Prevalence and morphology of leukocyte chemotactic factor 2-associated amyloid in renal biopsies
Prevalence and morphology of leukocyte chemotactic factor 2-associated amyloid in renal biopsies
复制标题
DOI：
10.1038/ki.2010.9
复制
发表时间：
2010-05-01
影响因子：
19.6
通讯作者：
Solomon, Alan
中科院分区：
文献类型：
--
作者：
Larsen, Christopher P.;Walker, Patrick D.;Solomon, Alan
肾脏病理学家通过免疫组织化学鉴定肾脏淀粉样蛋白沉积物的蛋白质成分，使用抗体对抗已知的淀粉样蛋白。大多数淀粉样蛋白病例可以通过简单的抗体组进行分类，包括免疫球蛋白轻链lambda和kappa，以及血清淀粉样蛋白a。然而，在某些情况下，这些试剂不能识别刚果红染色的材料或产生模糊的染色结果，从而造成诊断困境。对从无反应性肾活检中提取的原纤维进行化学分析，发现了一种以前未知的由白细胞趋化因子2 （LECT2）形成的淀粉样蛋白。在过去的8年中，我们收到285例肾脏淀粉样蛋白样本，其中31例未分类。为了确定后一种样品是否与LECT2相关，进行了串联质谱分析。总的来说，31例中有7例被鉴定为淀粉样蛋白LECT2 (ALECT2)，这一发现使用LECT2特异性抗体进行免疫组织化学证实。刚果红染色强烈的沉积物，在大多数情况下，具有明显的形态学特征，弥漫性累及间质、动脉和肾小球。因此，我们认为ALECT2代表了肾脏淀粉样变性的第三种常见形式。肾脏国际（2010）77,816-819；doi: 10.1038 / ki.2010.9;2010年2月24日在线发布
Renal pathologists identify the protein component of renal amyloid deposits by immunohistochemistry using antibodies against known amyloidogenic proteins. The majority of amyloid cases can be categorized by a simple antibody panel that includes immunoglobulin light chains lambda and kappa, and serum amyloid A. In some instances, however, these reagents do not recognize materials that stain with Congo red or yield ambiguous staining results, thus creating a diagnostic dilemma. Chemical analysis of fibrils extracted from such a nonreactive renal biopsy led to the discovery of a previously unknown amyloid formed from leukocyte chemotactic factor 2 (LECT2). Over the past 8 years, we received 285 renal amyloid samples, of which 31 remained unclassified. In an effort to determine whether any of the latter samples were LECT2 related, tandem mass spectrometry was performed. In all, 7 of the 31 cases were identified as an amyloid LECT2 (ALECT2), a finding confirmed immunohistochemically using a LECT2-specific antibody. The deposits strongly stained for Congo red and, in most cases, had distinctive morphological features with diffuse involvement of the interstitium, arteries, and glomeruli. Hence, we believe that ALECT2 represents the third common form of renal amyloidosis. Kidney International (2010) 77, 816-819; doi: 10.1038/ki.2010.9; published online 24 February 2010