Modern aspects of classification, pathogenesis and morphological diagnostics of amyloidosis (literature review)

Abstract

In clinical practice, amyloidosis is classified as a disease caused by extracellular accumulation of amyloid, which was initially considered a purely pathological phenomenon. It is now known that the fibrillar structure typical of amyloid has been identified in some hormones and proteins, which are identified as "functional amyloid." In medicine, amyloid retains its status as a pathological substance, the infiltration of which into body tissues leads to cell dysfunction and death. Analysis of studies on amyloidosis has revealed new variants of amyloid fibrils that determine the nature of amyloid deposits, which is reflected in modern classifications of amyloidosis. New concepts of amyloidosis pathogenesis have been formulated: the theory of dysproteinosis and local cellular synthesis, immunological and mutational theories, but each of these theories only partially explains the mechanism of amyloid's damaging effects. Suspicious amyloid deposits require not only morphological confirmation of the presence of amyloid in tissues, but also verification of the type of amyloid to specify treatment tactics and analyze its prospects.