Amyloid seeding of transthyretin by ex vivo cardiac fibrils and its inhibition

Lorena Saelices, Kevin Chung, Ji H. Lee, Whitaker Cohn, Julian P. Whitelegge, Merrill D. Benson, David S. Eisenberg

Research output: Contribution to journalArticlepeer-review

53 Scopus citations


Each of the 30 human amyloid diseases is associated with the aggregation of a particular precursor protein into amyloid fibrils. In transthyretin amyloidosis (ATTR), mutant or wild-type forms of the serum carrier protein transthyretin (TTR), synthesized and secreted by the liver, convert to amyloid fibrils deposited in the heart and other organs. The current standard of care for hereditary ATTR is liver transplantation, which replaces the mutant TTR gene with the wild-type gene. However, the procedure is often followed by cardiac deposition of wild-type TTR secreted by the new liver. Here we find that amyloid fibrils extracted from autopsied and explanted hearts of ATTR patients robustly seed wild-type TTR into amyloid fibrils in vitro. Cardiac-derived ATTR seeds can accelerate fibril formation of wild-type and monomeric TTR at acidic pH and under physiological conditions, respectively. We show that this seeding is inhibited by peptides designed to complement structures of TTR fibrils. These inhibitors cap fibril growth, suggesting an approach for halting progression of ATTR.

Original languageEnglish (US)
Pages (from-to)E6741-E6750
JournalProceedings of the National Academy of Sciences of the United States of America
Issue number29
StatePublished - Jul 17 2018
Externally publishedYes


  • Amyloid
  • Amyloidosis
  • Cardiomyopathy
  • Seeding
  • Transthyretin

ASJC Scopus subject areas

  • General


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