Biotechnologically engineered protein binders for applications in amyloid diseases

• We explain strategies to generate proteinaceous binders with affinity for different types of amyloid.
• We describe their specificities and underlying recognition mechanisms.
• The different modifications of amyloid-binders to facilitate detection and diagnosis are summarized.
• Inhibitory mechanisms and resulting therapeutic perspectives are outlined.

The aberrant self-assembly of polypeptide chains into amyloid structures is a common phenomenon in several neurodegenerative diseases, systemic amyloidosis, and ‘normal’ aging. Improvements in laboratory-scale detection of these structures, their clinical diagnosis, and the treatment of disease likely depend on the advent of new molecules that recognize particular states or induce their clearance in vivo. This review will describe what biotechnology can do to generate proteinaceous amyloid-binders, explain their molecular recognition mechanisms, and summarize possibilities to functionalize further these ligands for specific applications.