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Pharmaceutical amyloidosis associated with subcutaneous insulin and enfuvirtide administration. Amyloid 2014 Jun;21(2):71-5

Date

01/23/2014

Pubmed ID

24446896

Pubmed Central ID

PMC4021035

DOI

10.3109/13506129.2013.876984

Scopus ID

2-s2.0-84900549760   38 Citations

Abstract

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 A

Author

Anita D'Souza MD Associate Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Aged
Amyloid
Amyloidogenic Proteins
Amyloidosis
Apolipoprotein A-I
Female
HIV Envelope Protein gp41
Humans
Insulin
Male
Middle Aged
Peptide Fragments
Tandem Mass Spectrometry
jenkins-FCD Prod-482 91ad8a360b6da540234915ea01ff80e38bfdb40a