Characterization of AL amyloid protein identified by immunoelectron microscopy: a simple method using the protein A-gold technique.

The classification of amyloidosis depends on the chemical nature of the specific amyloid protein involved. Because AL amyloid protein consists mainly of variable regions of light chain (LC), immunohistochemical staining with conventional anti-LC antisera cannot identify its protein. We were able to classify three cases of AL amyloidosis, including one case of AL-kappa LC and two cases of AL-lambda LC, using post-embedding protein A-gold immunoelectron microscopy on autopsy-derived tissues. We describe here our procedure in which a protein A-gold staining apparatus was used. The main advantage of this method is that many sections can be stained and washed simultaneously under the same conditions. These results suggest that the post-embedding protein A-gold technique using conventional kappa or lambda LC may be useful in diagnosing AL amyloidosis.