Changed affinity of apolipoprotein AII to high density lipoprotein (HDL) in patients with familial amyloidotic polyneuropathy (FAP) type I.

Patients with familial amyloidotic polyneuropathy (FAP) showed extremely low plasma apolipoprotein AII (apoAII) levels and apolipoprotein AII/AI (apoAII/AI) ratio while plasma levels of AI, B, CII, CIII, and E were all within normal ranges. To elucidate the reason for these phenomena, we investigated the percent of these proteins contained in high density lipoprotein (HDL) extracted from plasma of FAP patients by ultracentrifugation. The apoAII/AI ratio in extracted HDL was much lower in asymptomatic carriers of FAP as well as FAP patients than that in control subjects. Since a significant amount of apoAII as well as apoAI was recognized in the fraction of the density > 1.21 g/ml in the samples from asymptomatic carriers of FAP and FAP patients, decreased apoAII/AI ratio may result from the increased dissociation of apoAII from HDL during the process of the ultracentrifugation. Electrophoresis of HDL extracted by agarose gel revealed that HDL from asymptomatic carriers of FAP as well as FAP patients increased negative charge, suggesting that nature of HDL itself may change in these subjects. Although urinary excretion of apoAII was increased in carriers of FAP and FAP patients, there was no correlation between plasma and urinary apoAII levels and also no relationship between urinary total protein and apoAII levels. These results suggest that changed affinity of apoAII to HDL may cause the increased secretion of apoAII to the urine and the decreased plasma apoAII level in carriers of FAP and FAP patients.