@article{oai:niigata-u.repo.nii.ac.jp:00006580,
 author = {Floege, J. and Koch, K. M. and Shaldon, S.},
 journal = {Acta medica et biologica, Acta medica et biologica},
 month = {Mar},
 note = {AB-amyloidosis, characterized by the presence of β_2-microglobulin in the amyloid fibrils, has become a major complication of long-term therapy in chronic hemodialysis or peritoneal dialysis patients. The pathogenesis of AB-amyloidosis is incompletely understood, but most likely is based on the uremic retention of β_2-microglobulin. In addition, posttranslational modification of the molecule also seems to be an important step in the amyloidogenesis, since in addition to intact β_2-microglobulin, fragmented β_2-microglobulin or β_2-microglobulin with altered isoelectric properties can be detected in the AB-amyloid fibrils. The occurence of these β_2-microglobulin species could be linked to a chronic intermittent stimulation of monokine release or other subclinical inflammatory processes during renal replacement therapy. Thus, it is possible that, as a consequence of repeated cellular activation, subsequent protease release and/or intracellular processing of β_2-microglobulin occurs. Renal transplantation, though effective in preventing dialysis associated amyloidosis or arresting its progress, does not help to dsistinguish between the relative importance of retention of β_2-microglobulin or inflammatory events. Retrospective studies on AB-amyloid related symptomatology in patients on chronic hemodialysis with synthetic highflux membranes have suggested a lesser prevalence in these patients as compared to patients chronically treated with standard cellulosic membranes. However, a possible benefical effect of chronic treatment with synthetic membranes also might be of multifactorial orgin. To further evaluate this issue and to test whether non-transplant therapies indeed may play a role in the prevention of AB-amyloidosis, prospective studies will be needed. Recently introduced non-invasive scanning methods, employing radiolabelled β_2-microglobulin or amyloid P component, may provide an objective, sensitive and specific basis for such studies.},
 pages = {67--73},
 title = {AB-Amyloidosis and Monokines},
 volume = {39(Supplement)},
 year = {1991}
}