This site is intended only for healthcare professionals resident in India

Search

Menu

Close

Sign InLog Out
Our medicinesTherapy areasExplore ContentExplore content

  

EventsMaterialsVideosLet's connectPfizer medical informationOnConnect

Menu

Close

ATTR-CMATTR-CMATTR-CM HomeAbout ATTR-CMMechanism of DiseaseWild-Type ATTR-CMHereditary ATTR-CMSuspect ATTR-CMDetect ATTR-CMResourcesEventsMaterialsVideos
ATTR amyloidosis is due to the misfolding of the TTR protein1 TTR is a transport protein for the thyroid hormone T4 and is a retinol-binding protein.2
  • Produced mainly in the liver, there is also some production in the choroid plexus (brain) and the retinal epithelium (eye)2
  • The TTR protein plays an important role in the body. The long-term impact of TTR reduction in humans is unknown2,3
  • The complete absence of TTR in humans has not been reported2
The physiologic role of TTR is not fully defined, but the growing body of evidence suggests that TTR has additional important functions.2
Biological functions of TTR from mouse and human studies2,*
Other important functions of TTR that are independent of protein transport include the following:

Neuroprotective effects have been shown in both the PNS and the CNS in both animal and clinical studies2

Protection against neurodegeneration and Alzheimer disease in a mouse model2

 The pathogenesis of ATTR amyloidosis is caused by the destabilisation, not the production, of TTR protein tetramers2

In ATTR-CM, a TTR gene mutation or age-related changes destabilise the protein tetramers, which separate into monomers and then misfold and aggregate into amyloid fibrils that deposit in the heart and other organs over time.2,4

 Fibrils can deposit in multiple areas5

Because amyloid fibrils can deposit in different parts of the body, including the heart and nerves, some patients may present with a mixed phenotype, namely, symptoms of both cardiomyopathy and polyneuropathy.2,5

Suspicion of cardiac involvement should prompt an immediate cardiac evaluation to rule out ATTR-CM.6

Review the mechanism of disease brochure
 Download now  Loading Wild-Type ATTR-CM > Loading*Human and mouse TTR share 80% similarity at the amino acid level, so it may be expected that insights into the physiologic function of human TTR could be gained through the generation of TTR knockout mice.2

ATTR, transthyretin amyloidosis; ATTR-CM, transthyretin amyloid cardiomyopathy; CNS, central nervous system; PNS, peripheral nervous system; T4, thyroxine; TTR, transthyretin.
 
  ReferencesCoelho T, Ericzon B, Falk R, et al. A guide to transthyretin amyloidosis. Amyloidosis Foundation. 2018. Accessed June 02, 2023. https://amyloidosis.org/sites/default/files/pdf-docs/pages/resources/2023-03/2018%20ATTR.pdfLiz MA, Coelho T, Bellotti V, Fernandez-Arias MI, Mallaina P, Obici L. A narrative review of the role of transthyretin in health and disease. Neurol Ther. 2020;9(2):395-402. doi:10.1007/s40120-020-00217-0Adams D, Ando Y, Beirão JM, et al. Expert consensus recommendations to improve diagnosis of ATTR amyloidosis with polyneuropathy. J Neurol. 2021;268(6):2109-2122. doi:10.1007/s00415-019-09688-0Ruberg FL, Berk JL. Transthyretin (TTR) cardiac amyloidosis. Circulation. 2012;126(10):1286-1300. doi:10.1161/CIRCULATIONAHA.111.078915Maurer MS, Bokhari S, Damy T, et al. Expert consensus recommendations for the suspicion and diagnosis of transthyretin cardiac amyloidosis. Circ Heart Fail. 2019;12(9):e006075. doi:10.1161/CIRCHEARTFAILURE.119.006075Garcia-Pavia P, Rapezzi C, Adler Y, et al. Diagnosis and treatment of cardiac amyloidosis: a position statement of the ESC Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2021;42(16):1554-1568. doi:10.1093/eurheartj/ehab072Dorbala S, Ando Y, Bokhari S, et al. ASNC/AHA/ASE/EANM/HFSA/ISA/SCMR/SNMMI expert consensus recommendations for multimodality imaging in cardiac amyloidosis: part 1 of 2 – evidence base and standardized methods of imaging. J Nucl Cardiol. 2019;26(6):2065-2123. doi:10.1007/s12350-019-01760-6. Addendum: J Nucl Cardiol. Published online July 1, 2021. doi:10.1007/s12350-020-02455-zATTR-CM Discover more about ATTR-CM Which imaging modalities help raise the suspicion of ATTR-CM?

Gain a deeper understanding of echo and CMR.

 See the tools  LoadingDetect ATTR-CM noninvasively with nuclear scintigraphy7

Review the evidence and consensus recommendations for diagnosis.

 Learn more  Loading
PP-UNP-IND-0084 13 March 2023
Contact Center for Health Care Professionals | Monday to Saturday 9:00 AM to 6:00 PM IST(exlcuding public holidays)

0008000503188

PfizerPro AccountPfizerPro Account

To access further materials, resources and receive communication about medicines and vaccines promoted by Pfizer.

Sign in or RegisterSign inRegisterAccountSign OutThese pages are not intended for patients or for members of the general public. The web pages contain promotional content. For the use only of Registered Medical Practitioners or a Hospital or a Laboratory. Full prescribing information available on request. For more details on, Who is a Registered Medical Practitioner, please visit "https://cdsco.gov.in/opencms/export/sites/CDSCO_WEB/Pdf-documents/acts_rules/2016DrugsandCosmeticsAct1940Rules1945.pdf", Page No. 39, Rule 2 part (ee), last accessed on 26th April2021.

Address: The Capital,  A Wing, 1802, 18th Floor, Plot No. C-70, ‘G’ Block, Bandra Kurla Complex, Bandra East, Mumbai – 400051, India.
PP-UNP-IND-0084

Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua.

Heading

Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua.

ButtonButton

Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Hac habitasse platea dictumst quisque sagittis purus sit amet volutpat. Lectus magna fringilla urna porttitor rhoncus. Venenatis urna cursus eget nunc scelerisque viverra. Id donec ultrices tincidunt arcu non sodales.

Sagittis aliquam malesuada bibendum arcu vitae elementum curabitur. Pellentesque elit ullamcorper dignissim cras tincidunt. Orci ac auctor augue mauris augue neque. Dui vivamus arcu felis bibendum ut tristique et egestas quis. Sed vulputate mi sit amet mauris commodo.

Nunc eget lorem dolor sed viverra ipsum. Sed ullamcorper morbi tincidunt ornare.

Copyright © 2024 Pfizer Limited, India. All rights reserved. Applicable for Pfizer Products, Product Microsites and Therapy Areas section of the website:
  • All content published herein is intended and strictly only for informational, educational, academic and/or research purposes and shall not be utilized to diagnose or treat a health problem or disease without referring to the full prescribing information for list of approved indications as contained in the product package insert
  • While due care and caution has been taken to ensure that the content herein is free from mistakes or omissions, Pfizer makes no claims, promises or guarantees about the accuracy, completeness or adequacy of the information herein
For the use only of Registered medical practitioners* or a Hospital or a Laboratory

These pages are not intended for patients or for members of the general public. The web pages contain promotional content.

 

If you select 'No', you will be redirected to Pfizer.co.in

For more details on, Who is a Registered medical practitioner*, please visit "https://cdsco.gov.in/opencms/export/sites/CDSCO_WEB/Pdf-documents/acts_rules/2016DrugsandCosmeticsAct1940Rules1945.pdf", Page No. 39, Rule 2 part (ee), last accessed on 26th April 2021.
Address: The Capital, A Wing, 1802, 18th Floor, Plot No. C-70, 'G' Block, Bandra Kurla Complex, Bandra East, Mumbai - 400051.


PP-DOL-IND-0597  01 Mar 2024Yes No
You are now leaving PfizerPro website
​
​​​​​You are now leaving Pfizer Pro website and will be redirected to another website. Note that you will be governed by the Terms & Conditions and Privacy Policy of the external website. Would you like to continue?
PP-DOL-IND-0597  01 Mar 2024