title: Amyloid neuropathies.
abstract: OBJECTIVE
  As amyloid neuropathies have benefited from recent major progress, this review is timely and relevant.
  
  
  RESULTS
  The main recent articles on amyloid neuropathy cover its description, methods for diagnosis and therapies. Varied clinical presentations are described in transthyretin (TTR)-familial amyloidosis with polyneuropathy (FAP) and light chain amyloid neuropathy. Mass spectrometry is able to identify the biochemical nature of amyloidogenic protein in nerve biopsy and skin biopsy samples for diagnosis of small fiber polyneuropathy. Both nerve biopsy and TTR gene sequencing are important to identify sporadic cases of amyloid neuropathy. Nerve biopsy is useful in demonstrating the amyloid origin of neuropathies developing after domino liver transplant recipients. Liver transplantation improves long-term survival in Met30 TTR-FAP. Factors recognized as leading to cardiomyopathy progression or heart involvement after liver transplantation are late disease onset and fibril composition. Combined heart and liver transplantation is recommended in severe restrictive cardiomyopathy. Antiamyloid drugs are emerging: tafamidis, a TTR stabilizer, showed in a phase III controlled study its ability to slow stage 1 FAP progression. Other strategies are emerging for TTR-FAP (combination doxycycline-tauroursodeoxycholic acid, small interfering RNA, antisense oligonucleotide, monoclonal antibody antiserum amyloid P component). For light chain neuropathy, intensive chemotherapy may be helpful.
  
  
  CONCLUSIONS
  There is better recognition of amyloid neuropathies, and hope for enrolling patients with FAP in future clinical trials testing new antiamyloid drugs.
authors.affiliation: Department of Neurology, APHP, U788 Inserm, Univ Paris Sud, Le Kremlin-Bicêtre, France. david.adams@bct.aphp.fr
authors.forename: David
authors.initials: D
authors.lastname: Adams
authors.forename: Pierre
authors.initials: P
authors.lastname: Lozeron
authors.forename: Catherine
authors.initials: C
authors.lastname: Lacroix
mesh_terms: D017772:Amyloid Neuropathies / Q000175:diagnosis / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D028226:Amyloidosis, Familial / Q000175:diagnosis / Q000235:genetics / Q000473:pathology; D000818:Animals; D019353:Endemic Diseases; D006801:Humans; D016031:Liver Transplantation; D011228:Prealbumin / Q000187:drug effects / Q000378:metabolism / Q000502:physiology
chemical_list: D011228:Prealbumin