Pharmaceutical amyloidosis associated with subcutaneous insulin and enfuvirtide administration. Amyloid 2014 Jun;21(2):71-5
Date
01/23/2014Pubmed ID
24446896Pubmed Central ID
PMC4021035DOI
10.3109/13506129.2013.876984Scopus ID
2-s2.0-84900549760 (requires institutional sign-in at Scopus site) 65 CitationsAbstract
Protein and peptide drugs administered subcutaneously, such as insulin can be amyloidogenic and result in localized amyloid deposits at the sites of medication injections. These iatrogenic amyloidoses typically present as a localized subcutaneous nodule or skin reaction at the site of administration, and often pose diagnostic challenges. We have analyzed the amyloid proteome in 52 cases of insulin and enfuvirtide associated amyloidosis using laser microdissection/tandem mass spectrometry. We show that the deposits are composed of the drug, as well as other amyloid precursor proteins such as apolipoproteins A-I, A-IV, E and serum amyloid protein. Mass spectrometry-based amyloid sub-typing allows for accurate amyloid diagnosis with resultant therapeutic and prognostic implications. This insight into the amyloid proteome in drug-induced amyloidosis may help further understand pathogenesis of amyloid fibril formation.
Author List
D'Souza A, Theis JD, Vrana JA, Dogan AAuthor
Anita D'Souza MD Associate Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Amyloid
Amyloidogenic Proteins
Amyloidosis
Apolipoprotein A-I
Female
HIV Envelope Protein gp41
Humans
Insulin
Male
Middle Aged
Peptide Fragments
Tandem Mass Spectrometry
