The Process of Amyloid Formation due to Monoclonal Immunoglobulins

Hematol Oncol Clin North Am. 2020 Dec;34(6):1041-1054. doi: 10.1016/j.hoc.2020.07.003. Epub 2020 Sep 12.

Abstract

Monoclonal antibodies secreted by clonally expanded plasma cells can form a range of pathologic aggregates including amyloid fibrils. The enormous diversity in the sequences of the involved light chains may be responsible for complexity of the disease. Nevertheless, important common features have been recognized. Two recent high-resolution structures of light chain fibrils show related but distinct conformations. The native structure of the light chains is lost when they are incorporated into the amyloid fibrils. The authors discuss the processes that lead to aggregation and describe how existing and emerging therapies aim to prevent aggregation or remove amyloid fibrils from tissues.

Keywords: Amyloid fibrils; Amyloidosis; Antibody; Cross-beta; Protein aggregation.

Publication types

  • Review

MeSH terms

  • Amyloid / metabolism*
  • Antibodies, Monoclonal / metabolism*
  • Humans
  • Immunoglobulin Light Chains / metabolism*
  • Immunoglobulin Light-chain Amyloidosis / metabolism*
  • Immunoglobulin Light-chain Amyloidosis / pathology
  • Plasma Cells / metabolism*
  • Plasma Cells / pathology

Substances

  • Amyloid
  • Antibodies, Monoclonal
  • Immunoglobulin Light Chains