92 research outputs found

    Light chain amyloidosis

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    Light chain amyloidosis (AL) is the most common subtype of amyloidosis except wild type tranthyretine amyloidosis and is caused by the deposition of misfolded monoclonal light chains of immunoglobulins produced by a monoclonal B cell, mainly of plasma cell origin. Affected patients may present with amyloidosis alone or in association with other plasma cell or lymphoid dyscrasias (multiple myeloma, Waldenström macroglobulinemia or other B lymphoma). Diagnosis of amyloidosis is histological. Cardiac and renal involvement are the most frequent and present in nearly two thirds of patients as hypertrophic heart disease and/or nephrotic syndrome, respectively. AL amyloidosis is a clonal plasma cell disorder and is treated by chemotherapy dedicated to eradicate the underlying clone. Assessment of the severity of the disease with the Mayo Clinic score is used to guide the choice of treatment. First-line treatment combine bortezomib, cyclophosphamide or melphalan and dexamethasone for severe cases, plus or minus daratumumab, an anti-CD-38 monoclonal antibody, following the excellent results of the ANDROMEDA phase 3 study; mild cases can still benefit from melphalan and dexamethasone

    New genetic loci link adipose and insulin biology to body fat distribution.

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    Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms
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