![Sample our Bioscience journals, sign in here to start your access, Latest two full volumes FREE to you for 14 days]({"type":"image" , "src" : "/sda/5925/TOC-Subject-Sample-2021-Bioscience.jpg"})
Abstract
Dialysis related amyloidosis (DRA) is a major complication of long term hemodialysis therapy. It is well recognized that scintigraphic study using radioisotope-labeled β2microglobulin (β2M) as a tracer is a sensitive and specific technique to diagnose DRA non-invasively. The aim of this study is to clarify the mechanism of 131I-β2M accumulation around the amyloid tissue. Three dialysis patients with carpal tunnel syndromes were examined for consecutive 131I-β2M scintigraphies every 24 hours for 3 days till the carpal tunnel synovectomy. Removed synovial tissues were processed for histological study. The scintigraphic study demonstrated tracer accumulations in the joints involved with DRA and the intensity increased in a time dependent fashion. Microscopic observations revealed many inflammatory cells presenting CD68-monocytes/macrophages antigen infiltrated into the synovial tissues. 131I-β2M was evident in the cytoplasm of the infiltrating cells, while no radioactivity was detected above background in the amyloid tissues. In conclusion, the tracer accumulations observed in the 131I-β2M scintigraphic studies were the consequence of circulating β2M assimilated by the infiltrating monocytes/macrophages. Thus, the undetermined elimination pathway of circulating β2M in the dialysis patients was identified as the storage pool in those inflammatory cells. The inflammatory change may play a crucial role in the local progression of DRA through the accumulation of circulating β2M around the established amyloid tissues.