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Abstract
Amyloid deposits in several heredofamilial forms of amyloidosis are known to be chemically
related to transthyretin (TTR, the plasma protein usually referred to as prealbumin).
A genetic mutation, leading to an abnormal TTR, may be involved. Studies were conducted
to investigate whether or not Portuguese patients with familial amyloidotic polyneuropathy
(FAP) have an abnormal species of TTR circulating in their plasma and, if so, whether
this might have any impact on vitamin A transport and retinol-binding protein (RBP)
metabolism in these patients. The initial studies examined the plasma concentrations
of TTR, RBP, and retinol in patients with FAP. Significantly reduced (p < 0.005) levels
of TTR were found in patients with FAP. The TTR levels in 24 FAP patients were approximately
two thirds of those of a group of 18 control subjects from the same geographic area.
In contrast, RBP levels were not reduced, nor was there an abnormality in the ratio
of retinol to RBP, in the patients with FAP. Thus there does not appear to be an abnormality
in vitamin A transport in Portuguese patients with FAP. There does, however, appear
to be an abnormality of TTR metabolism, accounting for the reduced plasma levels of
TTR. TTR was isolated from pooled sera of the FAP patients and was characterized in
detail. FAP-TTR was indistinguishable from normal TTR with regard to a variety of
parameters, including (1) electrophoretic mobility, (2) chromatographic behavior,
(3) molecular weight, (4) stability of the TTR tetramer, (5) immunoreactivity in TTR
radioimmunoassays using antisera prepared against both normal and FAP-TTR, (6) ability
to form a protein-protein complex with RBP and affinity for RBP as assessed by polarization
of fluorescence, and (7) overall amino acid composition. The possible explanations
are as follows: (1) an abnormal TTR molecule is not produced in this form of FAP;
(2) the abnormal molecule is present in only trace amounts (not detectable in the
present study) in FAP plasma; or (3) the abnormal TTR is structurally almost identical
to normal TTR and does not differ from normal TTR with regard to the various physical
and chemical properties investigated in this study. Preliminary observations suggest
that FAP patients do produce an abnormal form of TTR that selectively deposits in
tissues as amyloid protein.
Abbreviations:
transthyretin ((TTR)), retinol-binding protein ((RBP)), familial amyloidotic polyneuropathy ((FAP)), normal TTR ((N-TTR)), TTR from patients with FAP ((FAP-TTR)), sodium dodecyl sulfate ((SDS)), polyacrylamide gel electrophoresis ((PAGE)), blood urea nitrogen ((BUN)), diethylaminoethyl ((DEAE))To read this article in full you will need to make a payment
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Article info
Publication history
Accepted:
June 7,
1983
Received:
March 1,
1983
Footnotes
☆This work was supported by NIH grants HL-21006 (SCOR) and AM-05968.
Identification
Copyright
© 1983 Published by Elsevier Inc.