Amini Pishro, A.; Zhang, S.; Zhang, Z.; Zhao, Y.; Amini Pishro, M.; Zhang, L.; Yang, Q.; Postel, V. Structural Behavior of FRP-Retrofitted RC Beams under Combined Torsion and Bending. Materials 2022, 15, 3213.
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Amini Pishro, Ahad, Shiquan Zhang, Zhengrui Zhang, Yana Zhao, Mojdeh Amini Pishro, Lili Zhang, Qihong Yang, and Victor Postel. 2022. "Structural Behavior of FRP-Retrofitted RC Beams under Combined Torsion and Bending" Materials 15, no. 9: 3213.
Once amyloid has been identified, further characterization and typing must be performed. Direct immunofluorescence microscopy, which is routinely performed on native kidney biopsies, is one of the most common and convenient methods of amyloid typing and should be the first step. It is most useful in cases of amyloid composed of immunoglobulin components where antibodies are widely available. AL and/or AH amyloid can be typed by immunofluorescence using FITC-labeled antibodies to IgA, IgM, IgG, κ, and λ light chain. For AL amyloidosis, only one of the immunoglobulin light chains should stain positive in the amyloid deposits. For AH amyloidosis, the deposits will stain positive for a single subclass of immunoglobulin heavy chain without light chain, whereas a single light chain will also stain in ALH. Standard immunofluorescence is performed on fresh frozen tissue. In the absence of frozen tissue, immunofluorescence can be performed with pronase-digested paraffin-embedded tissue. Determining the immunoglobulin component involved in amyloidogenesis identifies the target of therapy. Recent studies found that reduction of the involved free light chain is more important than the intact immunoglobulin for patients with AL amyloidosis.53 An alternative method is immunohistochemistry using immunoperoxidase staining of formalin-fixed, paraffin-embedded tissue. This works well for AL, AH, AA, AFib, ATTR, AApoA1, and AB2m where antibodies are available commercially. Immunohistochemistry can also aid in the diagnosis of amyloidosis. Antibodies against serum amyloid P (SAP), which codeposits with amyloid, can be used to distinguish light chain deposits of AL amyloidosis from monoclonal immunoglobulin deposition disease. Immunofluorescence is superior to immunohistochemistry for the accurate typing of AL or AH amyloidosis because of the lower background staining in the former. Because frozen tissue is not usually available in nonrenal samples, immunohistochemistry, not immunofluorescence, is typically performed on these samples. 2ff7e9595c
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