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与全长甲状腺素运载蛋白相比,截短型甲状腺素运载蛋白中野生型和突变型蛋白的比例:对移植性甲状腺素运载蛋白T60A淀粉样变性患者的分析

Proportion between wild-type and mutant protein in truncated compared to full-length ATTR: an analysis on transplanted transthyretin T60A amyloidosis patients.

作者信息

Ihse Elisabet, Stangou Arie J, Heaton Nigel D, O'Grady John, Ybo Anna, Hellman Ulf, Edvinsson Asa, Westermark Per

机构信息

Department of Genetics and Pathology, Rudbeck Laboratory, Uppsala University, SE 751 85 Uppsala, Sweden.

出版信息

Biochem Biophys Res Commun. 2009 Feb 20;379(4):846-50. doi: 10.1016/j.bbrc.2008.12.095. Epub 2008 Dec 30.

Abstract

Familial ATTR amyloidosis is caused by point mutations in the transthyretin gene. The clinical manifestations are highly varied but polyneuropathy and/or cardiomyopathy are generally the main symptoms. The amyloid fibrils can either be composed of only intact ATTR molecules or intact together with fragmented ATTR species. As plasma TTR is almost exclusively synthesized in the liver, liver transplantation is performed in order to eliminate the mutant plasma TTR. The procedure has shown best results among patients with the V30M mutation, while a rapid continued cardiac deposition of wild-type (wt) TTR has been seen for many other mutations. In this paper we investigated the proportion of wtATTR in two TTRT60A patients that underwent liver transplantation; one patient died 3 weeks after surgery, the other patient survived for 12 months. As the role of fragmented TTR species in the pathogenesis is far from understood, we investigated the proportion of wt in these species separately to the full-length molecules, which has not been done before in transplanted patients. The results show a higher proportion of wtTTR in the 12-months-surviving patient than the 3-weeks-surviving patient, but interestingly this difference in wt proportion is mainly seen among the full-length, and not the fragmented, molecules.

摘要

家族性转甲状腺素蛋白淀粉样变性由转甲状腺素蛋白基因突变引起。其临床表现高度多样,但多发性神经病和/或心肌病通常是主要症状。淀粉样纤维可仅由完整的转甲状腺素蛋白分子组成,或与片段化的转甲状腺素蛋白种类一起完整存在。由于血浆转甲状腺素蛋白几乎完全在肝脏中合成,因此进行肝移植以消除突变的血浆转甲状腺素蛋白。该手术在携带V30M突变的患者中显示出最佳效果,而对于许多其他突变,野生型(wt)转甲状腺素蛋白在心脏中持续快速沉积。在本文中,我们研究了两名接受肝移植的转甲状腺素蛋白T60A患者中wtATTR的比例;一名患者术后3周死亡,另一名患者存活了12个月。由于片段化转甲状腺素蛋白种类在发病机制中的作用远未明确,我们分别研究了这些种类中wt与全长分子的比例,这在移植患者中此前尚未进行过。结果显示,存活12个月的患者中wtTTR的比例高于存活3周的患者,但有趣的是,wt比例的这种差异主要见于全长分子,而非片段化分子。

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