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The pathophysiology of variant transthyretin (TTR) amyloidosis (ATTRv) is associated with destabilizing mutations in the TTR tetramer. However, why TTR with a wild-type genetic sequence misfolds and aggregates in wild-type transthyretin amyloidosis (ATTRwt) is unknown. Here, we evaluate kinetic TTR stability with a newly developed ELISA system in combination with urea-induced protein denaturation. Compared with that in control patients, endogenous TTR in patients with wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM) exhibited thermodynamic instability, indicating that circulating TTR instability may be associated with the pathogenesis of ATTRwt as well as ATTRv. Our findings provide new insight into the underlying mechanisms of ATTRwt.
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http://dx.doi.org/10.1038/s41598-024-71446-8 | DOI Listing |
Heart Rhythm O2
August 2025
Cardiac Electrophysiology Section, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Background: Cardiac amyloidosis (CA) is characterized by atrial myopathy, which predisposes patients to atrial fibrillation (AF) and other atrial arrhythmias (AA). Although catheter ablation of AA is effective in the general population, its efficacy and safety in patients with CA remain unclear.
Objective: The study aimed to evaluate outcomes in patients with CA undergoing catheter ablation for typical atrial flutter (TAFL) and left atrial (LA) arrhythmias and to assess the presence and influence of LA low-voltage areas (LVA) in the latter.
Proteins
September 2025
School of Advanced Sciences and Languages (SASL), VIT Bhopal University, Sehore, Madhya Pradesh, India.
The mechanisms driving amyloid assembly have long intrigued structural biologists, as they offer insights into systemic fibrotic changes and the dynamic behavior of transthyretin (TTR) aggregation, crucial for developing amyloid-targeted therapies. In TTR-associated amyloidosis, amyloid fibrils form via destabilization of the tetramer into dimers and monomers. While many TTR mutations have been studied, the atomistic impact of multiple mutations on amyloid transthyretin (ATTR) self-assembly remains underexplored.
View Article and Find Full Text PDFJ Am Soc Echocardiogr
September 2025
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.
Background And Aims: Light chain cardiac amyloidosis (AL-CA), wild-type-transthyretin cardiac amyloidosis (ATTRwt-CA) and hereditary type-transthyretin cardiac amyloidosis (ATTRv-CA) have distinct presentations, clinical courses, and prognosis. To identify differentiating echocardiographic features and their prognostic significance, we investigated a large cohort of patients with CA.
Methods: In this multi-site cohort study, CA diagnosis was verified according to guidelines.
Amyloid
September 2025
Institute of Systems, Integrative and Molecular Biology, University of Liverpool, Liverpool, UK.
Background: Cross-seeding and co-assembly of multiple amyloid species are increasingly recognised in various organs and amyloidoses. Medin and wild-type transthyretin (TTR) both form age-related amyloid deposits and have been identified within the aortic wall. Given the emerging role of amyloid in aortic disease, this study investigates the potential colocalisation of TTR and medin in the aorta.
View Article and Find Full Text PDFJ Peripher Nerv Syst
September 2025
Mayo Clinic Department of Neurology, Rochester, Minnesota, USA.
Aim: To report a novel case of biopsy-proven, mass spectrometry-confirmed, wild-type transthyretin amyloidosis (ATTRwt) in nerve.
Methods: The patient was identified and evaluated in the peripheral nerve clinic. Our nerve laboratory's pathology database and the literature were searched for prior evidence of pathologically confirmed cases of ATTRwt.