%). The present immunohistochemistry antibody panel represents a sensitive, reliable, fast, and low-cost method for amyloid typing. Since immunohistochemistry is available in most pathology laboratories, it may become the new gold standard for amyloidosis classification, either used alone or combined with mass spectrometry in selected cases.
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Affiliation(s)
- Antonella Barreca
- Pathology Unit, City of Health and Science Hospital, Turin, Italy
- * E-mail:
| | - Emanuel Bottasso
- Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Manuela Giarin
- Pathology Unit, City of Health and Science Hospital, Turin, Italy
| | | | - Nadia Martinetti
- Pathology Unit, City of Health and Science Hospital, Turin, Italy
| | - Angelo Attanasio
- Pathology Unit, City of Health and Science Hospital, Turin, Italy
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Luigi Biancone
- Department of Medical Sciences, University of Turin, Turin, Italy
- Division of Nephrology Dialysis and Transplantation, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Giulia Benevolo
- Division of Hematology, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Dario Roccatello
- CMID, Coordinating Center of the Network for Rare Diseases of Piedmont and Aosta Valley, and Nephrology and Dialysis Unit (ERK-net Member), San Giovanni Bosco Hub Hospital and University of Turin, Turin, Italy
| | - Paola Cassoni
- Pathology Unit, City of Health and Science Hospital, Turin, Italy
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Mauro G. Papotti
- Pathology Unit, City of Health and Science Hospital, Turin, Italy
- Department of Oncology, University of Turin, Turin, Italy
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Abstract
Amyloidoses are a spectrum of disorders caused by abnormal folding and extracellular deposition of proteins. The deposits lead to tissue damage and organ dysfunction, particularly in the heart, kidneys, and nerves. There are at least 30 different proteins that can cause amyloidosis. The clinical management depends entirely on the type of protein deposited, and thus on the underlying pathogenesis, and often requires high-risk therapeutic intervention. Application of mass spectrometry-based proteomic technologies for analysis of amyloid plaques has transformed the way amyloidosis is diagnosed and classified. Proteomic assays have been extensively used for clinical management of patients with amyloidosis, providing unprecedented diagnostic and biological information. They have shed light on the pathogenesis of different amyloid types and have led to identification of numerous new amyloid types, including ALECT2 amyloidosis, which is now recognized as one of the most common causes of systemic amyloidosis in North America.
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Affiliation(s)
- Ahmet Dogan
- Departments of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065;
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Reitboeck JG, Feldmann R, Loader D, Breier F, Steiner A. Primary cutaneous amyloidoma: a case report. Case Rep Dermatol 2014; 6:264-7. [PMID: 25520648 PMCID: PMC4264485 DOI: 10.1159/000369245] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Amyloidoma is defined as solitary, localized, tumor-like deposit of amyloid in diverse organs without evidence of systemic amyloidosis. Here we report the case of a 49-year-old male patient with a solitary amyloidoma of the skin seated on the left upper lip. Full medical examination showed no signs of systemic amyloidosis. The mass was removed surgically with tangential shave and so far no signs of recurrence have been found.
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Affiliation(s)
| | - Robert Feldmann
- Department of Dermatology, Municipal Hospital Hietzing, Vienna, Austria
| | - Dagmara Loader
- Department of Dermatology, Municipal Hospital Hietzing, Vienna, Austria
| | - Friedrich Breier
- Department of Dermatology, Municipal Hospital Hietzing, Vienna, Austria
| | - Andreas Steiner
- Department of Dermatology, Municipal Hospital Hietzing, Vienna, Austria
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