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Marchi F, Kessler C, Distefano D, Terzi di Bergamo L, Fumagalli L, Averaimo M, Crupi E, Bergamini F, Melli G, Stussi G, Rossi D, Gobbi C, Ripellino P, Pravatà E, Kuhlen DE, Röcken C, Scarone P, Gerber B, Condoluci A. Prevalence of amyloid in ligamentum flavum of patients with lumbar spinal stenosis. Amyloid 2023; 30:416-423. [PMID: 37431662 DOI: 10.1080/13506129.2023.2230516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/20/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Transthyretin (ATTR) amyloidosis is often diagnosed in an advanced stage, when irreversible cardiac damage has occurred. Lumbar spinal stenosis (LSS) may precede cardiac ATTR amyloidosis by many years, offering the opportunity to detect ATTR already at the time of LSS surgery. We prospectively assessed the prevalence of ATTR in the ligamentum flavum by tissue biopsy in patients aged >50 years undergoing surgery for LSS. METHODS Ligamentum flavum thickness was assessed pre-operatively on axial T2 magnetic resonance imaging (MRI) slices. Tissue samples from ligamentum flavum were screened centrally by Congo red staining and immunohistochemistry (IHC). RESULTS Amyloid in the ligamentum flavum was detected in 74/94 patients (78.7%). IHC revealed ATTR in 61 (64.9%), whereas amyloid subtyping was inconclusive in 13 (13.8%). Mean thickness of ligamentum flavum was significantly higher at all levels in patients with amyloid (p < .05). Patients with amyloid deposits were older (73.1 ± 9.2 vs. 64.6 ± 10.1 years, p = .01). No differences in sex, comorbidities, previous surgery for carpal tunnel syndrome or LSS were observed. CONCLUSIONS Amyloid, mostly of the ATTR subtype, was found in four out of five patients with LSS and is associated with age and ligamentum flavum thickness. Histopathological work-up of ligamentum flavum might inform future decision making.
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Affiliation(s)
- Francesco Marchi
- Neurosurgical Service, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Chiara Kessler
- Clinic of Hematology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Daniela Distefano
- Department of Neuroradiology, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | | | - Luca Fumagalli
- Neurosurgical Service, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Manuela Averaimo
- Cardiocentro Ticino, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Emanuele Crupi
- Clinic of Hematology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Fabio Bergamini
- Clinic of Hematology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Giorgia Melli
- Neurology Department, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Georg Stussi
- Clinic of Hematology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Davide Rossi
- Clinic of Hematology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Laboratory of Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Claudio Gobbi
- Neurology Department, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Paolo Ripellino
- Neurology Department, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Emanuele Pravatà
- Department of Neuroradiology, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Dominique E Kuhlen
- Neurosurgical Service, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Christoph Röcken
- Department of Pathology, Christian-Albrechts-University and University Hospital Schleswig-Holstein, Kiel, Germany
| | - Pietro Scarone
- Neurosurgical Service, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Bernhard Gerber
- Clinic of Hematology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Adalgisa Condoluci
- Clinic of Hematology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Laboratory of Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
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Treitz C, Gottwald J, Gericke E, Urban P, Meliß RR, Axmann HD, Siebert F, Becker K, Tholey A, Röcken C. Quantitative proteome profiling provides evidence of an activation of the complement cascade in ATTR amyloidosis. Amyloid 2022; 29:102-109. [PMID: 34913770 DOI: 10.1080/13506129.2021.2015316] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Amyloidosis is a disease group caused by pathological aggregation and deposition of peptides in diverse tissue sites. Apart from the fibril protein, amyloid deposits frequently enclose non-fibrillar constituents. In this study, carpal tunnel tissue sections with ATTR amyloid were analysed by quantitative mass spectrometry-based proteomics. Following manual dissection, tissue samples of equal size and with heterogeneous amyloid load were dissected and forwarded to bottom-up proteome analysis and label-free protein profiling. The amyloid-associated proteins showed significant correlations of label-free intensity profiles. A comprehensive list of 83 proteins specifically enriched in amyloid deposits was discovered. In addition to well-known signature proteins (e.g. apolipoprotein E, apolipoprotein A-IV, and vitronectin), 22 members of the complement system, including all seven components of the membrane attack complex could be associated to the disease. These data lend support to the hypothesis that the complement system is activated in ATTR amyloidosis.
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Affiliation(s)
- Christian Treitz
- Systematic Proteome Research and Bioanalytics, Institute of Experimental Medicine, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Juliane Gottwald
- Department of Pathology, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Eva Gericke
- Department of Pathology, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Peter Urban
- Institute of Pathology and Dermatopathology, Hannover, Germany
| | | | | | | | | | - Andreas Tholey
- Systematic Proteome Research and Bioanalytics, Institute of Experimental Medicine, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Christoph Röcken
- Department of Pathology, Christian-Albrechts-University Kiel, Kiel, Germany
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3
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Mattig I, Heidecker B, Tschöpe C, Messroghli D, Eurich D, Kleefeld F, Gaedeke J, Stenzel W, Schmidt HHJ, Röcken C, Knebel F, Hahn K. Progressive Hereditary Transthyretin-Related Amyloidosis (ATTRv) Aggravated by ATTR Wild-Type and Complement Activation. J Neuropathol Exp Neurol 2022; 81:299-303. [DOI: 10.1093/jnen/nlab138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Isabel Mattig
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie, Campus Charité Mitte, Berlin, Germany
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Amyloidosis Center Charité Berlin (ACCB), Berlin, Germany
| | - Bettina Heidecker
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Amyloidosis Center Charité Berlin (ACCB), Berlin, Germany
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Medizinische Klinik für Kardiologie, Campus Benjamin Franklin, Berlin, Germany
| | - Carsten Tschöpe
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Amyloidosis Center Charité Berlin (ACCB), Berlin, Germany
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Medizinische Klinik mit Schwerpunkt Kardiologie, Virchow Klinikum Campus, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Daniel Messroghli
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Amyloidosis Center Charité Berlin (ACCB), Berlin, Germany
- Deutsches Herzzentrum Berlin, Klinik für Innere Medizin—Kardiologie, Germany
| | - Dennis Eurich
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Amyloidosis Center Charité Berlin (ACCB), Berlin, Germany
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Chirurgische Klinik, Campus Virchow Klinikum, Berlin, Germany
| | - Felix Kleefeld
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Amyloidosis Center Charité Berlin (ACCB), Berlin, Germany
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Klinik für Neurologie mit Experimenteller Neurologie, Charité Campus Mitte, Berlin, Germany
| | - Jens Gaedeke
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Amyloidosis Center Charité Berlin (ACCB), Berlin, Germany
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Medizinische Klinik mit Schwerpunkt Nephrologie und Internistische Intensivmedizin, Berlin, Germany
| | - Werner Stenzel
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Amyloidosis Center Charité Berlin (ACCB), Berlin, Germany
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institut für Neuropathologie, Berlin, Germany
| | - Hartmut H -J Schmidt
- Klinik für Gastroenterologie und Hepatologie, Universitätsklinikum Essen, Germany
| | - Christoph Röcken
- Department of Pathology, University Hospital Schleswig-Holstein, Campus, Kiel, Germany
| | - Fabian Knebel
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie, Campus Charité Mitte, Berlin, Germany
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Amyloidosis Center Charité Berlin (ACCB), Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany
- Sana Klinikum Lichtenberg, Innere Medizin II: Schwerpunkt Kardiologie, Berlin, Germany
| | - Katrin Hahn
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Amyloidosis Center Charité Berlin (ACCB), Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Klinik für Neurologie mit Experimenteller Neurologie, Charité Campus Mitte, Berlin, Germany
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Palstrøm NB, Rojek AM, Møller HEH, Hansen CT, Matthiesen R, Rasmussen LM, Abildgaard N, Beck HC. Classification of Amyloidosis by Model-Assisted Mass Spectrometry-Based Proteomics. Int J Mol Sci 2021; 23:ijms23010319. [PMID: 35008745 PMCID: PMC8745254 DOI: 10.3390/ijms23010319] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/23/2021] [Accepted: 12/25/2021] [Indexed: 11/16/2022] Open
Abstract
Amyloidosis is a rare disease caused by the misfolding and extracellular aggregation of proteins as insoluble fibrillary deposits localized either in specific organs or systemically throughout the body. The organ targeted and the disease progression and outcome is highly dependent on the specific fibril-forming protein, and its accurate identification is essential to the choice of treatment. Mass spectrometry-based proteomics has become the method of choice for the identification of the amyloidogenic protein. Regrettably, this identification relies on manual and subjective interpretation of mass spectrometry data by an expert, which is undesirable and may bias diagnosis. To circumvent this, we developed a statistical model-assisted method for the unbiased identification of amyloid-containing biopsies and amyloidosis subtyping. Based on data from mass spectrometric analysis of amyloid-containing biopsies and corresponding controls. A Boruta method applied on a random forest classifier was applied to proteomics data obtained from the mass spectrometric analysis of 75 laser dissected Congo Red positive amyloid-containing biopsies and 78 Congo Red negative biopsies to identify novel “amyloid signature” proteins that included clusterin, fibulin-1, vitronectin complement component C9 and also three collagen proteins, as well as the well-known amyloid signature proteins apolipoprotein E, apolipoprotein A4, and serum amyloid P. A SVM learning algorithm were trained on the mass spectrometry data from the analysis of the 75 amyloid-containing biopsies and 78 amyloid-negative control biopsies. The trained algorithm performed superior in the discrimination of amyloid-containing biopsies from controls, with an accuracy of 1.0 when applied to a blinded mass spectrometry validation data set of 103 prospectively collected amyloid-containing biopsies. Moreover, our method successfully classified amyloidosis patients according to the subtype in 102 out of 103 blinded cases. Collectively, our model-assisted approach identified novel amyloid-associated proteins and demonstrated the use of mass spectrometry-based data in clinical diagnostics of disease by the unbiased and reliable model-assisted classification of amyloid deposits and of the specific amyloid subtype.
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Affiliation(s)
- Nicolai Bjødstrup Palstrøm
- Odense Amyloidosis Center, Odense University Hospital, 5000 Odense, Denmark; (N.B.P.); (A.M.R.); (H.E.H.M.); (C.T.H.); (L.M.R.); (N.A.)
- Centre for Clinical Proteomics, Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, 5000 Odense, Denmark
| | - Aleksandra M. Rojek
- Odense Amyloidosis Center, Odense University Hospital, 5000 Odense, Denmark; (N.B.P.); (A.M.R.); (H.E.H.M.); (C.T.H.); (L.M.R.); (N.A.)
- Department of Pathology, Odense University Hospital, 5000 Odense, Denmark
| | - Hanne E. H. Møller
- Odense Amyloidosis Center, Odense University Hospital, 5000 Odense, Denmark; (N.B.P.); (A.M.R.); (H.E.H.M.); (C.T.H.); (L.M.R.); (N.A.)
- Department of Pathology, Odense University Hospital, 5000 Odense, Denmark
| | - Charlotte Toftmann Hansen
- Odense Amyloidosis Center, Odense University Hospital, 5000 Odense, Denmark; (N.B.P.); (A.M.R.); (H.E.H.M.); (C.T.H.); (L.M.R.); (N.A.)
- Department of Hematology, Odense University Hospital, 5000 Odense, Denmark
| | - Rune Matthiesen
- Computational and Experimental Biology Group, CEDOC, Chronic Diseases Research Centre, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, 1169-056 Lisbon, Portugal;
| | - Lars Melholt Rasmussen
- Odense Amyloidosis Center, Odense University Hospital, 5000 Odense, Denmark; (N.B.P.); (A.M.R.); (H.E.H.M.); (C.T.H.); (L.M.R.); (N.A.)
- Centre for Clinical Proteomics, Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, 5000 Odense, Denmark
- Department of Clinical Research, Odense University Hospital, 5000 Odense, Denmark
| | - Niels Abildgaard
- Odense Amyloidosis Center, Odense University Hospital, 5000 Odense, Denmark; (N.B.P.); (A.M.R.); (H.E.H.M.); (C.T.H.); (L.M.R.); (N.A.)
- Department of Hematology, Odense University Hospital, 5000 Odense, Denmark
- Department of Clinical Research, Odense University Hospital, 5000 Odense, Denmark
- Haematology Pathology Research Laboratory, Department of Haematology, Odense University Hospital, 5000 Odense, Denmark
| | - Hans Christian Beck
- Odense Amyloidosis Center, Odense University Hospital, 5000 Odense, Denmark; (N.B.P.); (A.M.R.); (H.E.H.M.); (C.T.H.); (L.M.R.); (N.A.)
- Centre for Clinical Proteomics, Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, 5000 Odense, Denmark
- Department of Clinical Research, Odense University Hospital, 5000 Odense, Denmark
- Correspondence: ; Tel.: +45-29647470
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