Assessment of transthyretin instability in patients with wild-type transthyretin amyloid cardiomyopathy.

The pathophysiology of variant transthyretin (TTR) amyloidosis (ATTRv) is associated with destabilizing mutations in the TTR tetramer. However, why TTR with a wild-type genetic sequence misfolds and aggregates in wild-type transthyretin amyloidosis (ATTRwt) is unknown. Here, we evaluate kinetic TTR stability with a newly developed ELISA system in combination with urea-induced protein denaturation. Compared with that in control patients, endogenous TTR in patients with wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM) exhibited thermodynamic instability, indicating that circulating TTR instability may be associated with the pathogenesis of ATTRwt as well as ATTRv. Our findings provide new insight into the underlying mechanisms of ATTRwt. © 2024. The Author(s).

Citation

Takuya Iino, Manabu Nagao, Hidekazu Tanaka, Sachiko Yoshikawa, Junko Asakura, Makoto Nishimori, Masakazu Shinohara, Amane Harada, Shunsuke Watanabe, Tatsuro Ishida, Ken-Ichi Hirata, Ryuji Toh. Assessment of transthyretin instability in patients with wild-type transthyretin amyloid cardiomyopathy. Scientific reports. 2024 Sep 03;14(1):20508

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PMID: 39227655

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