Current State Of Monoclonal Antibody Therapy for Transthyretin Amyloidosis

The disease of transthyretin (TTR) amyloidosis (ATTR) has been known since the 1960s, and during these past 60 or so years, there has been a sustained peri-od of steady discoveries that have led to the current model of ATTR pathogene-sis. More recent research has achieved major advances in both diagnostics and therapeutics for ATTR, which are having a significant impact on ATTR patients today. Aiding these recent achievements has been the remarkable ability of cryo-electron microscopy (EM) to determine high-resolution structures of amy-loid fibrils obtained from individual patients. Here, we will examine cryo-EM structures of transthyretin amyloid fibrils to explore the structural basis of re-cent monoclonal antibody therapies for ATTR, including ALXN-2220 and Co-ramitug; as well as to point out potential applications of this approach to other systemic amyloid diseases.