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Amyloid fibrils are aggregates of misfolded proteins.  Under most circumstances, misfolded proteins are either refolded by chaperone proteins or degraded by the proteasome. However, in the case of a mutation or a disease, these proteins can accumulate to form large clusters and often further assemble to form elongated fibers, called fibrils. 
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Genetic Analysis of Hereditary Transthyretin Ala97Ser Related Amyloidosis
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Systemic amyloidosis.

Ashutosh D Wechalekar1, Julian D Gillmore1, Philip N Hawkins1

  • 1National Amyloidosis Centre, University College London (Royal Free Campus), London, UK.

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|January 1, 2016
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Summary
This summary is machine-generated.

Systemic amyloidoses, caused by protein fibril deposits, are increasingly diagnosed. Advances in diagnosis and novel treatments offer hope, but early detection remains crucial for better outcomes in these rare diseases.

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Area of Science:

  • Rare diseases
  • Protein misfolding disorders
  • Systemic amyloidoses

Background:

  • Systemic amyloidoses result from protein fibril deposition in tissues.
  • Systemic light chain (AL) amyloidosis is most common, with wild-type transthyretin cardiac amyloidosis (ATTRwt) rising.
  • Epidemiology, diagnosis, and treatment of these rare conditions are evolving.

Purpose of the Study:

  • To review current epidemiology of systemic amyloidoses.
  • To discuss advancements in diagnostic approaches.
  • To highlight progress in therapeutic strategies.

Main Methods:

  • Improved amyloid fibril typing using laser capture and mass spectrometry.
  • Enhanced cardiac amyloidosis evaluation with cardiac MRI and bone scintigraphy tracers.
  • Review of novel chemotherapy agents and emerging therapeutic targets.

Main Results:

  • Survival in AL amyloidosis has improved with new chemotherapy.
  • Cardiac amyloidosis diagnosis is more accurate with advanced imaging.
  • Early diagnosis remains a significant challenge despite treatment advances.

Conclusions:

  • Novel diagnostic tools improve amyloidosis detection and typing.
  • Emerging therapies like RNA inhibitors and immunotherapies show promise.
  • Transforming outcomes requires addressing challenges in advanced disease and early diagnosis.