Sensitive and rapid assessment of amyloid by oligothiophene fluorescence in subcutaneous fat tissue

Daniel Sjolander, Johan Bijzet, Bouke P. Hazenberg, Peter R. Nilsson, Per Hammarstrom*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

25 Citations (Scopus)
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Abstract

Systemic amyloidosis (SA) is often diagnosed late. Combining clinical and biochemical biomarkers is necessary for raising suspicion of disease. Fine needle aspiration (FNA) of subcutaneous fat enables SA detection by Congo red staining. The luminescent conjugated probe heptameric formic thiophene acetic acid (h-FTAA) is a sensitive alternative to Congo red-staining of tissue samples. Our objective was to compare h-FTAA fluorescence with the Congo red stain for amyloid detection in FNA-obtained fat tissue. Herein, we studied samples from 57 patients with established SA (19 with AA, 20 with AL, and 18 with ATTR) and 17 age-matched controls (34-75 years). Positivity for h-FTAA was graded according to a Congo red-based grading scale ranging from 0 to 4+. Amyloid grading by both methods correlated strongly (r = 0.87). Here h-FTAA was positive in 53 of 54 Congo red-positive cases (sensitivity 98%) and h-FTAA was negative in 7 of 17 Congo red-negative controls (specificity 41%), but was also positive for 3 Congo red-negative SA cases. We conclude that h-FTAA fluorescence is more sensitive than Congo red staining in this small exploratory study of fat tissue samples, implicating potential sensitivity for prodromal amyloidosis, but is less specific for clinical amyloidosis defined by Congo red positivity. Given its simplicity h-FTAA staining may therefore be the most appropriate method for rapid screening of fat tissue samples but should presently treat grade 1+ as only suggestive, whereas 2+ or higher as positive for amyloidosis. Parallel assessment of h-FTAA and Congo red staining appears highly promising for clinical applications.

Original languageEnglish
Pages (from-to)19-25
Number of pages7
JournalAmyloid:International journal of experimental and clinical investigation
Volume22
Issue number1
DOIs
Publication statusPublished - Mar-2015

Keywords

  • AA amyloidosis
  • amyloid light chain
  • hyper spectral imaging
  • systemic amyloidosis
  • transthyretin
  • CONJUGATED POLYELECTROLYTES
  • SYSTEMIC AMYLOIDOSIS
  • OPTICAL PROBES
  • DEPOSITS
  • DISEASE

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