Genetic analysis of familial amyloidotic polyneuropathy, an autosomal dominant disease

Familial amyloidotic polyneuropathy (FAP) is an autosomal dominant genetic disease, and the major component of the amyloid fibrils from FAP patients was shown to be variants of transthyretin (TTR) with single amino acid substitutions. The nucleotide sequence analysis of the TTR cDNA and its corresponding gene enabled us to detect the base substitutions responsible for the variant TTR by conventional Southern blotting or polymerase chain reaction (PCR) method and allowed us to screen a number of FAP families in Japan. Among seven TTR variants related to FAP, all the FAP patients tested in Japan had the particular 30 Val → Met mutation. Haplotype analysis revealed that the Val → Met mutation has recurred frequently in the population to generate the FAP families of independent origins. Although the primary cause of FAP has become clear, extensive screening of FAP families revealed that there existed late onset cases and also patients with atypical symptoms in FAP families with the Val → Met mutation, suggesting that the expression of FAP is a complex process and affected by some (unknown) factors other than TTR.