Amyloid Fibril Typing - Histology and Proteomic Analysis

Accurate identification of the amyloid fibril protein is the critical first step in the diagnostic pathway for any patient with amyloidosis.

Key Staff

The Jack O’Neill Amyloidosis Laboratory at the NAC provides a comprehensive clinical diagnostic fibril typing service for amyloid. It is a UKAS accredited medical laboratory, No. 9878. (list of accredited services can be viewed via the UKAS website: https://www.ukas.com/download-schedule/9878/Medical )

Amyloid histology we perform H&E and Congo red staining to confirm amyloid deposition. Amyloid fibril typing is undertaken with a panel of specialised antibodies to a variety of amyloid fibril proteins using immunohistochemical methods optimised for amyloid fibril typing.  In cases where the immunohistochemistry is not decisive, or additional information is considered useful for clinical or diagnostic purposes, samples are further analysed by laser capturing the amyloid deposits (LCDMS) and subjecting them to mass spectrometry and proteomic analysis; a sophisticated and highly accurate approach to determine the amyloid fibril type.

Changes to methods 

The performance of our methods is under constant review to ensure that we continue to provide a high-quality service. Occasionally we will change our method as part of the quality improvement. When we change methods, details of the change will be made on the patient reports. 

Also, our users may be notified via email, multidisciplinary team meetings or in a letter depending on the change.

For any questions regarding histology or or the fibril typing service at the NAC please contact Janet Gilbertson tel +44 (0)20 7433 2752.

Any clinical advice about amyloid typing must be discussed with one of our consultant staff on tel +44 (0)20 7433 2811 or by email to: Professor Julian Gillmore,  Professor Helen Lachmann or Professor Ashutosh Wechalekar.