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Routine Use of Amyloid Typing on Formalin-Fixed Paraffin Sections from 626 Patients by Immunohistochemistry

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Book cover Amyloid and Related Disorders

Part of the book series: Current Clinical Pathology ((CCPATH))

Abstract

After diagnosing amyloid by the Congo red procedure (see Chap. 13), identifying the chemical nature of the amyloidotic protein causing the disease is mandatory for therapeutic considerations. Here is illustrated how immunohistochemical typing of amyloid can be achieved on formalin-fixed tissue sections using a panel of amyloid antibodies which were produced for this purpose. These antibodies and the histological expert evaluation are the key for a successful amyloid typing while the various pitfalls are being avoided. The single strong, consistent, and therefore diagnostic reaction has to be distinguished from the other weaker, inconsistent, and unspecific reactions since amyloid deposits contain various substances. The prevalence of the amyloid types among 626 samples submitted for typing is presented. Other laboratories have achieved similar results with these antibodies since this typing is easy, fast, and affordable. Finally, mass spectrometry has confirmed the high sensitivity and precision of this routine method for classifying amyloid.

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Notes

  1. 1.

     AIg is proposed here as a practical acronym for the combination of AL and AH.

References

  1. Sipe JD, Benson MD, Buxbaum JN, Ikeda S, Merlini G, Saraiva MJ, Westermark P. Amyloid fibril protein nomenclature: 2010 recommendations from the nomenclature committee of the International Society of Amyloidosis. Amyloid. 2010;17:101–4.

    Article  PubMed  CAS  Google Scholar 

  2. Merlini G, Westermark P. The systemic amyloidoses: clearer understanding of the molecular mechanisms offer hope for more effective therapies. J Int Med. 2004;255:159–78.

    Article  CAS  Google Scholar 

  3. Lavatelli F, Perlman DH, Spencer B, Prokaeva T, McComb ME, Théberge R, Conners LH, Belotti V, Sheldin DC, Merlini G, Skinner N, Cortello CE. Amyloidogenic and associated proteins in systemic amyloidosis proteome of adipose tissue. Mol Cell Proteomics. 2008;7:1570–83.

    Article  PubMed  CAS  Google Scholar 

  4. Linke RP. Congo red staining of amyloid. Improvements and practical guide for a more ­precise diagnosis of amyloid and the different ­amyloidoses. In: Uversky VN, Fink AL, editors. Protein Misfol­ding, aggregation and conformational diseases, Protein reviews, Volume 4, (MZ Atassi, editor); Chapter 11.1, pp. 239–76; Springer 2006.

    Google Scholar 

  5. Schroeder R, Deckert M, Linke RP. Novel isolated cerebral ALλ (lamda) amyloid angiopathy with widespread subcortical distribution and leukoencephalopathy due to atypical monoclonal plasma cell prolife­ration, and terminal systemic gammopathy. J Neuropath Exp Neurol. 2009;68:286–99.

    Article  CAS  Google Scholar 

  6. Murphy CL, Wang S, Williams T, Weiss DT, Solomon A. Characterization of systemic amyloid deposits by mass spectrometry. Methods Enzymol. 2006;412: 48–62.

    Article  PubMed  CAS  Google Scholar 

  7. Vrana JA, Gamez JD, Madden BJ, Theis JD, Bergen 3rd HR, Dogan A. Classification of amyloidosis by laser micro dissection and mass spectrometry based proteomic analysis in clinical biopsy specimens. Blood. 2009;114(24):4957–9.

    Article  PubMed  CAS  Google Scholar 

  8. Linke RP, Oos R, Wiegel NM, Nathrath WBJ. Classification of amyloidosis: misdiagnosing by way of incomplete immunohistochemistry and how to prevent it. Acta Histochem. 2006;108:197–208.

    Article  PubMed  Google Scholar 

  9. Picken MM, Herrera GA. The burden of “sticky” amyloid: typing challenges. Arch Pathol Lab Med. 2007;131:850–1.

    PubMed  Google Scholar 

  10. Linke RP. Classifying of amyloid on fixed tissue sections for routine use by validated immunohistochemistry. Amyloid. 2011;18 Suppl1, 67–70.

    Google Scholar 

  11. Linke RP, Joswig R, Murphy CL, Wang S, Zhou H, Gross U, Rocken C, Westermark P, Weiss DT, Solomon A. Senile seminal vesicle amyloid is derived from semenogelin I. J Lab Clin Med. 2005;145:87–193.

    Article  Google Scholar 

  12. Linke RP, Adler S, Hegenbart U, Schönland S, Gröne HJ. Chronic, slowly progressing nephropathy due to amyloid of cSAA (SAA4) origin. Abstract XIth Internat. Symposium on Amyloidosis, Nov. 5–9, 2006 Woodshole, MA/USA.

    Google Scholar 

  13. Wiegel NM, Mentele R, Kellermann J, Meyer L, Riess H, Linke RP. ALκ (kappa)(I) (UNK)—primary structure of an AL-amyloid protein presenting an organ-limited subcutaneous nodular amyloid syndrome of long duration. Case report and review. Amyloid. 2010;17:10–23.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

This work was only possible as a result of contributions by many colleagues over several decades. Full acknowledgment of some of these contributions can be found in a forthcoming in-depth review (work in progress). Here, I would like to thank Prof. Dr. R. Huber, director emeritus of the Max-Planck-Institute of Biochemistry in Martinsried, who provided laboratory space, and supported some of the technicians and coworkers involved in the laboratory work. They include: Mrs. A. Rail, Mrs. A. Kerling, Mrs. R. Oos, Mrs A. Meinel and Dr. N. Wiegel. For secretarial work, I thank Mrs. A. Feix, Martinsried, Germany, and for the artwork Ms A. K. M. Linke, Essen, Germany.

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Authors and Affiliations

  1. Reference Center of Amyloid Diseases amYmed, Innovation Center of Biotechnology, Am Klopferspitz 19, Martinsried, D-82152, Germany

    Reinhold P. Linke M.D., Ph.D.

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  1. Reinhold P. Linke M.D., Ph.D.
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Correspondence to Reinhold P. Linke M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Bldg#110, Rm#2242, Department of Pathology, Loyola University Medical Center, S. First Avenue 2160, Maywood, 60153, Illinois, USA

    Maria M. Picken MD, PhD, FASN

  2. , Department of Laboratory Medicine and Pa, Mayo Clinic, First Street SW 200, Rochester, 55905, USA

    Ahmet Dogan, M.D., Ph.D.

  3. , Department of Renal Pathology, Bostwick Laboratories, Lake Ellenor Dr. 8001, Orlando, 32809, Florida, USA

    Guillermo A. Herrera, M.D.

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Linke, R.P. (2012). Routine Use of Amyloid Typing on Formalin-Fixed Paraffin Sections from 626 Patients by Immunohistochemistry. In: Picken MD, PhD, FASN, M., Dogan, M.D., Ph.D., A., Herrera, M.D., G. (eds) Amyloid and Related Disorders. Current Clinical Pathology. Humana Press. https://doi.org/10.1007/978-1-60761-389-3_17

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  • DOI: https://doi.org/10.1007/978-1-60761-389-3_17

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  • Publisher Name: Humana Press

  • Print ISBN: 978-1-60761-388-6

  • Online ISBN: 978-1-60761-389-3

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