Is there a cure or treatment for amyloidosis?

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Is there a cure or treatment for amyloidosis?

Most forms of cardiac amyloidosis are treatable, but curing this condition isn’t always possible. The treatment also varies depending on the type of amyloidosis. In general, early detection is extremely important. Catching amyloidosis early can help long-term limit heart damage. Without early detection and treatment, permanent damage is possible. The only way to fix permanent heart damage is a heart transplant.

AL amyloidosis

AL amyloidosis treatment is similar to many common treatments for treating cancer. These include:

  • Chemotherapy. Similar to its use in cancer, chemotherapy can destroy the malfunctioning plasma cells.
  • Stem cell transplant. This treatment usually happens along with chemotherapy and replaces the malfunctioning plasma cells. The stem cells are usually autologous, meaning they come from you. Because they’re yours, your body already recognizes them and won’t reject or negatively react to them.
  • Immunotherapy. Your immune system can ordinarily recognize malfunctioning cells as hostile and destroy them. With diseases like cancer or AL amyloidosis, your immune system doesn’t recognize that those cells are faulty. Immunotherapy teaches your immune system to see the malfunctioning cells and destroy them.

ATTR amyloidosis

This type of amyloidosis happens because your liver is making proteins that break apart too easily. Treating this problem always involves putting a stop to that. The following list includes some methods that have government approval and some that are still experimental.

  • Liver transplant. In years past, the only way to stop your liver from making faulty proteins was a liver transplant. While this is no longer the only option, it’s still a helpful and effective one.
  • Genetic silencers. ATTR amyloidosis happens because of a genetic mutation in your DNA, much like a typo in a cookbook recipe. Genetic silencers are drugs that act as a temporary recipe card. Instead of your cells following the recipe with a typo, this medication gives them new instructions so they can make the protein correctly.
  • Stabilizers. These medications keep TTR molecules from misfolding or breaking apart.
  • Fibril inhibitors. When amyloid proteins start to clump together, they form fiber-like structures called fibrils. These medications stop fibrils from forming.

This type of amyloidosis happens because people who need dialysis have a buildup of β2M proteins. Normally, your kidneys filter out those proteins, but standard dialysis can’t do that. That’s why it takes years for people on dialysis to develop this condition. Currently, there are two ways to treat this:

  • Kidney transplant. A healthy kidney means you don’t need dialysis anymore, and a transplanted kidney can filter out excess β2M proteins. While a kidney transplant will stop dialysis-related amyloidosis from getting worse, there’s disagreement among researchers on whether or not it also reverses amyloid protein buildup in your body.
  • Special filters. While standard dialysis filters can’t remove β2M proteins, there are specialized filters that can at least partially remove them. Unfortunately, these filters are costly, and they don't filter out all of the proteins. That means that years of dialysis will eventually lead to dialysis-related amyloidosis even with preventive measures.

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