TTR antibodies are immunoglobulins designed to bind conformational epitopes exposed in misfolded or aggregated TTR. Unlike normal tetrameric TTR, pathogenic forms (monomers, oligomers, or fibrils) expose cryptic regions such as residues 39–44, 89–97, or 115–124, which serve as antibody targets . Their primary functions include:
Fibrillization inhibition: Blocking TTR self-assembly into amyloid structures
Immune clearance: Promoting macrophage phagocytosis of TTR aggregates
Diagnostic utility: Detecting circulating misfolded TTR for disease monitoring
RT24: Reduced TTR deposits by 60–75% in FAP model rats after 6-month administration, with no adverse effects on liver or renal function . Demonstrated fibril inhibition at 1:100 antibody:TTR molar ratio .
NI006: Showed nanomolar affinity for TTR fibrils (>100x selectivity over tetramers) in competitive ELISA . Enhanced macrophage uptake by 3.8-fold compared to controls .
PRX004: Inhibited fibril formation at substoichiometric concentrations (10 nM antibody vs. 1 μM TTR) .
Diagnostic potential: Anti-TTR (39–44) antibodies detected amyloidogenic TTR in 92% of ATTRv patients vs. 0% in controls .
Cardiac amyloidosis: A monoclonal antibody reduced cardiac pyrophosphate signals by 40% in wild-type ATTR models, improving ejection fraction by 12% .
ELISA-based detection:
Plasma biomarker quantification: Aggregated TTR levels correlate with disease progression (r=0.78, p<0.01)
Current limitations include epitope heterogeneity across TTR variants and blood-brain barrier penetration for CNS targets. Next-generation antibodies are exploring:
Transthyretin (TTR), also known as prealbumin, is a protein primarily synthesized in the liver and choroid plexus of the brain. It functions as a transport protein for thyroxine (T4) and retinol (vitamin A) by forming a complex with retinol-binding protein . TTR is a homo-tetrameric protein, meaning it consists of four identical subunits .
TTR plays a crucial role in the transport of thyroid hormones and vitamin A, which are essential for various physiological processes, including metabolism, growth, and development . Additionally, TTR is involved in other intracellular processes such as proteolysis, nerve regeneration, autophagy, and glucose homeostasis .
Mouse anti-human transthyretin antibodies are used in several scientific applications, including: