Proteomic analysis links urinary N-glycosylated light-chain sequences to renal amyloid deposits in AL amyloidosis, confirming that urinary proteoforms serve as precursors to kidney fibrils.
Systemic immunoglobulin light-chain (AL) amyloidosis is characterized by clonal immunoglobulin-secreting cells that produce a monoclonal light chain prone to misfolding and amyloid fibril formation in tissues. Understanding its molecular basis requires accurate full-length sequencing of amyloidogenic light chains and linkage of circulating light chains to renal deposits. Achieving this is technically challenging because the low abundance and N-glycosylation of amyloidogenic light chains can complicate protein purification and peptide-level sequence analysis. To address these challenges, we implemented a robust analytical pipeline that integrates intact-mass measurement by Q-TOF MS before and after deglycosylation with multi-protease digestion and de novo peptide sequencing to systematically characterize urinary N-glycosylated light chains. Mass shifts observed before and after deglycosylation supported the presence of N-glycosylation, whereas deglycosylated intact masses were used to constrain full-length sequence assembly. The assembled urinary light-chain sequences were subsequently compared with matched renal amyloid proteomes isolated by laser microdissection and analyzed by bottom-up liquid chromatography–tandem mass spectrometry (LC–MS/MS). Enzymatic deglycosylation reduced glycan-induced spectral interference. Eight monoclonal light-chain sequences were assembled from urinary light chains, including five derived from the immunoglobulin kappa variable 1 ( IGKV1 ), two from the immunoglobulin lambda variable 2 ( IGLV2 ), and one from IGKV4 . The close agreement between theoretical and experimental intact masses confirmed the accuracy and completeness of sequence assembly. In each renal amyloid proteome, the corresponding urine-derived sequence had the highest score among light-chain identifications of the patient's clinically determined isotype (κ or λ) and showed 87.6–100% variable-region peptide coverage. Together, these findings support urinary N-glycosylated monoclonal light chains as the precursor proteins of the corresponding renal amyloid fibrils. In conclusion, we have demonstrated a robust workflow that applies established de novo peptide sequencing to characterize urinary N-glycosylated light chains and trace the corresponding sequences in renal amyloid deposits, with potential applications across light chain-related diseases.
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Zhu et al. (2026) studied this question.
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