Current and future circulating biomarkers for cardiac amyloidosis

Acta Pharmacologica Sinica
Marco LucianiFederica Del Monte

Abstract

Cardiac amyloidosis (CA) comprises a heterogeneous group of medical conditions affecting the myocardium. It presents with proteinaceous infiltration with variable degrees of severity, prevalence and evolution. Despite this heterogeneity, erroneous protein folding is the common pathophysiologic process, yielding the formation of a single misfolded protein (monomer) that progressively evolves and ultimately forms amyloid fibers. Additionally, by seeding out from the organs of origin, intermediates called oligomers metastasize and restart the process. Such self-echoing behavior makes the secondary affected organs as important as the primary ones. Unfortunately, CA can be clinically challenging and only suggestive in a late stage of its natural history, leaving a narrow therapeutic time window available. In light of the evolutionary nature of amyloidosis, here, we propose a new classification of the currently used biomarkers based on time stages with different specificity and applicability across CA subtypes. Early markers (free light chains, serum amyloid A, β2-microglobulin, osteopontin and osteoprotegerin) can be employed for disease detection. Intermediate markers [soluble suppression of tumorigenicity 2 (sST-2), midregional pr...Continue Reading

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Citations

Jun 22, 2018·Acta Pharmacologica Sinica·Lei XiNazareno Paolocci
Jun 8, 2021·Journal of UOEH·Tsukasa KarasuyamaMasaru Harada

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Methods Mentioned

BETA
protein folding
electron microscopy

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