Download MendeleyStructural and molecular homogeneity of ATTRv-T60A amyloid fibrils across patients and organs.
Fernandez-Ramirez, M.D.C., Nguyen, B.A., Afrin, S., Singh, V., Evers, B., Shelton, J.M., Escobar, C.L., Bassett, P., Wang, L., Pekala, M., Ahmed, Y., Cabrera Hernandez, L.O., Pedretti, R., Singh, P., Canepa, J., Wosztyl, A., Li, Y., Boyer, D.R., Cao, Q., Saelices, L.(2025) Structure 33: 2013-2019.e4
- PubMed: 41106377 Search on PubMed
- DOI: https://doi.org/10.1016/j.str.2025.09.008
- Primary Citation Related Structures:
9D21, 9D23, 9D24, 9D27, 9D2G - PubMed Abstract:
Transthyretin amyloidosis is a systemic protein misfolding disorder with diverse clinical phenotypes, including cardiomyopathy, polyneuropathy, or a combination of both. While structural polymorphism of amyloid fibrils has been linked to disease heterogeneity in neurodegenerative disorders, its role in transthyretin amyloidosis remains unclear. Here, we used cryo-electron microscopy to analyze ex vivo fibrils extracted from the hearts of three patients carrying the T60A mutation, a variant associated with mixed cardiac and neuropathic symptoms. In one patient, we additionally examined fibrils from the thyroid, kidney, and liver. All fibrils across patients and tissues adopted a single morphology previously associated with cardiomyopathy. Complementary molecular analyses revealed high compositional homogeneity. Notably, we extracted fibrils from the liver, an organ considered fibril-free, with seeding capacity in vitro. These findings suggest structural homogeneity as a hallmark of cardiac and mixed phenotypes, and provide a mechanistic rationale for the transmission of amyloidosis following domino liver transplantation.
- Center for Alzheimer's and Neurodegenerative Diseases, Department of Biophysics, Peter O'Donnell Jr. Brain Institute, University of Texas Southwestern Medical Center (UTSW), Dallas, TX, USA.
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