Review Article

Proteomics in Molecular Diagnosis: Typing of Amyloidosis

Table 2

Summary of recent reports on the use of proteomics techniques for amyloidosis typing. Studies are grouped according to broad methodological categories.

InvestigatorsSample typeProteomics techniquesOutcome

Immuno affinity MS
Advantages: Identify mutations on
 known amyloid proteins.
Disadvantages: Only applicable to
 known amyloid proteins; Require
 antibody of high specificity;
 Mutation may destroy antigenic
 epitope, leading to reduction of
 antibody binding; Amyloid proteins
 may deposit in tissues leading to low
 serum levels; Not as efficient as
 DNA sequencing.
Tachibana et al. [29]SerumImmunoprecipitation, MALDI-TOFSpectral pattern matching to genetic mutation
Sen et al. [44]Serum, cerebrospinal fluidOn-line immunoaffinity capture, ESI-MSInformations on relative abundance of protein isoforms, requires specific antibodies
Bergen et al. [28, 45]SerumAutomated-online affinity purification, ESI-MSClinical assay to detect transthyretin mutations
Nepomuceno et al. [46]SerumImmunoprecipitation, Fourier-transform ion-cyclotron-resonance MSAble to detect 91% of known transthyretin mutations due to high mass accuracy
Lavatelli et al. [47]SerumImmunopurification, SDS-PAGE or 2DE, MSCan detect posttranslational modifications

Antibody-free serum or tissue extract analysis
Advantages: Identify mutations on
 known amyloid proteins; Measure
 relative abundance of mutant to
 wide type proteins.
Disadvantages: Only applicable to
 known amyloid protein.
Kishikawa et al. [48]SerumMultidimensional liquid chromatography, ESI-MSApplied to serum samples without requiring specific antibodies
da Costa et al. [49]SerumSDS-PAGE fractionation, MALDI-Fourier transform ion cyclotron resonance MSQuantitation of mutant to wild type transthyretin
Ueda et al. [50]Tissue and serumHPLC separation, SELDI-TOFQuantitation of mutant to wild type transthyretin within 3 hours
Lavatelli et al. [25]Fine needle aspiration of abdominal adipose tissue2DE, PMF by MALDI-TOFIdentification of amyloidogenic proteins

Direct extraction from FFPE samples
Advantages: Identify unknown
 amyloid proteins in tissue sections
 or fat aspirates.
Disadvantages: Protein extraction
 requires days.  
Murphy et al. [11]FFPEHPLC purification, N-terminal sequencing, PMFSuccessful identification
Murphy et al. [51]FFPEHPLC, MS/MS de novo sequencingSuccessful identification

LMD with LC-MS/MS
Advantages: Capture specific regions
 of interest: amyloid deposits from
 FFPE sections; Identify unknown
 amyloid proteins in tissue sections;
 Protein extraction within hours.
Disadvantages: Requires specialist
 LMD equipment and expertise.
Rodrigues et al. [52]FFPE of immunoglobulin deposits in nerve tissueLMD, LC-MS/MSSuccessful identification
Vrana et al. [55]FFPE samples of four amyloid types, 50 cases in training set, 41 cases in validation setLMD, LC-MS/MS, algorithm to assign amyloid type according to highest number of spectra>98% specificity and sensitivity for the 4 amyloid types examined
Klein et al. [53]FFPE of various amyloid types in nerve tissueLMD, LC-MS/MSSuccessful identification of all 21 cases including transthyretin mutations
Sethi et al. [54]FFPE of immunoglobulin renal depositsLMD, LC-MS/MSSuccessful identification

MS Imaging
Advantages: Detecting amyloids in
 situ, allowing correlation to
 deposits; No extraction steps.
Disadvantages: Specialist MS
 imaging software and expertise
 required.
Stoeckli et al. [58]Frozen tissueMSILocalization of amyloid β peptides in mouse brain sections
Seely and Caprioli [59]One 100 year old amyloid FFPE sampleIn-situ tryptic digest and imaging MALDI-MS/MSSuccessful identification of serum amyloid A