Diagnostic performance of transthyretin measurement in fat tissue of patients with ATTR amyloidosis

In this article, the diagnostic performance of a transthyretin (TTR) ELISA for detection and characterization of transthyretin-derived (ATTR) amyloid in abdominal subcutaneous fat tissue was studied. Fat tissue specimens were analyzed of 38 patients with ATTR amyloidosis, 70 controls, and 17 carriers of a TTR mutation. Amyloid amount was graded semi-quantitatively in Congo red-stained specimens (0-4+). Amyloid was extracted from tissue in guanidine, and the TTR concentration was measured using a sandwich TTR-ELISA. The TTR concentration of patients with ATTR amyloidosis (mean 0.84 ng/mg fat tissue) was significantly higher than controls (p<0.001). With a TTR concentration of 0.13 ng/mg fat tissue as cut-off value, 32 of the 38 ATTR patients were identified resulting in a sensitivity of 84%. Sixty-seven of the 70 controls had values below the cut-off value resulting in a specificity of 96%. Thus, measuring TTR in fat tissue is useful for detecting ATTR amyloidosis and for characterizing amyloid as ATTR type

Serum levels of matrix metalloproteinase-3 in relation to the development of radiological damage in patients with early rheumatoid arthritis

Objective. To evaluate the significance of serum matrix metalloproteinase-3 (MMP-3) levels in relation to the development of radiological damage (X-ray damage) in early rheumatoid arthritis (RA).Methods. Serum MMP-3 levels were measured in 46 healthy controls (CTRL), 19 osteoarthritis (OA) and 78 RA patients with joint symptoms forResults. MMP-3 levels in CTRL and OA were low or undetectable with no differences between the groups (P = 0.19). Levels in RA were higher than in CTRL (P &lt;0.01). Initial MMP-3 levels in patients with X-ray damage at T0 (n = 30) were higher than the levels in patients without any X-ray damage during follow-up (n = 19) (P &lt;0.01), but were not different from those in patients who developed X-ray damage during the study (n = 29) (P = 0.11). In the patients without X-ray damage at T0, there was a significant correlation between MMP-3 at TO and the total X-ray damage after 6 months (r = 0.34, P = 0.02) and 12 months (r = 0.32, P = 0.03). This correlation was almost exclusively determined by joint space narrowing in the Sharp score.Conclusion. The serum MMP-3 level seems to be an indicator for the development of radiological damage in patients with early RA and appears to be particularly indicative of cartilage degradation.</p

Individual relationship between progression of radiological damage and the acute phase response in early rheumatoid arthritis: towards development of a decision support system

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Aanvullend archeologisch onderzoek aan de A7 Zuidelijke Ringweg Groningen, het Euvelgunnetracé

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IgM, IgA and IgG rheumatoid factors in early rheumatoid arthritis. Predictive of radiological progression?

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Diagnostic performance of transthyretin measurement in fat tissue of patients with ATTR amyloidosis

Background: The diagnostic performance was studied of a transthyretin (TTR) ELISA for detection and characterisation of transthyretin-derived (ATTR) amyloid in abdominal subcutaneous fat tissue. Methods: Fat tissue specimens were analysed of 38 consecutive patients with hereditary ATTR amyloidosis, 70 controls (30 disease controls, 20 AA amyloidosis and 20 AL amyloidosis) and 17 mutation carriers. The amount of amyloid was graded semi-quantitatively in Congo red-stained specimens (0-4+). Amyloid was extracted from tissue in guanidine and the TTR concentration was measured using a TTR-ELISA. Results: Mean TTR concentration in all controls was 0.006 ng/mg fat tissue with a 95% interval (mean±2SD) ranging from 0.0001 to 0.33 ng/mg fat tissue. The TTR concentration of patients with ATTR amyloidosis (mean 0.84 ng/mg fat tissue; 95% interval 0.012-58.4 ng/mg fat tissue) was significantly higher than controls (