Hello, this disease includes different types of amyloidosis for the invasion of the heart, so its etiology also includes different types of related causes.
As a result of the proliferation and malignant transformation of single plasma cell, the proportion of heavy and light chain synthesis is unbalanced, resulting in excessive light chain, mostly type lambda light chain, which exceeds the catabolic capacity of macrophages and forms amyloid protein fibers. The mechanism of myeloma-associated amyloid protein is basically the same.
Antigen stimulation of various primary diseases activates macrophages. Under the action of interleukin-1, hepatocytes produce a large number of serum AA (SAA) proteins, which cause macrophage dysfunction and can not degrade them completely, resulting in the formation of insoluble AA proteins. Family heredity is represented by Mediterranean fever, and the mechanism of AA protein in amyloid fibers is similar.
In some cases, plasma cell infiltration was common in the lesions. Histochemical analysis showed that amyloid fibers were AL, so the mechanism was similar to that of the original. In some cases, the hormones secreted by the endocrine glands, such as amyloid fibers of medullary thyroid carcinoma, are mainly procalcitonin. The mechanism of the limitation of amyloid deposition remains unclear.
Prealbumin was isolated from the myocardium of some cases. It is not produced by cardiac myocytes. It is presumed that the precursors of cardiac myocytes are formed in extracardiac tissues and deposited in lesions through circulation. In some cases, atrial natriuretic peptide (ANP) was isolated and produced mainly from atrial myocytes.
5. Relevance of hemodialysis
In hemodialysis patients, long-term use of copper-like membrane or acetate fiber membrane can not precipitate beta-2 microglobulin, so that a large number of deposits in the body, which provides conditions for the formation of amyloid fibers.