Starting at the beginning: endoplasmic reticulum proteostasis and systemic amyloid disease
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Updated: Dec 21, 2025

Rapid Generation of Amyloid from Native Proteins In vitro
Published on: December 5, 2013
Isabelle C Romine1, R Luke Wiseman1
1Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA 92037, U.S.A.
Abstract:
Systemic amyloid diseases are characterized by the deposition of an amyloidogenic protein as toxic oligomers and amyloid fibrils on tissues distal from the site of protein synthesis. Traditionally, these diseases have been viewed as disorders of peripheral target tissues where aggregates are deposited, and toxicity is observed. However, recent evidence highlights an important role for endoplasmic reticulum (ER) proteostasis pathways within tissues synthesizing and secreting amyloidogenic proteins, such as the liver, in the pathogenesis of these disorders. Here, we describe the pathologic implications of ER proteostasis and its regulation on the toxic extracellular aggregation of amyloidogenic proteins implicated in systemic amyloid disease pathogenesis. Furthermore, we discuss the therapeutic potential for targeting ER proteostasis to reduce the secretion and toxic aggregation of amyloidogenic proteins to mitigate peripheral amyloid-associated toxicity involved in the onset and progression of systemic amyloid diseases.
Insights
Systemic amyloid diseases involve toxic protein aggregation. Targeting endoplasmic reticulum (ER) proteostasis in protein-producing cells, like the liver, offers a novel therapeutic strategy to reduce amyloid formation and associated toxicity.
Area of Science:
- Biochemistry
- Cell Biology
- Pathology
Background:
- Systemic amyloid diseases feature amyloidogenic protein deposition in peripheral tissues.
- Traditionally, focus has been on target tissue pathology, overlooking protein synthesis sites.
- Emerging evidence implicates endoplasmic reticulum (ER) proteostasis in disease pathogenesis.
Purpose of the Study:
- To explore the pathological role of ER proteostasis in systemic amyloid diseases.
- To investigate how ER proteostasis regulation impacts extracellular amyloid aggregation.
- To discuss therapeutic strategies targeting ER proteostasis for amyloid disease treatment.
Main Methods:
- Review of existing literature on ER proteostasis and systemic amyloid diseases.
- Analysis of the mechanisms linking ER function to amyloidogenic protein secretion and aggregation.
- Discussion of potential therapeutic interventions.
Main Results:
- ER proteostasis pathways significantly influence the pathogenesis of systemic amyloid diseases.
- Dysregulation of ER proteostasis promotes toxic extracellular aggregation of amyloidogenic proteins.
- Targeting ER proteostasis can reduce amyloidogenic protein secretion and aggregation.
Conclusions:
- ER proteostasis is a critical factor in systemic amyloid disease development.
- Therapeutic strategies aimed at modulating ER proteostasis hold promise for treating these debilitating conditions.
- Interventions targeting the liver's ER proteostasis could mitigate peripheral amyloid toxicity.
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