Apolipoprotein A-IV fibrils: structural diagnosis of mixed cardiac amyloidosis

Shintaro Aibara, Astrid Kassner, Edmond Wong, Karin Klingel, Monika Papworth, Magnus Althage, Qing-Dong Wang, Claudia Correia, Hendrik Milting () and Taiana Maia de Oliveira ()
Additional contact information
Shintaro Aibara: R&D
Astrid Kassner: Heart and Diabetes Center NRW
Edmond Wong: R&D
Karin Klingel: University Hospital Tübingen,Liebermeisterstr. 8
Monika Papworth: AstraZeneca
Magnus Althage: AstraZeneca
Qing-Dong Wang: AstraZeneca
Claudia Correia: AstraZeneca
Hendrik Milting: Heart and Diabetes Center NRW
Taiana Maia de Oliveira: R&D

Nature Communications, 2025, vol. 16, issue 1, 1-6

Abstract: Abstract Cardiac amyloidosis (CA) occurs when misfolded proteins deposit as fibrils in the extracellular space of the heart. The fibrillogenic properties of apolipoprotein A-IV (ApoAIV) have been histologically observed and associated with CA pathogenesis. We report the structure of an ApoAIV amyloid from a patient’s heart, which coexist amongst transthyretin (TTR) amyloids. These cases of undetected mixed CA highlight the importance of developing broad-spectrum anti-amyloid treatments to improve outcomes in patients.

Date: 2025
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DOI: 10.1038/s41467-025-64902-0

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