Living with the enemy: from protein-misfolding pathologies we know, to those we want to know
Abdul‐Hamid Emwas, Mawadda Alghrably, Manel Dhahri, Abeer A. Sharfalddin, Rawiah Alsiary, Mariusz Jaremko, Gavino Faa, Marcello Campagna, Terenzio Congiu, Monica Piras, Marco Piludu, Giuseppina Pichiri, Pierpaolo Coni, Joanna Izabela Lachowicz
Abstract
Conformational diseases are caused by the aggregation of misfolded proteins. The risk for such pathologies develops years before clinical symptoms appear, and is higher in people with alpha-1 antitrypsin (AAT) polymorphisms. Thousands of people with alpha-1 antitrypsin deficiency (AATD) are underdiagnosed. Enemy-aggregating proteins may reside in these underdiagnosed AATD patients for many years before a pathology for AATD fully develops. In this perspective review, we hypothesize that the AAT protein could exert a new and previously unconsidered biological effect as an endogenous metal ion chelator that plays a significant role in essential metal ion homeostasis. In this respect, AAT polymorphism may cause an imbalance of metal ions, which could be correlated with the aggregation of amylin, tau, amyloid beta, and alpha synuclein proteins in type 2 diabetes mellitus (T2DM), Alzheimer's and Parkinson's diseases, respectively.