Transthyretin (TTR or TBPA) is a transport protein in the plasma and cerebrospinal fluid that transports the thyroid hormone thyroxine (T4) and retinol to the liver. This is how transthyretin gained its name: transports thyroxine and retinol. The liver secretes TTR into the blood, and the choroid plexus secretes TTR into the cerebrospinal fluid. TTR was originally called prealbumin (or thyroxine-binding prealbumin) because it migrated faster than albumin on electrophoresis gels. Prealbumin was felt to be a misleading name, it is not a synthetic precursor of albumin. The alternative name TTR was proposed by DeWitt Goodman in 1981. Human transthyretrin protein is encoded by the TTR gene, which is located on the long arm of chromosome 18, in cytogenetic band 18q12.1.
Background References
1. Ranasinghe RN et al. Prealbumin: The clinical utility and analytical methodologies. Ann Clin Biochem. 2022 Jan
2. Yu Q et al. Serum prealbumin as a predictor of adverse outcomes in patients with heart failure: a systematic review and meta-analysis. Biomark Med. 2022 May
Sequence Similarity
Belongs to the transthyretin family.
Tissue Specificity
Detected in serum and cerebrospinal fluid (at protein level). Highly expressed in choroid plexus epithelial cells. Detected in retina pigment epithelium and liver.
Post-translational Modification
Not glycosylated under normal conditions. Following unfolding, caused for example by variant AMYL-TTR 'Gly-38', the cryptic Asn-118 site is exposed and glycosylated by STT3B-containing OST complex, leading to its degradation by the ER-associated degradation (ERAD) pathway.