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Gaire BP, Koronyo Y, Fuchs DT, Shi H, Rentsendorj A, Danziger R, Vit JP, Mirzaei N, Doustar J, Sheyn J, Hampel H, Vergallo A, Davis MR, Jallow O, Baldacci F, Verdooner SR, Barron E, Mirzaei M, Gupta VK, Graham SL, Tayebi M, Carare RO, Sadun AA, Miller CA, Dumitrascu OM, Lahiri S, Gao L, Black KL, Koronyo-Hamaoui M. Alzheimer's disease pathophysiology in the Retina. Prog Retin Eye Res 2024; 101:101273. [PMID: 38759947 PMCID: PMC11285518 DOI: 10.1016/j.preteyeres.2024.101273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 04/23/2024] [Accepted: 05/10/2024] [Indexed: 05/19/2024]
Abstract
The retina is an emerging CNS target for potential noninvasive diagnosis and tracking of Alzheimer's disease (AD). Studies have identified the pathological hallmarks of AD, including amyloid β-protein (Aβ) deposits and abnormal tau protein isoforms, in the retinas of AD patients and animal models. Moreover, structural and functional vascular abnormalities such as reduced blood flow, vascular Aβ deposition, and blood-retinal barrier damage, along with inflammation and neurodegeneration, have been described in retinas of patients with mild cognitive impairment and AD dementia. Histological, biochemical, and clinical studies have demonstrated that the nature and severity of AD pathologies in the retina and brain correspond. Proteomics analysis revealed a similar pattern of dysregulated proteins and biological pathways in the retina and brain of AD patients, with enhanced inflammatory and neurodegenerative processes, impaired oxidative-phosphorylation, and mitochondrial dysfunction. Notably, investigational imaging technologies can now detect AD-specific amyloid deposits, as well as vasculopathy and neurodegeneration in the retina of living AD patients, suggesting alterations at different disease stages and links to brain pathology. Current and exploratory ophthalmic imaging modalities, such as optical coherence tomography (OCT), OCT-angiography, confocal scanning laser ophthalmoscopy, and hyperspectral imaging, may offer promise in the clinical assessment of AD. However, further research is needed to deepen our understanding of AD's impact on the retina and its progression. To advance this field, future studies require replication in larger and diverse cohorts with confirmed AD biomarkers and standardized retinal imaging techniques. This will validate potential retinal biomarkers for AD, aiding in early screening and monitoring.
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Affiliation(s)
- Bhakta Prasad Gaire
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Yosef Koronyo
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Dieu-Trang Fuchs
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Haoshen Shi
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Altan Rentsendorj
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Ron Danziger
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jean-Philippe Vit
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Nazanin Mirzaei
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jonah Doustar
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Julia Sheyn
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Harald Hampel
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Andrea Vergallo
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Miyah R Davis
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Ousman Jallow
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Filippo Baldacci
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France; Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | | | - Ernesto Barron
- Department of Ophthalmology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA; Doheny Eye Institute, Los Angeles, CA, USA
| | - Mehdi Mirzaei
- Department of Clinical Medicine, Health and Human Sciences, Macquarie Medical School, Macquarie University, Sydney, NSW, Australia
| | - Vivek K Gupta
- Department of Clinical Medicine, Health and Human Sciences, Macquarie Medical School, Macquarie University, Sydney, NSW, Australia
| | - Stuart L Graham
- Department of Clinical Medicine, Health and Human Sciences, Macquarie Medical School, Macquarie University, Sydney, NSW, Australia; Department of Clinical Medicine, Macquarie University, Sydney, NSW, Australia
| | - Mourad Tayebi
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
| | - Roxana O Carare
- Department of Clinical Neuroanatomy, University of Southampton, Southampton, UK
| | - Alfredo A Sadun
- Department of Ophthalmology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA; Doheny Eye Institute, Los Angeles, CA, USA
| | - Carol A Miller
- Department of Pathology Program in Neuroscience, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Shouri Lahiri
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Liang Gao
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA
| | - Keith L Black
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Maya Koronyo-Hamaoui
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Biomedical Sciences, Division of Applied Cell Biology and Physiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
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2
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Hayden MR. Cerebral Microbleeds Associate with Brain Endothelial Cell Activation-Dysfunction and Blood-Brain Barrier Dysfunction/Disruption with Increased Risk of Hemorrhagic and Ischemic Stroke. Biomedicines 2024; 12:1463. [PMID: 39062035 PMCID: PMC11274519 DOI: 10.3390/biomedicines12071463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/25/2024] [Accepted: 06/27/2024] [Indexed: 07/28/2024] Open
Abstract
Globally, cerebral microbleeds (CMBs) are increasingly being viewed not only as a marker for cerebral small vessel disease (SVD) but also as having an increased risk for the development of stroke (hemorrhagic/ischemic) and aging-related dementia. Recently, brain endothelial cell activation and dysfunction and blood-brain barrier dysfunction and/or disruption have been shown to be associated with SVD, enlarged perivascular spaces, and the development and evolution of CMBs. CMBs are a known disorder of cerebral microvessels that are visualized as 3-5 mm, smooth, round, or oval, and hypointense (black) lesions seen only on T2*-weighted gradient recall echo or susceptibility-weighted sequences MRI images. CMBs are known to occur with high prevalence in community-dwelling older individuals. Since our current global population is the oldest recorded in history and is only expected to continue to grow, we can expect the healthcare burdens associated with CMBs to also grow. Increased numbers (≥10) of CMBs should raise a red flag regarding the increased risk of large symptomatic neurologic intracerebral hemorrhages. Importantly, CMBs are also currently regarded as markers of diffuse vascular and neurodegenerative brain damage. Herein author highlights that it is essential to learn as much as we can about CMB development, evolution, and their relation to impaired cognition, dementia, and the exacerbation of neurodegeneration.
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Affiliation(s)
- Melvin R Hayden
- Department of Internal Medicine, Endocrinology Diabetes and Metabolism, Diabetes and Cardiovascular Disease Center, University of Missouri School of Medicine, One Hospital Drive, Columbia, MO 65211, USA
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3
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Vos SJB, Delvenne A, Jack CR, Thal DR, Visser PJ. The clinical importance of suspected non-Alzheimer disease pathophysiology. Nat Rev Neurol 2024; 20:337-346. [PMID: 38724589 DOI: 10.1038/s41582-024-00962-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2024] [Indexed: 06/06/2024]
Abstract
The development of biomarkers for Alzheimer disease (AD) has led to the origin of suspected non-AD pathophysiology (SNAP) - a heterogeneous biomarker-based concept that describes individuals with normal amyloid and abnormal tau and/or neurodegeneration biomarker status. In this Review, we describe the origins of the SNAP construct, along with its prevalence, diagnostic and prognostic implications, and underlying neuropathology. As we discuss, SNAP can be operationalized using different biomarker modalities, which could affect prevalence estimates and reported characteristics of SNAP in ways that are not yet fully understood. Moreover, the underlying aetiologies that lead to a SNAP biomarker profile, and whether SNAP is the same in people with and without cognitive impairment, remains unclear. Improved insight into the clinical characteristics and pathophysiology of SNAP is of major importance for research and clinical practice, as well as for trial design to optimize care and treatment of individuals with SNAP.
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Affiliation(s)
- Stephanie J B Vos
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands.
| | - Aurore Delvenne
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Clifford R Jack
- Department of Radiology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Dietmar R Thal
- Laboratory for Neuropathology, Department of Imaging and Pathology and Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Department of Pathology, University Hospital Leuven, Leuven, Belgium
| | - Pieter Jelle Visser
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
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4
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Grenon MB, Papavergi MT, Bathini P, Sadowski M, Lemere CA. Temporal Characterization of the Amyloidogenic APPswe/PS1dE9;hAPOE4 Mouse Model of Alzheimer's Disease. Int J Mol Sci 2024; 25:5754. [PMID: 38891941 PMCID: PMC11172317 DOI: 10.3390/ijms25115754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 05/16/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
Alzheimer's disease (AD) is a devastating disorder with a global prevalence estimated at 55 million people. In clinical studies administering certain anti-beta-amyloid (Aβ) antibodies, amyloid-related imaging abnormalities (ARIAs) have emerged as major adverse events. The frequency of these events is higher among apolipoprotein ε4 allele carriers (APOE4) compared to non-carriers. To reflect patients most at risk for vascular complications of anti-Aβ immunotherapy, we selected an APPswe/PS1dE9 transgenic mouse model bearing the human APOE4 gene (APPPS1:E4) and compared it with the same APP/PS1 mouse model bearing the human APOE3 gene (APOE ε3 allele; APPPS1:E3). Using histological and biochemical analyses, we characterized mice at three ages: 8, 12, and 16 months. Female and male mice were assayed for general cerebral fibrillar and pyroglutamate (pGlu-3) Aβ deposition, cerebral amyloid angiopathy (CAA), microhemorrhages, apoE and cholesterol composition, astrocytes, microglia, inflammation, lysosomal dysfunction, and neuritic dystrophy. Amyloidosis, lipid deposition, and astrogliosis increased with age in APPPS1:E4 mice, while inflammation did not reveal significant changes with age. In general, APOE4 carriers showed elevated Aβ, apoE, reactive astrocytes, pro-inflammatory cytokines, microglial response, and neuritic dystrophy compared to APOE3 carriers at different ages. These results highlight the potential of the APPPS1:E4 mouse model as a valuable tool in investigating the vascular side effects associated with anti-amyloid immunotherapy.
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Affiliation(s)
- Martine B. Grenon
- Ann Romney Center for Neurologic Diseases, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; (M.B.G.); (M.-T.P.); (P.B.)
- Section Neuropsychology & Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Maria-Tzousi Papavergi
- Ann Romney Center for Neurologic Diseases, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; (M.B.G.); (M.-T.P.); (P.B.)
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Praveen Bathini
- Ann Romney Center for Neurologic Diseases, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; (M.B.G.); (M.-T.P.); (P.B.)
| | - Martin Sadowski
- Departments of Neurology, Psychiatry, and Biochemistry and Molecular Pharmacology, New York University Grossman School of Medicine, New York, NY 10016, USA;
| | - Cynthia A. Lemere
- Ann Romney Center for Neurologic Diseases, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; (M.B.G.); (M.-T.P.); (P.B.)
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5
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Ventura-Antunes L, Nackenoff A, Romero-Fernandez W, Bosworth AM, Prusky A, Wang E, Carvajal-Tapia C, Shostak A, Harmsen H, Mobley B, Maldonado J, Solopova E, Caleb Snider J, David Merryman W, Lippmann ES, Schrag M. Arteriolar degeneration and stiffness in cerebral amyloid angiopathy are linked to β-amyloid deposition and lysyl oxidase. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.08.583563. [PMID: 38659767 PMCID: PMC11042178 DOI: 10.1101/2024.03.08.583563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Cerebral amyloid angiopathy (CAA) is a vasculopathy characterized by vascular β-amyloid (Aβ) deposition on cerebral blood vessels. CAA is closely linked to Alzheimer's disease (AD) and intracerebral hemorrhage. CAA is associated with the loss of autoregulation in the brain, vascular rupture, and cognitive decline. To assess morphological and molecular changes associated with the degeneration of penetrating arterioles in CAA, we analyzed post-mortem human brain tissue from 26 patients with mild, moderate, and severe CAA end neurological controls. The tissue was optically cleared for three-dimensional light sheet microscopy, and morphological features were quantified using surface volume rendering. We stained Aβ, vascular smooth muscle (VSM), lysyl oxidase (LOX), and vascular markers to visualize the relationship between degenerative morphological features, including vascular dilation, dolichoectasia (variability in lumenal diameter) and tortuosity, and the volumes of VSM, Aβ, and LOX in arterioles. Atomic force microscopy (AFM) was used to assess arteriolar wall stiffness, and we identified a pattern of morphological features associated with degenerating arterioles in the cortex. The volume of VSM associated with the arteriole was reduced by around 80% in arterioles with severe CAA and around 60% in cases with mild/moderate CAA. This loss of VSM correlated with increased arteriolar diameter and variability of diameter, suggesting VSM loss contributes to arteriolar laxity. These vascular morphological features correlated strongly with Aβ deposits. At sites of microhemorrhage, Aβ was consistently present, although the morphology of the deposits changed from the typical organized ring shape to sharply contoured shards with marked dilation of the vessel. AFM showed that arteriolar walls with CAA were more than 400% stiffer than those without CAA. Finally, we characterized the association of vascular degeneration with LOX, finding strong associations with VSM loss and vascular degeneration. These results show an association between vascular Aβ deposition, microvascular degeneration, and increased vascular stiffness, likely due to the combined effects of replacement of VSM by β-amyloid, cross-linking of extracellular matrices (ECM) by LOX, and possibly fibrosis. This advanced microscopic imaging study clarifies the association between Aβ deposition and vascular fragility. Restoration of physiologic ECM properties in penetrating arteries may yield a novel therapeutic strategy for CAA.
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Affiliation(s)
| | - Alex Nackenoff
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Allison M Bosworth
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Alex Prusky
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Emmeline Wang
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Alena Shostak
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hannah Harmsen
- Department of Pathology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Bret Mobley
- Department of Pathology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jose Maldonado
- Vanderbilt Neurovisualization Lab, Vanderbilt University, Nashville, TN, USA
| | - Elena Solopova
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - J. Caleb Snider
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - W. David Merryman
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Ethan S Lippmann
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville TN, USA
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN, USA
| | - Matthew Schrag
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville TN, USA
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN, USA
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6
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Yubolphan R, Pratchayasakul W, Koonrungsesomboon N, Chattipakorn N, Chattipakorn SC. Potential links between platelets and amyloid-β in the pathogenesis of Alzheimer's disease: Evidence from in vitro, in vivo, and clinical studies. Exp Neurol 2024; 374:114683. [PMID: 38211684 DOI: 10.1016/j.expneurol.2024.114683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/28/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
Cerebral amyloid angiopathy (CAA) is a prevalent comorbidity among patients with Alzheimer's disease (AD), present in up to 80% of cases with varying levels of severity. There is evidence to suggest that CAA might intensify cognitive deterioration in AD patients, thereby accelerating the development of AD pathology. As a source of amyloids, it has been postulated that platelets play a significant role in the pathogenesis of both AD and CAA. Although several studies have demonstrated that platelet activation plays an important role in the pathogenesis of AD and CAA, a clear understanding of the mechanisms involved in the three steps: platelet activation, platelet adhesion, and platelet aggregation in AD pathogenesis still remains elusive. Moreover, potential therapeutic targets in platelet-mediated AD pathogenesis have not been explicitly addressed. Therefore, the aim of this review is to collate and discuss the in vitro, in vivo, and clinical evidence related to platelet dysfunction, including associated activation, adhesion, and aggregation, with specific reference to amyloid-related AD pathogenesis. Potential therapeutic targets of platelet-mediated AD pathogenesis are also discussed. By enriching the understanding of the intricate relationship between platelet dysfunction and onset of AD, researchers may unveil new therapeutic targets or strategies to tackle this devastating neurodegeneration.
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Affiliation(s)
- Ruedeemars Yubolphan
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Wasana Pratchayasakul
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Nut Koonrungsesomboon
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nipon Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Siriporn C Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand; Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand.
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7
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Cichońska D, Mazuś M, Kusiak A. Recent Aspects of Periodontitis and Alzheimer's Disease-A Narrative Review. Int J Mol Sci 2024; 25:2612. [PMID: 38473858 DOI: 10.3390/ijms25052612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/13/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
Periodontitis is an inflammatory condition affecting the supporting structures of the teeth. Periodontal conditions may increase the susceptibility of individuals to various systemic illnesses, including Alzheimer's disease. Alzheimer's disease is a neurodegenerative condition characterized by a gradual onset and progressive deterioration, making it the primary cause of dementia, although the exact cause of the disease remains elusive. Both Alzheimer's disease and periodontitis share risk factors and clinical studies comparing the associations and occurrence of periodontitis among individuals with Alzheimer's disease have suggested a potential correlation between these conditions. Brains of individuals with Alzheimer's disease have substantiated the existence of microorganisms related to periodontitis, especially Porphyromonas gingivalis, which produces neurotoxic gingipains and may present the capability to breach the blood-brain barrier. Treponema denticola may induce tau hyperphosphorylation and lead to neuronal apoptosis. Lipopolysaccharides-components of bacterial cell membranes and mediators of inflammation-also have an impact on brain function. Further research could unveil therapeutic approaches targeting periodontal pathogens to potentially alleviate AD progression.
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Affiliation(s)
- Dominika Cichońska
- Department of Periodontology and Oral Mucosa Diseases, Medical University of Gdańsk, Orzeszkowej 18 St. 18, 80-208 Gdańsk, Poland
| | - Magda Mazuś
- Student Research Group of the Department of Periodontology and Oral Mucosa Diseases, Medical University of Gdańsk, Orzeszkowej 18 St. 18, 80-208 Gdańsk, Poland
| | - Aida Kusiak
- Department of Periodontology and Oral Mucosa Diseases, Medical University of Gdańsk, Orzeszkowej 18 St. 18, 80-208 Gdańsk, Poland
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8
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Yeganeh Markid T, Hosseinpour Feizi MA, Talebi M, Rezazadeh M, Khalaj-Kondori M. Gene expression investigation of four key regulators of polyadenylation and alternative adenylation in the periphery of late-onset Alzheimer's disease patients. Gene 2024; 895:148013. [PMID: 37981081 DOI: 10.1016/j.gene.2023.148013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/11/2023] [Accepted: 11/15/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) is a genetic and sporadic neurodegenerative disease considered by an archetypal cognitive impairment and a decrease in less common cognitive impairment. Notably, the discovery of goals in this paradigm is still a challenge, and understanding basic mechanisms is an important step toward improving disease management. Polyadenylation (PA) and alternative polyadenylation (APA) are two of the most critical RNA processing stages in 3'UTRs that influence various AD-related genes. METHODS In this study, we assessed Cleavage and polyadenylation specificity factors 1 and 6 (CPSF1 and CPSF6), cleavage stimulation factor 1 (CSTF1), and WD Repeat Domain 33 (WDR33) genes expression in the periphery of 50 AD patients and 50 healthy individuals with age and gender-matched by quantitative real-time PCR. RESULTS Comparing AD patients with healthy people using expression analysis revealed a substantial increase in CSTF1 (posterior beta = 0.773, adjusted P-value = 0.042). Significant positive correlations were found between CSTF1 and CPSF1 (r = 0.365, P < 0.001), WDR33 (r = 0.506, P < 0.001), and CPSF6 (r = 0.446, P < 0.001) expression levels. CONCLUSION Although further research is required to determine their potential contribution to AD, our findings offer a fresh perspective on molecular regulatory pathways associated with AD pathogenic mechanisms associated with PA and APA.
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Affiliation(s)
- Tarlan Yeganeh Markid
- Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Iran; Department of Animal Biology, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | | | - Mahnaz Talebi
- Neurosciences Research Center (NSRC), Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Rezazadeh
- Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Iran; Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mohammad Khalaj-Kondori
- Department of Animal Biology, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran.
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9
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Bangad A, Abbasi M, Payabvash S, de Havenon A. Imaging of Amyloid-beta-related Arteritis. Neuroimaging Clin N Am 2024; 34:167-173. [PMID: 37951701 DOI: 10.1016/j.nic.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
Cerebral amyloid angiopathy (CAA) is a cerebrovascular disorder marked by the accumulation of amyloid-beta peptide (Aβ) within the leptomeninges and smaller blood vessels of the brain. CAA can be both noninflammatory and inflammatory, and the inflammatory version includes Aβ-related angiitis (ABRA). ABRA is a vasculitis of the central nervous system related to an inflammatory response to Aβ in the vascular walls, which necessitates differentiating ABRA from noninflammatory CAA, as ABRA may require immunosuppressive treatment. MR imaging is typically the most effective imaging modality of choice to screen for these conditions, and they should be obtained at varying time points to track disease progression.
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Affiliation(s)
- Aaron Bangad
- Department of Neurology, Yale University, New Haven, CT, USA
| | - Mehdi Abbasi
- Department of Neurology, Yale University, New Haven, CT, USA
| | - Sam Payabvash
- Center for Brain and Mind Health, Yale University, New Haven, CT, USA
| | - Adam de Havenon
- Department of Neurology, Yale University, New Haven, CT, USA; Center for Brain and Mind Health, Yale University, New Haven, CT, USA.
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10
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Loeffler DA. Approaches for Increasing Cerebral Efflux of Amyloid-β in Experimental Systems. J Alzheimers Dis 2024; 100:379-411. [PMID: 38875041 PMCID: PMC11307100 DOI: 10.3233/jad-240212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2024] [Indexed: 06/16/2024]
Abstract
Amyloid protein-β (Aβ) concentrations are increased in the brain in both early onset and late onset Alzheimer's disease (AD). In early onset AD, cerebral Aβ production is increased and its clearance is decreased, while increased Aβ burden in late onset AD is due to impaired clearance. Aβ has been the focus of AD therapeutics since development of the amyloid hypothesis, but efforts to slow AD progression by lowering brain Aβ failed until phase 3 trials with the monoclonal antibodies lecanemab and donanemab. In addition to promoting phagocytic clearance of Aβ, antibodies lower cerebral Aβ by efflux of Aβ-antibody complexes across the capillary endothelia, dissolving Aβ aggregates, and a "peripheral sink" mechanism. Although the blood-brain barrier is the main route by which soluble Aβ leaves the brain (facilitated by low-density lipoprotein receptor-related protein-1 and ATP-binding cassette sub-family B member 1), Aβ can also be removed via the blood-cerebrospinal fluid barrier, glymphatic drainage, and intramural periarterial drainage. This review discusses experimental approaches to increase cerebral Aβ efflux via these mechanisms, clinical applications of these approaches, and findings in clinical trials with these approaches in patients with AD or mild cognitive impairment. Based on negative findings in clinical trials with previous approaches targeting monomeric Aβ, increasing the cerebral efflux of soluble Aβ is unlikely to slow AD progression if used as monotherapy. But if used as an adjunct to treatment with lecanemab or donanemab, this approach might allow greater slowing of AD progression than treatment with either antibody alone.
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Affiliation(s)
- David A. Loeffler
- Department of Neurology, Beaumont Research Institute, Corewell Health, Royal Oak, MI, USA
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11
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Wang L, Liu Q, Yue D, Liu J, Fu Y. Cerebral Amyloid Angiopathy: An Undeniable Small Vessel Disease. J Stroke 2024; 26:1-12. [PMID: 38326703 PMCID: PMC10850457 DOI: 10.5853/jos.2023.01942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 10/17/2023] [Accepted: 11/06/2023] [Indexed: 02/09/2024] Open
Abstract
Cerebral amyloid angiopathy (CAA) has been proven to be the most common pathological change in cerebral small vessel disease except arteriosclerosis. In recent years, with the discovery of imaging technology and new imaging markers, the diagnostic rate of CAA has greatly improved. CAA plays an important role in non-hypertensive cerebral hemorrhage and cognitive decline. This review comprehensively describes the etiology, epidemiology, pathophysiological mechanisms, clinical features, imaging manifestations, imaging markers, diagnostic criteria, and treatment of CAA to facilitate its diagnosis and treatment and reduce mortality.
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Affiliation(s)
- Litao Wang
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiong Liu
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dongqi Yue
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Liu
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Fu
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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12
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Seifert RM, Rauch M, Klingebiel R, Boese LM, Greeve I, Rudwaleit M, Schäbitz WR. Case report: Cerebral amyloid angiopathy-related inflammation in a patient with granulomatosis with polyangiitis. Front Neurol 2023; 14:1277843. [PMID: 38020617 PMCID: PMC10666051 DOI: 10.3389/fneur.2023.1277843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Background Cerebral amyloid angiopathy-related inflammation (CAA-ri) defines a subacute autoimmune encephalopathy, which is presumably caused by increased CSF concentrations of anti-Aβ autoantibodies. This autoinflammatory reaction is temporally and regionally associated with microglial activation, inflammation and radiological presence of vasogenic edema. Clinical characteristics include progressive demential development as well as headache and epileptic seizures. In the absence of histopathologic confirmation, the criteria defined by Auriel et al. allow diagnosis of probable resp. possible CAA-ri. CAA-ri shows responsiveness to immunosuppressive therapies and a possible coexistence with other autoinflammatory diseases. Methods We present a case report and literature review on the diagnosis of CAA-ri in a patient with known granulomatosis with polyangiitis (GPA). Results Initially, the presented patient showed neuropsychiatric abnormalities and latent arm paresis. Due to slight increase in CSF cell count, an initial antiviral therapy was started. MR tomography showed a pronounced frontotemporal edema as well as cerebral microhemorrhages, leading to the diagnosis of CAA-ri. Subsequent high-dose steroid treatment followed by six intravenous cyclophosphamide pulses resulted in decreased CSF cell count and regression of cerebral MRI findings. Conclusion The symptoms observed in the patient are consistent with previous case reports on CAA-ri. Due to previously known GPA, we considered a cerebral manifestation of this disease as a differential diagnosis. However, absence of pachymeningitis as well as granulomatous infiltrations on imaging made cerebral GPA less likely. An increased risk for Aβ-associated pathologies in systemic rheumatic diseases is discussed variously.
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Affiliation(s)
- Rebecca M. Seifert
- Universitätsklinik für Neurologie, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - Michael Rauch
- Universitätsklinik für Neurologie, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - Randolf Klingebiel
- Institut für diagnostische und interventionelle Neuroradiologie, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - Lennart-Maximilian Boese
- Institut für diagnostische und interventionelle Neuroradiologie, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - Isabell Greeve
- Universitätsklinik für Neurologie, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - Martin Rudwaleit
- Universitätsklinik für Innere Medizin und Rheumatologie, Klinikum Bielefeld Rosenhöhe, Bielefeld, Germany
| | - Wolf-Rüdiger Schäbitz
- Universitätsklinik für Neurologie, Evangelisches Klinikum Bethel, Bielefeld, Germany
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13
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Canepa E, Parodi-Rullan R, Vazquez-Torres R, Gamallo-Lana B, Guzman-Hernandez R, Lemon NL, Angiulli F, Debure L, Ilies MA, Østergaard L, Wisniewski T, Gutiérrez-Jiménez E, Mar AC, Fossati S. FDA-approved carbonic anhydrase inhibitors reduce amyloid β pathology and improve cognition, by ameliorating cerebrovascular health and glial fitness. Alzheimers Dement 2023; 19:5048-5073. [PMID: 37186121 PMCID: PMC10600328 DOI: 10.1002/alz.13063] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/09/2023] [Accepted: 03/09/2023] [Indexed: 05/17/2023]
Abstract
INTRODUCTION Cerebrovascular pathology is an early and causal hallmark of Alzheimer's disease (AD), in need of effective therapies. METHODS Based on the success of our previous in vitro studies, we tested for the first time in a model of AD and cerebral amyloid angiopathy (CAA), the carbonic anhydrase inhibitors (CAIs) methazolamide and acetazolamide, Food and Drug Administration-approved against glaucoma and high-altitude sickness. RESULTS Both CAIs reduced cerebral, vascular, and glial amyloid beta (Aβ) accumulation and caspase activation, diminished gliosis, and ameliorated cognition in TgSwDI mice. The CAIs also improved microvascular fitness and induced protective glial pro-clearance pathways, resulting in the reduction of Aβ deposition. Notably, we unveiled that the mitochondrial carbonic anhydrase-VB (CA-VB) is upregulated in TgSwDI brains, CAA and AD+CAA human subjects, and in endothelial cells upon Aβ treatment. Strikingly, CA-VB silencing specifically reduces Aβ-mediated endothelial apoptosis. DISCUSSION This work substantiates the potential application of CAIs in clinical trials for AD and CAA.
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Affiliation(s)
- Elisa Canepa
- Alzheimer’s Center at Temple, Department of Neural Sciences, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, USA
| | - Rebecca Parodi-Rullan
- Alzheimer’s Center at Temple, Department of Neural Sciences, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, USA
| | - Rafael Vazquez-Torres
- Alzheimer’s Center at Temple, Department of Neural Sciences, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, USA
| | - Begona Gamallo-Lana
- Department of Neuroscience and Physiology, Neuroscience Institute, NYU Grossman School of Medicine, New York, NY, 10016, USA
| | - Roberto Guzman-Hernandez
- Alzheimer’s Center at Temple, Department of Neural Sciences, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, USA
| | - Nicole L. Lemon
- Alzheimer’s Center at Temple, Department of Neural Sciences, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, USA
| | - Federica Angiulli
- Alzheimer’s Center at Temple, Department of Neural Sciences, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, USA
| | - Ludovic Debure
- Department on Neurology, Center for Cognitive Neurology, NYU Grossman School of Medicine, New York, NY, 10016, USA
| | - Marc A. Ilies
- Department of Pharmaceutical Sciences and Moulder Center for Drug Discovery Research, Temple University School of Pharmacy, Temple University, Philadelphia, PA, 19140, USA
| | - Leif Østergaard
- Center of Functionally Integrative Neuroscience (CFIN), Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark
| | - Thomas Wisniewski
- Department on Neurology, Center for Cognitive Neurology, NYU Grossman School of Medicine, New York, NY, 10016, USA
| | - Eugenio Gutiérrez-Jiménez
- Center of Functionally Integrative Neuroscience (CFIN), Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark
| | - Adam C. Mar
- Department of Neuroscience and Physiology, Neuroscience Institute, NYU Grossman School of Medicine, New York, NY, 10016, USA
| | - Silvia Fossati
- Alzheimer’s Center at Temple, Department of Neural Sciences, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, USA
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14
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Sawmiller D, Koyama N, Fujiwara M, Segawa T, Maeda M, Mori T. Targeting apolipoprotein E and N-terminal amyloid β-protein precursor interaction improves cognition and reduces amyloid pathology in Alzheimer's mice. J Biol Chem 2023; 299:104846. [PMID: 37211092 PMCID: PMC10331488 DOI: 10.1016/j.jbc.2023.104846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 05/09/2023] [Accepted: 05/13/2023] [Indexed: 05/23/2023] Open
Abstract
Apolipoprotein E (apoE) interaction with amyloid β-protein precursor (APP) has garnered attention as the therapeutic target for Alzheimer's disease (AD). Having discovered the apoE antagonist (6KApoEp) that blocks apoE binding to N-terminal APP, we tested the therapeutic potential of 6KApoEp on AD-relevant phenotypes in amyloid β-protein precursor/presenilin 1 (APP/PS1) mice that express each human apoE isoform of apoE2, apoE3, or apoE4 (designated APP/PS1/E2, APP/PS1/E3, or APP/PS1/E4 mice). At 12 months of age, we intraperitoneally administered 6KApoEp (250 μg/kg) or vehicle once daily for 3 months. At 15 months of age, blockage of apoE and N-terminal APP interaction by 6KApoEp treatment improved cognitive impairment in most tests of learning and memory, including novel object recognition and maze tasks in APP/PS1/E2, APP/PS1/E3, and APP/PS1/E4 mice versus each vehicle-treated mouse line and did not alter behavior in nontransgenic littermates. Moreover, 6KApoEp therapy ameliorated brain parenchymal and cerebral vascular β-amyloid deposits and decreased abundance of amyloid β-protein (Aβ) in APP/PS1/E2, APP/PS1/E3, and APP/PS1/E4 mice versus each vehicle-treated mouse group. Notably, the highest effect in Aβ-lowering by 6KApoEp treatment was observed in APP/PS1/E4 mice versus APP/PS1/E2 or APP/PS1/E3 mice. These effects occured through shifting toward lessened amyloidogenic APP processing due to decreasing APP abundance at the plasma membrane, reducing APP transcription, and inhibiting p44/42 mitogen-activated protein kinase phosphorylation. Our findings provide the preclinical evidence that 6KApoEp therapy aimed at targeting apoE and N-terminal APP interaction is a promising strategy and may be suitable for patients with AD carrying the apoE4 isoform.
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Affiliation(s)
- Darrell Sawmiller
- Department of Neurosurgery and Brain Repair, Center of Excellence for Aging and Brain Repair, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
| | - Naoki Koyama
- Department of Biomedical Sciences, Saitama Medical Center and University, Kawagoe, Saitama, Japan
| | - Masakazu Fujiwara
- Department of Biomedical Sciences, Saitama Medical Center and University, Kawagoe, Saitama, Japan
| | - Tatsuya Segawa
- Immuno-Biological Laboratories Co, Ltd, Fujioka, Gunma, Japan
| | - Masahiro Maeda
- Immuno-Biological Laboratories Co, Ltd, Fujioka, Gunma, Japan
| | - Takashi Mori
- Department of Biomedical Sciences, Saitama Medical Center and University, Kawagoe, Saitama, Japan; Department of Pathology, Saitama Medical Center and University, Kawagoe, Saitama, Japan.
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15
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Zúñiga D, Zúñiga G, Hincapié S, Salazar E. Cerebral Amyloid Angiopathy-Related Inflammation (CAA-ri): Presentation at an Unusual Age. Cureus 2023; 15:e42454. [PMID: 37637532 PMCID: PMC10457129 DOI: 10.7759/cureus.42454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2023] [Indexed: 08/29/2023] Open
Abstract
Cerebral amyloid angiopathy-related inflammation (CAA-ri) is a less common but aggressive manifestation of CAA caused by an autoimmune reaction to the amyloid-beta (Ab) deposits in affected vessels. Here, we report the case of a 96-year-old patient, with a history of Alzheimer's disease, who presented to our hospital due to a sudden onset of high-intensity holocranial headache followed by dysarthria, left hemiplegia, and gaze deviation to the right. MRI of the brain was performed, which revealed a heterogeneous hypointense signal on the right frontal T2 and fluid-attenuated inversion recovery (FLAIR) sequences, with an asymmetric hyperintensity surrounding the lesion compatible with perilesional vasogenic edema. Given the clinical radiographic findings, a diagnosis of CAA-ri was established and immediate treatment with intravenous corticosteroids was started, with a rapid clinical response and remarkable improvement in follow-up neuroimaging.
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Affiliation(s)
- Diego Zúñiga
- Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, ECU
| | - Gabriel Zúñiga
- Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, ECU
| | - Sofía Hincapié
- Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, ECU
| | - Erin Salazar
- Neurology, Hospital Luis Vernaza, Guayaquil, ECU
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16
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Kelly L, Sharp MM, Thomas I, Brown C, Schrag M, Antunes LV, Solopova E, Martinez-Gonzalez J, Rodríguez C, Carare RO. Targeting lysyl-oxidase (LOX) may facilitate intramural periarterial drainage for the treatment of Alzheimer's disease. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2023; 5:100171. [PMID: 37457664 PMCID: PMC10338210 DOI: 10.1016/j.cccb.2023.100171] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 06/07/2023] [Accepted: 06/16/2023] [Indexed: 07/18/2023]
Abstract
Alzheimer's disease is the commonest form of dementia. It is likely that a lack of clearance of amyloid beta (Aβ) results in its accumulation in the parenchyma as Aβ oligomers and insoluble plaques, and within the walls of blood vessels as cerebral amyloid angiopathy (CAA). The drainage of Aβ along the basement membranes of blood vessels as intramural periarterial drainage (IPAD), could be improved if the driving force behind IPAD could be augmented, therefore reducing Aβ accumulation. There are alterations in the composition of the vascular basement membrane in Alzheimer's disease. Lysyl oxidase (LOX) is an enzyme involved in the remodelling of the extracellular matrix and its expression and function is altered in various disease states. The expression of LOX is increased in Alzheimer's disease, but it is unclear whether this is a contributory factor in the impairment of IPAD in Alzheimer's disease. The pharmacological inhibition of LOX may be a strategy to improve IPAD and reduce the accumulation of Aβ in the parenchyma and within the walls of blood vessels.
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Affiliation(s)
- Louise Kelly
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom, UK
| | | | | | - Christopher Brown
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom, UK
| | - Matthew Schrag
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University, Nashville, Tennessee, United States of America
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee, USA
| | - Lissa Ventura Antunes
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University, Nashville, Tennessee, United States of America
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee, USA
| | - Elena Solopova
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University, Nashville, Tennessee, United States of America
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee, USA
| | - José Martinez-Gonzalez
- Instituto de Investigaciones Biomédicas de Barcelona (IIBB-CSIC), Barcelona, Spain
- CIBER de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Cristina Rodríguez
- CIBER de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
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17
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Vu TM, Hervé V, Ulfat AK, Lamontagne-Kam D, Brouillette J. Impact of non-neuronal cells in Alzheimer's disease from a single-nucleus profiling perspective. Front Cell Neurosci 2023; 17:1208122. [PMID: 37388411 PMCID: PMC10300346 DOI: 10.3389/fncel.2023.1208122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 05/29/2023] [Indexed: 07/01/2023] Open
Abstract
The role of non-neuronal cells has been relatively overlooked in Alzheimer's disease (AD) neuropathogenesis compared to neuronal cells since the first characterization of the disease. Genome wide-association studies (GWAS) performed in the last few decades have greatly contributed to highlighting the critical impact of non-neuronal cells in AD by uncovering major genetic risk factors that are found largely in these cell types. The recent development of single cell or single nucleus technologies has revolutionized the way we interrogate the transcriptomic and epigenetic profiles of neurons, microglia, astrocytes, oligodendrocytes, pericytes, and endothelial cells simultaneously in the same sample and in an individual manner. Here, we review the latest advances in single-cell/nucleus RNA sequencing and Assay for Transposase-Accessible Chromatin (ATAC) sequencing to more accurately understand the function of non-neuronal cells in AD. We conclude by giving an overview of what still needs to be achieved to better appreciate the interconnected roles of each cell type in the context of AD.
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18
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Yamagata K. Docosahexaenoic acid inhibits ischemic stroke to reduce vascular dementia and Alzheimer’s disease. Prostaglandins Other Lipid Mediat 2023; 167:106733. [PMID: 37028469 DOI: 10.1016/j.prostaglandins.2023.106733] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/17/2023] [Accepted: 04/04/2023] [Indexed: 04/08/2023]
Abstract
Stroke and dementia are global leading causes of neurological disability and death. The pathology of these diseases is interrelated and they share common, modifiable risk factors. It is suggested that docosahexaenoic acid (DHA) prevents neurological and vascular disorders induced by ischemic stroke and also prevent dementia. The purpose of this study was to review the potential preventative role of DHA against ischemic stroke-induced vascular dementia and Alzheimer's disease. In this review, I analyzed studies on stroke-induced dementia from the PubMed, ScienceDirect, and Web of Science databases as well as studies on the effects of DHA on stroke-induced dementia. As per the results of interventional studies, DHA intake can potentially ameliorate dementia and cognitive function. In particular, DHA derived from foods such as fish oil enters the blood and then migrates to the brain by binding to fatty acid binding protein 5 that is present in cerebral vascular endothelial cells. At this point, the esterified form of DHA produced by lysophosphatidylcholine is preferentially absorbed into the brain instead of free DHA. DHA accumulates in nerve cell membrane and is involved in the prevention of dementia. The antioxidative and anti-inflammatory properties of DHA and DHA metabolites as well as their ability to decrease amyloid beta (Aβ) 42 production were implicated in the improvement of cognitive function. The antioxidant effect of DHA, the inhibition of neuronal cell death by Aβ peptide, improvement in learning ability, and enhancement of synaptic plasticity may contribute to the prevention of dementia induced by ischemic stroke.
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19
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Mishra P, Davies DA, Albensi BC. The Interaction Between NF-κB and Estrogen in Alzheimer's Disease. Mol Neurobiol 2023; 60:1515-1526. [PMID: 36512265 DOI: 10.1007/s12035-022-03152-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 11/30/2022] [Indexed: 12/15/2022]
Abstract
Post-menopausal women are at a higher risk of developing Alzheimer's disease (AD) than males. The higher rates of AD in women are associated with the sharp decline in the estrogen levels after menopause. Estrogen has been shown to downregulate inflammatory cytokines in the central nervous system (CNS), which has a neuroprotective role against neurodegenerative diseases including AD. Sustained neuroinflammation is associated with neurodegeneration and contributes to AD. Nuclear factor kappa-B (NF-κB) is a transcription factor involved with the modulation of inflammation and interacts with estrogen to influence the progression of AD. Application of 17β-estradiol (E2) has been shown to inhibit NF-κB, thereby reducing transcription of NF-κB target genes. Despite accumulating evidence showing that estrogens have beneficial effects in pre-clinical AD studies, there are mixed results with hormone replacement therapy in clinical trials. Furthering our understanding of how NF-κB interacts with estrogen and alters the progression of neurodegenerative disorders including AD, should be beneficial and result in the development of novel therapeutics.
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Affiliation(s)
- Pranav Mishra
- Division of Neurodegenerative Disorders, St. Boniface Hospital Research, Winnipeg, MB, Canada.,Department of Pharmacology & Therapeutics, College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Don A Davies
- Department of Biology, York University, Toronto, ON, Canada
| | - Benedict C Albensi
- Division of Neurodegenerative Disorders, St. Boniface Hospital Research, Winnipeg, MB, Canada. .,Department of Pharmacology & Therapeutics, College of Medicine, University of Manitoba, Winnipeg, MB, Canada. .,Department of Pharmaceutical Sciences, College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL, USA.
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20
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Willumsen N, Arber C, Lovejoy C, Toombs J, Alatza A, Weston PSJ, Chávez-Gutiérrez L, Hardy J, Zetterberg H, Fox NC, Ryan NS, Lashley T, Wray S. The PSEN1 E280G mutation leads to increased amyloid-β43 production in induced pluripotent stem cell neurons and deposition in brain tissue. Brain Commun 2022; 5:fcac321. [PMID: 36687397 PMCID: PMC9847549 DOI: 10.1093/braincomms/fcac321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/06/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
Mutations in the presenilin 1 gene, PSEN1, which cause familial Alzheimer's disease alter the processing of amyloid precursor protein, leading to the generation of various amyloid-β peptide species. These species differ in their potential for aggregation. Mutation-specific amyloid-β peptide profiles may thereby influence pathogenicity and clinical heterogeneity. There is particular interest in comparing mutations with typical and atypical clinical presentations, such as E280G. We generated PSEN1 E280G mutation induced pluripotent stem cells from two patients and differentiated them into cortical neurons, along with previously reported PSEN1 M146I, PSEN1 R278I and two control lines. We assessed both the amyloid-β peptide profiles and presenilin 1 protein maturity. We also compared amyloid-β peptide profiles in human post-mortem brain tissue from cases with matched mutations. Amyloid-β ratios significantly differed compared with controls and between different patients, implicating mutation-specific alterations in amyloid-β ratios. Amyloid-β42:40 was increased in the M146I and both E280G lines compared with controls. Amyloid-β42:40 was not increased in the R278I line compared with controls. The amyloid-β43:40 ratio was increased in R278I and both E280G lines compared with controls, but not in M146I cells. Distinct amyloid-β peptide patterns were also observed in human brain tissue from individuals with these mutations, showing some similar patterns to cell line observations. Reduced presenilin 1 maturation was observed in neurons with the PSEN1 R278I and E280G mutations, but not the M146I mutation. These results suggest that mutation location can differentially alter the presenilin 1 protein and affect its autoendoproteolysis and processivity, contributing to the pathological phenotype. Investigating differences in underlying molecular mechanisms of familial Alzheimer's disease may inform our understanding of clinical heterogeneity.
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Affiliation(s)
- Nanet Willumsen
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London WC1N 1PJ, UK
- The Queen Square Brain Bank for Neurological Disorders, Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, London WC1N 1PJ, UK
| | - Charles Arber
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London WC1N 1PJ, UK
| | - Christopher Lovejoy
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London WC1N 1PJ, UK
| | - Jamie Toombs
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London WC1N 1PJ, UK
- UK Dementia Research Institute, University College London, London WC1E 6AU, UK
| | - Argyro Alatza
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London WC1N 1PJ, UK
| | - Philip S J Weston
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London WC1N 1PJ, UK
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London WC1E 6BT, UK
| | - Lucia Chávez-Gutiérrez
- VIB Center for Brain and Disease Research, 3000 Leuven, Belgium
- Department of Neurology, KU Leuven, 3000 Leuven, Belgium
| | - John Hardy
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London WC1N 1PJ, UK
- UK Dementia Research Institute, University College London, London WC1E 6AU, UK
| | - Henrik Zetterberg
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London WC1N 1PJ, UK
- UK Dementia Research Institute, University College London, London WC1E 6AU, UK
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, S-431 80 Mölndal, Sweden
| | - Nick C Fox
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London WC1N 1PJ, UK
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London WC1E 6BT, UK
- UK Dementia Research Institute, University College London, London WC1E 6AU, UK
| | - Natalie S Ryan
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London WC1N 1PJ, UK
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London WC1E 6BT, UK
- UK Dementia Research Institute, University College London, London WC1E 6AU, UK
| | - Tammaryn Lashley
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London WC1N 1PJ, UK
- The Queen Square Brain Bank for Neurological Disorders, Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, London WC1N 1PJ, UK
| | - Selina Wray
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London WC1N 1PJ, UK
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21
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Rabin JS, Nichols E, La Joie R, Casaletto KB, Palta P, Dams-O’Connor K, Kumar RG, George KM, Satizabal CL, Schneider JA, Pa J, Brickman AM. Cerebral amyloid angiopathy interacts with neuritic amyloid plaques to promote tau and cognitive decline. Brain 2022; 145:2823-2833. [PMID: 35759327 PMCID: PMC9420012 DOI: 10.1093/brain/awac178] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 12/12/2022] Open
Abstract
Accumulating data suggest that cerebrovascular disease contributes to Alzheimer's disease pathophysiology and progression toward dementia. Cerebral amyloid angiopathy is a form of cerebrovascular pathology that results from the build-up of β-amyloid in the vessel walls. Cerebral amyloid angiopathy commonly co-occurs with Alzheimer's disease pathology in the ageing brain and increases the risk of Alzheimer's disease dementia. In the present study, we examined whether cerebral amyloid angiopathy influences tau deposition and cognitive decline independently or synergistically with parenchymal β-amyloid burden. Secondly, we examined whether tau burden mediates the association between cerebral amyloid angiopathy and cognitive decline. We included data from autopsied subjects recruited from one of three longitudinal clinical-pathological cohort studies: the Rush Memory and Aging Project, the Religious Orders Study and the Minority Aging Research Study. Participants completed annual clinical and cognitive evaluations and underwent brain autopsy. Cerebral amyloid angiopathy pathology was rated as none, mild, moderate or severe. Bielschowsky silver stain was used to visualize neuritic β-amyloid plaques and neurofibrillary tangles. We used linear regression and linear mixed models to test independent versus interactive associations of cerebral amyloid angiopathy and neuritic plaque burden with tau burden and longitudinal cognitive decline, respectively. We used causal mediation models to examine whether tau mediates the association between cerebral amyloid angiopathy and cognitive decline. The study sample included 1722 autopsied subjects (age at baseline = 80.2 ± 7.1 years; age at death = 89.5 ± 6.7 years; 68% females). Cerebral amyloid angiopathy interacted with neuritic plaques to accelerate tau burden and cognitive decline. Specifically, those with more severe cerebral amyloid angiopathy pathology and higher levels of neuritic plaque burden had greater tau burden and faster cognitive decline. We also found that tau mediated the association between cerebral amyloid angiopathy and cognitive decline among participants with higher neuritic plaque burden. In summary, more severe levels of cerebral amyloid angiopathy and higher parenchymal β-amyloid burden interacted to promote cognitive decline indirectly via tau deposition. These results highlight the dynamic interplay between cerebral amyloid angiopathy and Alzheimer's disease pathology in accelerating progression toward dementia. These findings have implications for Alzheimer's disease clinical trials and therapeutic development.
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Affiliation(s)
- Jennifer S Rabin
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences
Centre, University of Toronto, Toronto, Canada M4N 3M5
- Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program,
Sunnybrook Research Institute, Toronto, Ontario,
Canada M4N 3M5
- Rehabilitation Sciences Institute, University of Toronto,
Toronto, Canada M5G 1V7
| | - Emma Nichols
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public
Health, Baltimore, MD, USA
| | - Renaud La Joie
- Memory and Aging Center, Department of Neurology, Weill Institute for
Neurosciences, University of California, San Francisco,
CA, USA 94158
| | - Kaitlin B Casaletto
- Memory and Aging Center, Department of Neurology, Weill Institute for
Neurosciences, University of California, San Francisco,
CA, USA 94158
| | - Priya Palta
- Departments of Medicine and Epidemiology, Columbia University Irving
Medical Center, New York, NY, USA
| | - Kristen Dams-O’Connor
- Department of Rehabilitation and Human Performance, Icahn School of
Medicine at Mount Sinai, New York, NY, USA 10029
- Department of Neurology, Icahn School of Medicine at Mount
Sinai, New York, NY, USA 10029
| | - Raj G Kumar
- Department of Rehabilitation and Human Performance, Icahn School of
Medicine at Mount Sinai, New York, NY, USA 10029
| | - Kristen M George
- Department of Public Health Sciences, University of California Davis School
of Medicine, Davis, CA, USA
| | - Claudia L Satizabal
- Department of Population Health Science and Biggs Institute for Alzheimer’s
and Neurodegenerative Diseases, UT Health San Antonio, San
Antonio, TX, USA
- Department of Neurology, Boston University School of
Medicine, Boston, MA, USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical
Center, Chicago, IL, USA
| | - Judy Pa
- Mark and Mary Stevens Neuroimaging and Informatics Institute, Department of
Neurology, University of Southern California, Los Angeles,
CA, USA
| | - Adam M Brickman
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain,
Department of Neurology, College of Physicians and Surgeons, Columbia
University, New York, NY, USA 10032
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22
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Liu X, Zhang G, Wei P, Hao L, Zhong L, Zhong K, Liu C, Liu P, Feng Q, Wang S, Zhang J, Tian R, Zhou L. 3D-printed collagen/silk fibroin/secretome derived from bFGF-pretreated HUCMSCs scaffolds enhanced therapeutic ability in canines traumatic brain injury model. Front Bioeng Biotechnol 2022; 10:995099. [PMID: 36091465 PMCID: PMC9449499 DOI: 10.3389/fbioe.2022.995099] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
The regeneration of brain tissue poses a great challenge because of the limited self-regenerative capabilities of neurons after traumatic brain injury (TBI). For this purpose, 3D-printed collagen/silk fibroin/secretome derived from human umbilical cord blood mesenchymal stem cells (HUCMSCs) pretreated with bFGF scaffolds (3D-CS-bFGF-ST) at a low temperature were prepared in this study. From an in vitro perspective, 3D-CS-bFGF-ST showed good biodegradation, appropriate mechanical properties, and good biocompatibility. In regard to vivo, during the tissue remodelling processes of TBI, the regeneration of brain tissues was obviously faster in the 3D-CS-bFGF-ST group than in the other two groups (3D-printed collagen/silk fibroin/secretome derived from human umbilical cord blood mesenchymal stem cells (3D-CS-ST) group and TBI group) by motor assay, histological analysis, and immunofluorescence assay. Satisfactory regeneration was achieved in the two 3D-printed scaffold-based groups at 6 months postsurgery, while the 3D-CS-bFGF-ST group showed a better outcome than the 3D-CS-ST group.
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Affiliation(s)
- Xiaoyin Liu
- Department of Neurosurgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
| | - Guijun Zhang
- Department of Neurosurgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
| | - Pan Wei
- Department of Neurosurgery, The First People’s Hospital of Long Quan yi District, Chengdu, China
| | - Lifang Hao
- Department of Radiology, Liao Cheng The Third People’s Hospital, Liaocheng, China
| | - Lin Zhong
- The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Kunhon Zhong
- State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
| | - Chang Liu
- Department of Neurosurgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
| | - Peng Liu
- Department of Neurosurgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
| | - Qingbo Feng
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Shan Wang
- Department of Neurosurgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
| | - Jianyong Zhang
- Department of General Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
- *Correspondence: Jianyong Zhang, ; Rui Tian, ; Liangxue Zhou,
| | - Rui Tian
- Department of Neurosurgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
- *Correspondence: Jianyong Zhang, ; Rui Tian, ; Liangxue Zhou,
| | - Liangxue Zhou
- Department of Neurosurgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
- *Correspondence: Jianyong Zhang, ; Rui Tian, ; Liangxue Zhou,
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23
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Agrawal S, Schneider JA. Vascular pathology and pathogenesis of cognitive impairment and dementia in older adults. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2022; 3:100148. [PMID: 36324408 PMCID: PMC9616381 DOI: 10.1016/j.cccb.2022.100148] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 05/25/2022] [Accepted: 06/23/2022] [Indexed: 12/24/2022]
Abstract
It is well recognized that brains of older people often harbor cerebrovascular disease pathology including vessel disease and vascular-related tissue injuries and that this is associated with vascular cognitive impairment and contributes to dementia. Here we review vascular pathologies, cognitive impairment, and dementia. We highlight the importance of mixed co-morbid AD/non-AD neurodegenerative and vascular pathology that has been collected in multiple clinical pathologic studies, especially in community-based studies. We also provide an update of vascular pathologies from the Rush Memory and Aging Project and Religious Orders Study cohorts with special emphasis on the differences across age in persons with and without dementia. Finally, we discuss neuropathological perspectives on the interpretation of clinical-pathological studies and emerging data in community-based studies.
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Affiliation(s)
- Sonal Agrawal
- Rush Alzheimer's Disease Center, Rush University Medical Center, Jelke Building, 1750 W. Harrison Street, Chicago 60612, IL, USA
- Department of Pathology, Rush University Medical Center, Chicago, IL, USA
| | - Julie A. Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, Jelke Building, 1750 W. Harrison Street, Chicago 60612, IL, USA
- Department of Pathology, Rush University Medical Center, Chicago, IL, USA
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24
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McCorkindale AN, Mundell HD, Guennewig B, Sutherland GT. Vascular Dysfunction Is Central to Alzheimer's Disease Pathogenesis in APOE e4 Carriers. Int J Mol Sci 2022; 23:7106. [PMID: 35806110 PMCID: PMC9266739 DOI: 10.3390/ijms23137106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 06/23/2022] [Accepted: 06/23/2022] [Indexed: 11/16/2022] Open
Abstract
Alzheimer's disease (AD) is the most common form of dementia and the leading risk factor, after age, is possession of the apolipoprotein E epsilon 4 allele (APOE4). Approximately 50% of AD patients carry one or two copies of APOE4 but the mechanisms by which it confers risk are still unknown. APOE4 carriers are reported to demonstrate changes in brain structure, cognition, and neuropathology, but findings have been inconsistent across studies. In the present study, we used multi-modal data to characterise the effects of APOE4 on the brain, to investigate whether AD pathology manifests differently in APOE4 carriers, and to determine if AD pathomechanisms are different between carriers and non-carriers. Brain structural differences in APOE4 carriers were characterised by applying machine learning to over 2000 brain MRI measurements from 33,384 non-demented UK biobank study participants. APOE4 carriers showed brain changes consistent with vascular dysfunction, such as reduced white matter integrity in posterior brain regions. The relationship between APOE4 and AD pathology was explored among the 1260 individuals from the Religious Orders Study and Memory and Aging Project (ROSMAP). APOE4 status had a greater effect on amyloid than tau load, particularly amyloid in the posterior cortical regions. APOE status was also highly correlated with cerebral amyloid angiopathy (CAA). Bulk tissue brain transcriptomic data from ROSMAP and a similar dataset from the Mount Sinai Brain Bank showed that differentially expressed genes between the dementia and non-dementia groups were enriched for vascular-related processes (e.g., "angiogenesis") in APOE4 carriers only. Immune-related transcripts were more strongly correlated with AD pathology in APOE4 carriers with some transcripts such as TREM2 and positively correlated with pathology severity in APOE4 carriers, but negatively in non-carriers. Overall, cumulative evidence from the largest neuroimaging, pathology, and transcriptomic studies available suggests that vascular dysfunction is key to the development of AD in APOE4 carriers. However, further studies are required to tease out non-APOE4-specific mechanisms.
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Affiliation(s)
- Andrew N. McCorkindale
- Charles Perkins Centre and School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia; (A.N.M.); (H.D.M.)
| | - Hamish D. Mundell
- Charles Perkins Centre and School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia; (A.N.M.); (H.D.M.)
- Brain and Mind Centre and School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia
| | - Boris Guennewig
- Brain and Mind Centre and School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia
| | - Greg T. Sutherland
- Charles Perkins Centre and School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia; (A.N.M.); (H.D.M.)
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25
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Huynh TT, Wang Y, Terpstra K, Cho HJ, Mirica LM, Rogers BE. 68Ga-Labeled Benzothiazole Derivatives for Imaging Aβ Plaques in Cerebral Amyloid Angiopathy. ACS OMEGA 2022; 7:20339-20346. [PMID: 35721913 PMCID: PMC9202065 DOI: 10.1021/acsomega.2c02369] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/20/2022] [Indexed: 05/17/2023]
Abstract
Timely diagnostic imaging plays a crucial role in managing cerebral amyloid angiopathy (CAA)-the condition in which amyloid β is deposited on blood vessels. To selectively map these amyloid plaques, we have designed amyloid-targeting ligands that can effectively complex with 68Ga3+ while maintaining good affinity for amyloid β. In this study, we introduced novel 1,4,7-triazacyclononane-based bifunctional chelators (BFCs) that incorporate a benzothiazole moiety as the Aβ-binding fragment and form charged and neutral species with 68Ga3+. In vitro autoradiography using 5xFAD and WT mouse brain sections (11-month-old) suggested strong and specific binding of the 68Ga complexes to amyloid β. Biodistribution studies in CD-1 mice revealed a low brain uptake of 0.10-0.33% ID/g, thus suggesting 68Ga-labeled novel BFCs as promising candidates for detecting CAA.
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Affiliation(s)
- Truc T. Huynh
- Department
of Radiation Oncology, Washington University
School of Medicine, 4511
Forest Park Avenue, St. Louis, Missouri 63108, United
States
- Department
of Chemistry, Washington University, St. Louis, Missouri 63130, United States
| | - Yujue Wang
- Department
of Chemistry, University of Illinois at
Urbana-Champaign, 600 S. Mathews Avenue, Urbana, Illinois 61801, United
States
| | - Karna Terpstra
- Department
of Chemistry, University of Illinois at
Urbana-Champaign, 600 S. Mathews Avenue, Urbana, Illinois 61801, United
States
| | - Hong-Jun Cho
- Department
of Chemistry, University of Illinois at
Urbana-Champaign, 600 S. Mathews Avenue, Urbana, Illinois 61801, United
States
| | - Liviu M. Mirica
- Department
of Chemistry, University of Illinois at
Urbana-Champaign, 600 S. Mathews Avenue, Urbana, Illinois 61801, United
States
- Hope
Center for Neurological Disorders, Washington
University School of Medicine, St. Louis, Missouri 63110, United States
| | - Buck E. Rogers
- Department
of Radiation Oncology, Washington University
School of Medicine, 4511
Forest Park Avenue, St. Louis, Missouri 63108, United
States
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26
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N-terminally truncated Aβ4-x proteoforms and their relevance for Alzheimer's pathophysiology. Transl Neurodegener 2022; 11:30. [PMID: 35641972 PMCID: PMC9158284 DOI: 10.1186/s40035-022-00303-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 04/21/2022] [Indexed: 01/22/2023] Open
Abstract
Background The molecular heterogeneity of Alzheimer’s amyloid-β (Aβ) deposits extends well beyond the classic Aβ1-40/Aβ1-42 dichotomy, substantially expanded by multiple post-translational modifications that increase the proteome diversity. Numerous truncated fragments consistently populate the brain Aβ peptidome, and their homeostatic regulation and potential contribution to disease pathogenesis are largely unknown. Aβ4-x peptides have been reported as major components of plaque cores and the limited studies available indicate their relative abundance in Alzheimer’s disease (AD). Methods Immunohistochemistry was used to assess the topographic distribution of Aβ4-x species in well-characterized AD cases using custom-generated monoclonal antibody 18H6—specific for Aβ4-x species and blind for full-length Aβ1-40/Aβ1-42—in conjunction with thioflavin-S and antibodies recognizing Aβx-40 and Aβx-42 proteoforms. Circular dichroism, thioflavin-T binding, and electron microscopy evaluated the biophysical and aggregation/oligomerization properties of full-length and truncated synthetic homologues, whereas stereotaxic intracerebral injections of monomeric and oligomeric radiolabeled homologues in wild-type mice were used to evaluate their brain clearance characteristics. Results All types of amyloid deposits contained the probed Aβ epitopes, albeit expressed in different proportions. Aβ4-x species showed preferential localization within thioflavin-S-positive cerebral amyloid angiopathy and cored plaques, strongly suggesting poor clearance characteristics and consistent with the reduced solubility and enhanced oligomerization of their synthetic homologues. In vivo clearance studies demonstrated a fast brain efflux of N-terminally truncated and full-length monomeric forms whereas their oligomeric counterparts—particularly of Aβ4-40 and Aβ4-42—consistently exhibited enhanced brain retention. Conclusions The persistence of aggregation-prone Aβ4-x proteoforms likely contributes to the process of amyloid formation, self-perpetuating the amyloidogenic loop and exacerbating amyloid-mediated pathogenic pathways.
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27
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Pandian SRK, Vijayakumar KK, Murugesan S, Kunjiappan S. Liposomes: An emerging carrier for targeting Alzheimer's and Parkinson's diseases. Heliyon 2022; 8:e09575. [PMID: 35706935 PMCID: PMC9189891 DOI: 10.1016/j.heliyon.2022.e09575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/19/2022] [Accepted: 05/23/2022] [Indexed: 11/19/2022] Open
Abstract
The function of the brain can be affected by various factors that include infection, tumor, and stroke. The major disorders reported with altered brain function are Alzheimer's disease (AD), Parkinson's disease (PD), dementia, brain cancer, seizures, mental disorders, and other movement disorders. The major barrier in treating CNS disease is the blood-brain barrier (BBB), which protects the brain from toxic molecules, and the cerebrospinal fluid (CSF) barrier, which separates blood from CSF. Brain endothelial cells and perivascular elements provide an integrated cellular barrier, the BBB, which hamper the invasion of molecules from the blood to the brain. Even though many drugs are available to treat neurological disorders, it fails to reach the desired site with the required concentration. In this purview, liposomes can carry required concentrations of molecules intracellular by diverse routes such as carrier-mediated transport and receptor-mediated transcytosis. Surface modification of liposomes enables them to deliver drugs to various brain cells, including neurons, astrocytes, oligodendrocytes, and microglia. The research studies supported the role of liposomes in delivering drugs across BBB and in reducing the pathogenesis of AD and PD. The liposomes were surface-functionalized with various molecules to reach the cells intricated with the AD or PD pathogenesis. The targeted and sustained delivery of drugs by liposomes is disturbed due to the antibody formation, renal clearance, accelerated blood clearance, and complement activation-related pseudoallergy (CARPA). Hence, this review will focus on the characteristics, surface functionalization, drug loading, and biodistribution of liposomes respective to AD and PD. In addition, the alternative strategies to overcome immunogenicity are discussed briefly.
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Affiliation(s)
- Sureshbabu Ram Kumar Pandian
- Department of Biotechnology, Kalasalingam Academy of Research and Education, Krishnankoil, 626126, Tamilnadu, India
- Corresponding author.
| | - Kevin Kumar Vijayakumar
- Department of Molecular Microbiology, School of Biotechnology, Madurai Kamaraj University, Madurai, Tamilnadu, India
| | - Sankaranarayanan Murugesan
- Medicinal Chemistry Research Laboratory, Department of Pharmacy, Birla Institute of Technology and Science, Pilani Campus, Vidya Vihar, Pilani, 333031, Rajasthan, India
| | - Selvaraj Kunjiappan
- Department of Biotechnology, Kalasalingam Academy of Research and Education, Krishnankoil, 626126, Tamilnadu, India
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28
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Chen H, Chen F, Jiang Y, Zhang L, Hu G, Sun F, Zhang M, Ji Y, Chen Y, Che G, Zhou X, Zhang Y. A Review of ApoE4 Interference Targeting Mitophagy Molecular Pathways for Alzheimer's Disease. Front Aging Neurosci 2022; 14:881239. [PMID: 35669462 PMCID: PMC9166238 DOI: 10.3389/fnagi.2022.881239] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/07/2022] [Indexed: 02/05/2023] Open
Abstract
Alzheimer's disease (AD) is one of the major worldwide causes of dementia that is characterized by irreversible decline in learning, memory loss, and behavioral impairments. Mitophagy is selective autophagy through the clearance of aberrant mitochondria, specifically for degradation to maintain energy generation and neuronal and synaptic function in the brain. Accumulating evidence shows that defective mitophagy is believed to be as one of the early and prominent features in AD pathogenesis and has drawn attention in the recent few years. APOE ε4 allele is the greatest genetic determinant for AD and is widely reported to mediate detrimental effects on mitochondria function and mitophagic process. Given the continuity of the physiological process, this review takes the mitochondrial dynamic and mitophagic core events into consideration, which highlights the current knowledge about the molecular alterations from an APOE-genotype perspective, synthesizes ApoE4-associated regulations, and the cross-talk between these signaling, along with the focuses on general autophagic process and several pivotal processes of mitophagy, including mitochondrial dynamic (DRP1, MFN-1), mitophagic induction (PINK1, Parkin). These may shed new light on the link between ApoE4 and AD and provide novel insights for promising mitophagy-targeted therapeutic strategies for AD.
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Affiliation(s)
- Huiyi Chen
- Department of Children Rehabilitation, Yuebei People's Hospital, Affiliated Hospital of Shantou University Medical College, Shaoguan, China
| | - Feng Chen
- Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Ying Jiang
- Department of Children Rehabilitation, Yuebei People's Hospital, Affiliated Hospital of Shantou University Medical College, Shaoguan, China
| | - Lu Zhang
- Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Guizhen Hu
- Department of Children Rehabilitation, Yuebei People's Hospital, Affiliated Hospital of Shantou University Medical College, Shaoguan, China
| | - Furong Sun
- Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Miaoping Zhang
- Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Yao Ji
- Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Yanting Chen
- Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Gang Che
- Department of Children Rehabilitation, Yuebei People's Hospital, Affiliated Hospital of Shantou University Medical College, Shaoguan, China
- Department of Surgical Oncology, The First Affiliated Hospital, Zhejian University School of Medicine, Hangzhou, China
| | - Xu Zhou
- Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Yu Zhang
- Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
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29
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Affiliation(s)
- Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
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30
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Zhu N, Wei M, Yuan L, He X, Chen C, Ji A, Zhang G. Claudin-5 relieves cognitive decline in Alzheimer's disease mice through suppression of inhibitory GABAergic neurotransmission. Aging (Albany NY) 2022; 14:3554-3568. [PMID: 35471411 PMCID: PMC9085235 DOI: 10.18632/aging.204029] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/08/2022] [Indexed: 11/25/2022]
Abstract
Alzheimer’s disease (AD) is characterized by progressive cognitive decline, which is considered as the most common form of dementia in the elderly. Recently, it is suggested that impaired cerebrovascular function may precede the onset of AD. Claudin-5, which is the most enriched tight junction protein, has been reported to prevent the passage of damaging material at the blood-brain barrier. However, whether claudin-5 impacts AD has no direct evidence. We found a decrease level of claudin-5 in the hippocampus of AD and elder mice. And intravenous injection of claudin-5 improved learning and memory ability in these mice, while knockout of the protein led to impaired learning and memory and long-term potentiation in adult control mice. Furthermore, the effects of claudin-5 are mediated by suppressing inhibitory GABAergic neurotransmission. Our results suggest benefit effects of claudin-5 on learning and memory, which may provide a new treatment strategy for AD.
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Affiliation(s)
- Ning Zhu
- General Practice Center, The Seventh Affiliated Hospital, Southern Medical University, Foshan 528244, China.,Department of Pharmacy, The Seventh Affiliated Hospital, Southern Medical University, Foshan 528244, China
| | - Meidan Wei
- Department of Pharmacy, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - Linguang Yuan
- College of Basic Medicine, Changsha Medical University, Changsha 410219, China
| | - Xiaodan He
- General Practice Center, The Seventh Affiliated Hospital, Southern Medical University, Foshan 528244, China
| | - Chunli Chen
- Department of Pharmacy, The Seventh Affiliated Hospital, Southern Medical University, Foshan 528244, China
| | - Aimin Ji
- Department of Pharmacy, The Seventh Affiliated Hospital, Southern Medical University, Foshan 528244, China
| | - Guozeng Zhang
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng 475004, China
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31
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Blackman J, Love S, Sinclair L, Cain R, Coulthard E. APOE ε4, Alzheimer's disease neuropathology and sleep disturbance, in individuals with and without dementia. Alzheimers Res Ther 2022; 14:47. [PMID: 35354468 PMCID: PMC8969347 DOI: 10.1186/s13195-022-00992-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/20/2022] [Indexed: 12/20/2022]
Abstract
Background Apolipoprotein E epsilon 4 (APOE-ε4) carrier status is an established risk factor for Alzheimer’s disease (AD) dementia. It has also been linked with sleep disturbance in healthy older adults and increased insomnia risk. This association may be driven by the effect of APOE-ε4 on AD pathological change, itself associated with sleep abnormalities. To assess this relationship, we have evaluated post-mortem neuropathological findings in patients with and without cognitive impairment and AD pathology, who had extensive clinical assessment within 12 months of death. Methods This retrospective cohort study used UK Brain Banks Network data. Eligible subjects were aged over 50, with pre-mortem neuropsychiatry inventory scores of sleep disturbance (NPI-K), neurocognitive testing and functional cognitive status assessment (Clinical Dementia Rating scale). Neuropathological data included Thal phase, Braak stage and CERAD scores (measures of Aβ plaque distribution, tangle distribution and neuritic plaque density, respectively) combined to form the National Institute on Aging Alzheimer’s Association (NIA-AA) ABC score reflecting AD neuropathology. Participants with other significant intracerebral pathology or pathological features of non-AD dementia were excluded. Multivariate linear regression was performed with NPIK Global Score (NPIK frequency score multiplied by severity score) as the dependent variable and APOE-ε4 heterozygosity or homozygosity as independent variables. Covariates included age, gender, APOE-ε2 status and ABC NPI measures reflecting depression and anxiety. Further models stratified by ABC score and functional cognitive status were also produced. Results Seven hundred twenty-eight records were identified. Two hundred two participants were included in the final analysis: mean (SD) age 84.0 (9.2) and MMSE 14.0 (11.8). Mean sleep disturbance scores were highest in ε4 homozygosity (n=11), 4.55 (5.4); intermediate in ε4 heterozygosity (n=95), 2.03 (4.0); and lowest in non-ε4 carriers (n=96), 1.36 (3.3). Within the full sample, controlling for pathological status, age, gender, depression, anxiety and CDR-SOB status, APOE-ε4 homozygosity was associated with sleep disturbance (β 2.53, p=0.034). APOE-ε4 heterozygosity was similarly associated in individuals without dementia (β 1.21, p=0.048). Conclusion These findings lend weight to the hypothesis that APOE-ε4 affects sleep by mechanisms independent of AD pathological change. Evaluation of those mechanisms would enhance understanding of sleep disturbance pathways and potentially provide treatment targets. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-022-00992-y.
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Affiliation(s)
| | - Seth Love
- Learning and Research, University of Bristol, Southmead, Bristol, BS10 5NB, UK
| | - Lindsey Sinclair
- Learning and Research, University of Bristol, Southmead, Bristol, BS10 5NB, UK
| | - Richard Cain
- Learning and Research, University of Bristol, Southmead, Bristol, BS10 5NB, UK
| | - Elizabeth Coulthard
- Learning and Research, University of Bristol, Southmead, Bristol, BS10 5NB, UK.
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Stanisavljevic A, Schrader JM, Zhu X, Mattar JM, Hanks A, Xu F, Majchrzak M, Robinson JK, Van Nostrand WE. Impact of Non-pharmacological Chronic Hypertension on a Transgenic Rat Model of Cerebral Amyloid Angiopathy. Front Neurosci 2022; 16:811371. [PMID: 35368255 PMCID: PMC8964963 DOI: 10.3389/fnins.2022.811371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 02/09/2022] [Indexed: 11/13/2022] Open
Abstract
Cerebral amyloid angiopathy (CAA), a common comorbidity of Alzheimer’s disease (AD), is a cerebral small vessel disease (CSVD) characterized by deposition of fibrillar amyloid β (Aβ) in blood vessels of the brain and promotes neuroinflammation and vascular cognitive impairment and dementia (VCID). Hypertension, a prominent non-amyloidal CSVD, has been found to increase risk of dementia, but clinical data regarding its effects in CAA patients is controversial. To understand the effects of hypertension on CAA, we bred rTg-DI transgenic rats, a model of CAA, with spontaneously hypertensive, stroke prone (SHR-SP) rats producing bigenic rTg-DI/SHR-SP and non-transgenic SHR-SP littermates. At 7 months (M) of age, cohorts of both rTg-DI/SHR-SP and SHR-SP littermates exhibit elevated systolic blood pressures. However, transgene human amyloid β-protein (Aβ) precursor and Aβ peptide levels, as well as behavioral testing showed no changes between bigenic rTg-DI/SHR-SP and rTg-DI rats. Subsequent cohorts of rats were aged further to 10 M where bigenic rTg-DI/SHR-SP and SHR-SP littermates exhibit elevated systolic and diastolic blood pressures. Vascular amyloid load in hippocampus and thalamus was significantly decreased, whereas pial surface vessel amyloid increased, in bigenic rTg-DI/SHR-SP rats compared to rTg-DI rats suggesting a redistribution of vascular amyloid in bigenic animals. There was activation of both astrocytes and microglia in rTg-DI rats and bigenic rTg-DI/SHR-SP rats not observed in SHR-SP rats indicating that glial activation was likely in response to the presence of vascular amyloid. Thalamic microbleeds were present in both rTg-DI rats and bigenic rTg-DI/SHR-SP rats. Although the number of thalamic small vessel occlusions were not different between rTg-DI and bigenic rTg-DI/SHR-SP rats, a significant difference in occlusion size and distribution in the thalamus was found. Proteomic analysis of cortical tissue indicated that bigenic rTg-DI/SHR-SP rats largely adopt features of the rTg-DI rats with enhancement of certain changes. Our findings indicate that at 10 M of age non-pharmacological hypertension in rTg-DI rats causes a redistribution of vascular amyloid and significantly alters the size and distribution of thalamic occluded vessels. In addition, our findings indicate that bigenic rTg-DI/SHR-SP rats provide a non-pharmacological model to further study hypertension and CAA as co-morbidities for CSVD and VCID.
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Affiliation(s)
- Aleksandra Stanisavljevic
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI, United States
- George and Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, RI, United States
| | - Joseph M. Schrader
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI, United States
- George and Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, RI, United States
| | - Xiaoyue Zhu
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI, United States
- George and Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, RI, United States
| | - Jennifer M. Mattar
- George and Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, RI, United States
| | - Ashley Hanks
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI, United States
- George and Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, RI, United States
| | - Feng Xu
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI, United States
- George and Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, RI, United States
| | - Mark Majchrzak
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI, United States
- George and Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, RI, United States
| | - John K. Robinson
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI, United States
- George and Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, RI, United States
- Department of Psychology, University of Rhode Island, Kingston, RI, United States
| | - William E. Van Nostrand
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI, United States
- George and Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, RI, United States
- *Correspondence: William E. Van Nostrand,
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Finze A, Wahl H, Janowitz D, Buerger K, Linn J, Rominger A, Stöcklein S, Bartenstein P, Wollenweber FA, Catak C, Brendel M. Regional Associations of Cortical Superficial Siderosis and β-Amyloid-Positron-Emission-Tomography Positivity in Patients With Cerebral Amyloid Angiopathy. Front Aging Neurosci 2022; 13:786143. [PMID: 35185518 PMCID: PMC8851392 DOI: 10.3389/fnagi.2021.786143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/20/2021] [Indexed: 11/20/2022] Open
Abstract
Objective This is a cross-sectional study to evaluate whether β-amyloid-(Aβ)-PET positivity and cortical superficial siderosis (cSS) in patients with cerebral amyloid angiopathy (CAA) are regionally colocalized. Methods Ten patients with probable or possible CAA (73.3 ± 10.9 years, 40% women) underwent MRI examination with a gradient-echo-T2*-weighted-imaging sequence to detect cSS and 18F-florbetaben PET examination to detect fibrillar Aβ. In all cortical regions of the Hammers Atlas, cSS positivity (MRI: ITK-SNAP segmentation) and Aβ-PET positivity (PET: ≥ mean value + 2 standard deviations of 14 healthy controls) were defined. Regional agreement of cSS- and Aβ-PET positivity was evaluated. Aβ-PET quantification was compared between cSS-positive and corresponding contralateral cSS-negative atlas regions. Furthermore, the Aβ-PET quantification of cSS-positive regions was evaluated in voxels close to cSS and in direct cSS voxels. Results cSS- and Aβ-PET positivity did not indicate similarity of their regional patterns, despite a minor association between the frequency of Aβ-positive patients and the frequency of cSS-positive patients within individual regions (rs = 0.277, p = 0.032). However, this association was driven by temporal regions lacking cSS- and Aβ-PET positivity. When analyzing all composite brain regions, Aβ-PET values in regions close to cSS were significantly higher than in regions directly affected with cSS (p < 0.0001). However, Aβ-PET values in regions close to cSS were not different when compared to corresponding contralateral cSS-negative regions (p = 0.603). Conclusion In this cross-sectional study, cSS and Aβ-PET positivity did not show regional association in patients with CAA and deserve further exploitation in longitudinal designs. In clinical routine, a specific cross-sectional evaluation of Aβ-PET in cSS-positive regions is probably not useful for visual reading of Aβ-PETs in patients with CAA.
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Affiliation(s)
- Anika Finze
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Hannes Wahl
- Department of Neuroradiology, University Hospital of Dresden, Carl Gustav Carus University Dresden, Dresden, Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Katharina Buerger
- Institute for Stroke and Dementia Research, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Jennifer Linn
- Department of Neuroradiology, University Hospital of Dresden, Carl Gustav Carus University Dresden, Dresden, Germany
| | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sophia Stöcklein
- Department of Radiology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Frank Arne Wollenweber
- Institute for Stroke and Dementia Research, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Cihan Catak
- Institute for Stroke and Dementia Research, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- *Correspondence: Matthias Brendel,
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Walker JM, Richardson TE, Farrell K, White Iii CL, Crary JF. The Frequency of Cerebral Amyloid Angiopathy in Primary Age-Related Tauopathy. J Neuropathol Exp Neurol 2022; 81:246-248. [PMID: 34981120 PMCID: PMC9020475 DOI: 10.1093/jnen/nlab131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Jamie M Walker
- Department of Pathology and Laboratory Medicine, University of Texas Health San Antonio, San Antonio, Texas, USA.,Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health San Antonio, San Antonio, Texas, USA
| | - Timothy E Richardson
- Department of Pathology and Laboratory Medicine, University of Texas Health San Antonio, San Antonio, Texas, USA.,Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health San Antonio, San Antonio, Texas, USA
| | - Kurt Farrell
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Artificial Intelligence and Human Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Ronald M. Loeb Center for Alzheimer's Disease, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Charles L White Iii
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - John F Crary
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Artificial Intelligence and Human Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Ronald M. Loeb Center for Alzheimer's Disease, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Michiels L, Dobbels L, Demeestere J, Demaerel P, Van Laere K, Lemmens R. Simplified Edinburgh and modified Boston criteria in relation to amyloid PET for lobar intracerebral hemorrhage. NEUROIMAGE: CLINICAL 2022; 35:103107. [PMID: 35853346 PMCID: PMC9421490 DOI: 10.1016/j.nicl.2022.103107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/28/2022] [Accepted: 07/10/2022] [Indexed: 11/26/2022] Open
Abstract
Amyloid PET was positive in 63% of patients with lobar ICH. Simplified Edinburgh criteria and amyloid PET have similar accuracy vs Boston criteria. Simplified Edinburgh and Boston criteria have similar accuracy vs amyloid PET. Amyloid PET could assist in diagnosing CAA.
Background Histopathological evidence of cerebral vascular amyloid β accumulation is the gold standard to diagnose cerebral amyloid angiopathy (CAA). Neuroimaging findings obtained with CT and MRI can suggest the presence of CAA when histopathology is lacking. We explored the role of amyloid PET in patients with lobar intracerebral hemorrhage (ICH) as this may provide molecular evidence for CAA as well. Methods In this retrospective, monocenter analysis, we included consecutive patients with non-traumatic lobar ICH who had undergone amyloid PET. We categorized patients according to amyloid PET status and compared demographics and neuroimaging findings. We calculated sensitivity and specificity of the simplified Edinburgh criteria and amyloid PET with probable modified Boston criteria as reference standard, as well as sensitivity and specificity of the simplified Edinburgh and modified Boston criteria with amyloid PET status as molecular marker for presence or absence of CAA. Results We included 38 patients of whom 24 (63%) were amyloid PET positive. Amyloid PET positive patients were older at presentation (p = 0.004). We observed no difference in prevalence of subarachnoid hemorrhages, fingerlike projections or microbleeds between both groups, but cortical superficial siderosis (p = 0.003) was more frequent in the amyloid PET positive group. In 5 out of 38 patients (13%), the modified Boston criteria were not fulfilled due to young age or concomitant vitamin K antagonist use with INR > 3.0. With the modified Boston criteria as reference standard, there was no difference in sensitivity nor specificity between the simplified Edinburgh criteria and amyloid PET status. With amyloid PET status as reference standard, there was also no difference in sensitivity nor specificity between the simplified Edinburgh and modified Boston criteria. Conclusions Amyloid PET was positive in 63% of lobar ICH patients. Under certain circumstances, patients might not be diagnosed with probable CAA according to the modified Boston criteria and in these cases, amyloid PET may be useful. Accuracy to predict CAA based on amyloid PET status did not differ between the simplified Edinburgh and modified Boston criteria.
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Peters EC, Gee MT, Pawlowski LN, Kath AM, Polk FD, Vance CJ, Sacoman JL, Pires PW. Amyloid- β disrupts unitary calcium entry through endothelial NMDA receptors in mouse cerebral arteries. J Cereb Blood Flow Metab 2022; 42:145-161. [PMID: 34465229 PMCID: PMC8721780 DOI: 10.1177/0271678x211039592] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 01/07/2023]
Abstract
Transient increases in intracellular Ca2+ activate endothelium-dependent vasodilatory pathways. This process is impaired in cerebral amyloid angiopathy, where amyloid-β(1-40) accumulates around blood vessels. In neurons, amyloid-β impairs the Ca2+-permeable N-methyl-D-aspartate receptor (NMDAR), a mediator of endothelium-dependent dilation in arteries. We hypothesized that amyloid-β(1-40) reduces NMDAR-elicited Ca2+ signals in mouse cerebral artery endothelial cells, blunting dilation. Cerebral arteries isolated from 4-5 months-old, male and female cdh5:Gcamp8 mice were used for imaging of unitary Ca2+ influx through NMDAR (NMDAR sparklets) and intracellular Ca2+ transients. The NMDAR agonist NMDA (10 µmol/L) increased frequency of NMDAR sparklets and intracellular Ca2+ transients in endothelial cells; these effects were prevented by NMDAR antagonists D-AP5 and MK-801. Next, we tested if amyloid-β(1-40) impairs NMDAR-elicited Ca2+ transients. Cerebral arteries incubated with amyloid-β(1-40) (5 µmol/L) exhibited reduced NMDAR sparklets and intracellular Ca2+ transients. Lastly, we observed that NMDA-induced dilation of pial arteries is reduced by acute intraluminal amyloid-β(1-40), as well as in a mouse model of Alzheimer's disease, the 5x-FAD, linked to downregulation of Grin1 mRNA compared to wild-type littermates. These data suggest that endothelial NMDAR mediate dilation via Ca2+-dependent pathways, a process disrupted by amyloid-β(1-40) and impaired in 5x-FAD mice.
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Affiliation(s)
- Emily C Peters
- Department of Physiology, University of Arizona College of Medicine Tucson, Tucson, AZ, USA
| | - Michael T Gee
- Department of Physiology, University of Arizona College of Medicine Tucson, Tucson, AZ, USA
| | - Lukas N Pawlowski
- Department of Physiology, University of Arizona College of Medicine Tucson, Tucson, AZ, USA
| | - Allison M Kath
- Department of Physiology, University of Arizona College of Medicine Tucson, Tucson, AZ, USA
| | - Felipe D Polk
- Department of Physiology, University of Arizona College of Medicine Tucson, Tucson, AZ, USA
| | - Christopher J Vance
- Department of Physiology, University of Arizona College of Medicine Tucson, Tucson, AZ, USA
| | - Juliana L Sacoman
- Department of Physiology, University of Arizona College of Medicine Tucson, Tucson, AZ, USA
| | - Paulo W Pires
- Department of Physiology, University of Arizona College of Medicine Tucson, Tucson, AZ, USA
- Sarver Heart Center, University of Arizona College of Medicine Tucson, Tucson, AZ, USA
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Sveikata L, Charidimou A, Viswanathan A. Vessels Sing Their ARIAs: The Role of Vascular Amyloid in the Age of Aducanumab. Stroke 2021; 53:298-302. [PMID: 34905943 DOI: 10.1161/strokeaha.121.036873] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We review the implications of the recently approved aducanumab amyloid-β immunotherapy for treating Alzheimer disease with comorbid cerebral amyloid angiopathy. In clinical trials, amyloid-β immunotherapy has been associated with a high rate of amyloid-related imaging abnormalities, potentially driven by coexisting cerebral amyloid angiopathy. Therefore, immunotherapy's efficacy in patients may be modified by coexisting cerebrovascular pathology. We discuss the contributions of cerebral amyloid angiopathy on the development of amyloid-related imaging abnormalities and propose strategies to identify cerebral amyloid angiopathy in patients considered for immunotherapy.
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Affiliation(s)
- Lukas Sveikata
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston (L.S., A.C., A.V.).,Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Switzerland (L.S.)
| | - Andreas Charidimou
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston (L.S., A.C., A.V.)
| | - Anand Viswanathan
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston (L.S., A.C., A.V.)
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38
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Antolini L, DiFrancesco JC, Zedde M, Basso G, Arighi A, Shima A, Cagnin A, Caulo M, Carare RO, Charidimou A, Cirillo M, Di Lazzaro V, Ferrarese C, Giossi A, Inzitari D, Marcon M, Marconi R, Ihara M, Nitrini R, Orlandi B, Padovani A, Pascarella R, Perini F, Perini G, Sessa M, Scarpini E, Tagliavini F, Valenti R, Vázquez-Costa JF, Villarejo-Galende A, Hagiwara Y, Ziliotto N, Piazza F. Spontaneous ARIA-like Events in Cerebral Amyloid Angiopathy-Related Inflammation: A Multicenter Prospective Longitudinal Cohort Study. Neurology 2021; 97:e1809-e1822. [PMID: 34531298 PMCID: PMC8610623 DOI: 10.1212/wnl.0000000000012778] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 08/18/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The goal of this work was to investigate the natural history and outcomes after treatment for spontaneous amyloid-related imaging abnormalities (ARIA)-like in cerebral amyloid angiopathy-related inflammation (CAA-ri). METHODS This was a multicenter, hospital-based, longitudinal, prospective observational study of inpatients meeting CAA-ri diagnostic criteria recruited through the Inflammatory Cerebral Amyloid Angiopathy and Alzheimer's Disease βiomarkers International Network from January 2013 to March 2017. A protocol for systematic data collection at first-ever presentation and at subsequent in-person visits, including T1-weighted, gradient recalled echo-T2*, fluid-suppressed T2-weighted (fluid-attenuated inversion recovery), and T1 postgadolinium contrast-enhanced images acquired on 1.5T MRI, was used at the 3-, 6-, 12-, and 24-month follow-up. Centralized reads of MRIs were performed by investigators blinded to clinical, therapeutic, and time-point information. Main outcomes were survival, clinical and radiologic recovery, intracerebral hemorrhage (ICH), and recurrence of CAA-ri. RESULTS The study enrolled 113 participants (10.6% definite, 71.7% probable, and 17.7% possible CAA-ri). Their mean age was 72.9 years; 43.4% were female; 37.1% were APOEε4 carriers; 36.3% had a history of Alzheimer disease; and 33.6% had a history of ICH. A history of ICH and the occurrence of new ICH at follow-up were more common in patients with cortical superficial siderosis at baseline (52.6% vs 14.3%, p < 0.0001 and 19.3% vs 3.6%, p < 0.009, respectively). After the first-ever presentation of CAA-ri, 70.3% (95% confidence interval [CI] 61.6%-78.5%) and 84.1% (95% CI 76.2%-90.6%) clinically recovered within 3 and 12 months, followed by radiologic recovery in 45.1% (95% CI 36.4%-54.8%) and 77.4% (95% CI 67.7%-85.9%), respectively. After clinicoradiologic resolution of the first-ever episode, 38.3% (95% CI 22.9%-59.2%) had at least 1 recurrence within the following 24 months. Recurrence was more likely if IV high-dose corticosteroid pulse therapy was suddenly stopped compared to slow oral tapering off (hazard ratio 4.68, 95% CI 1.57-13.93; p = 0.006). DISCUSSION These results from the largest longitudinal cohort registry of patients with CAA-ri support the transient and potentially relapsing inflammatory nature of the clinical-radiologic acute manifestations of the disease and the effectiveness of slow oral tapering off after IV corticosteroid pulse therapy in preventing recurrences. Our results highlight the importance of differential diagnosis for spontaneous ARIA-like events in β-amyloid-driven diseases, including treatment-related ARIA in patients with Alzheimer disease exposed to immunotherapy drugs.
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Affiliation(s)
- Laura Antolini
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Jacopo C DiFrancesco
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Marialuisa Zedde
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Gianpaolo Basso
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Andrea Arighi
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Atsushi Shima
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Annachiara Cagnin
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Massimo Caulo
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Roxana O Carare
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Andreas Charidimou
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Mario Cirillo
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Vincenzo Di Lazzaro
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Carlo Ferrarese
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Alessia Giossi
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Domenico Inzitari
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Michela Marcon
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Roberto Marconi
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Masafumi Ihara
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Ricardo Nitrini
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Berardino Orlandi
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Alessandro Padovani
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Rosario Pascarella
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Francesco Perini
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Giulia Perini
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Maria Sessa
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Elio Scarpini
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Fabrizio Tagliavini
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Raffaella Valenti
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Juan Francisco Vázquez-Costa
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Alberto Villarejo-Galende
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Yuta Hagiwara
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Nicole Ziliotto
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Fabrizio Piazza
- From the School of Medicine and Surgery (L.A., J.C.D., G.B., C.F., N.Z., F. Piazza), University of Milano-Bicocca, Monza; Neurology Unit (M.Z.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico Milano and University of Milan (A.A., E.S.), Italy; Kyoto University Graduate School of Medicine (A.S.), Japan; University of Padova (A.C.); University of Chieti (M. Caulo), Italy; University of Southampton (R.O.C.), UK; Department of Neurology (A.C.), Boston Medical Center, Boston University, MA; University of Campania "Luigi Vanvitelli" (M. Cirillo), Napoli; Università Campus Biomedico (V.D.L.), Rome; Azienda Socio Sanitaria Territoriale di Cremona (A.G.); Italian National Research Council (D.I.), University of Florence; Neuroscience Institute (D.I.), Pisa; S. Bortolo Hospital (M.M., F. Perini), Vicenza; Azienda USL Toscana sud est (R.M.), Grosseto, Italy; National Cerebral and Cardiovascular Center (M.I.), Osaka, Japan; University of São Paulo Medical School (R.N.), Brazil; S.S. Filippo and Nicola Hospital (B.O.), Avezzano; University of Brescia (A.P.); Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; IRCCS Mondino Foundation and University of Pavia (G.P.); Ospedale Papa Giovanni XXIII (M.S.), Bergamo; Fondazione IRCCS "Carlo Besta" National Neurological Institute (F.T.), Milan, Italy; Azienda USL Toscana Centro (R.V.), Prato, Italy; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (J.F.V.-C.), Valencia; Hospital Universitario 12 de Octubre (A.V.-G.), Madrid, Spain; St. Marianna University School of Medicine (Y.H.), Kawasaki, Japan; and CAA and AD Translational Research and Biomarkers Laboratory (F. Piazza), PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
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Lee MC, Liao YH, Chen SH, Chen YR. Amyloid-β40 E22K fibril in familial Alzheimer's disease is more thermostable and susceptible to seeding. IUBMB Life 2021; 74:739-747. [PMID: 34724333 DOI: 10.1002/iub.2570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 09/25/2021] [Accepted: 10/10/2021] [Indexed: 11/11/2022]
Abstract
Alzheimer's disease (AD) is the most prevalent and devastating neurodegenerative disease occurred in the elderly. One of the pathogenic hallmarks is senile plaques composed of amyloid-β (Aβ) fibrils. Single mutations resided in Aβ were found in familial AD (FAD) patients that have early onset of the disease. The molecular details and properties of each FAD Aβ variants are still elusive. Here, we employed collective spectroscopic techniques to examine the properties of various Aβ40 fibrils. We generated fibrils of wild type (WT) and three FAD mutants on residue E22 including E22G, E22K, and E22Q. We monitored fibril formation by thioflavin T (ThT) assay, examined secondary structure by Fourier transform infrared and far-UV circular dichroism spectroscopy, imaged fibril morphology by transmission electron microscopy, and evaluated ThT-binding kinetics. In the thermal experiments, we found E22K fibrils resisted to high temperature and retained significant β-sheet content than the others. E22K fibril seeds after high-temperature treatment still possess the seeding property, whereas WT fibril seeds are disturbed after the treatment. Therefore, in this study we demonstrated the mutation at E22K increases the thermal stability and seeding function of amyloid fibrils.
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Affiliation(s)
- Ming-Che Lee
- Genomics Research Center, Academia Sinica, Taipei, Taiwan.,Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Hung Liao
- Genomics Research Center, Academia Sinica, Taipei, Taiwan
| | - Shih-Hui Chen
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei, Taiwan
| | - Yun-Ru Chen
- Genomics Research Center, Academia Sinica, Taipei, Taiwan.,Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
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Tataryn NM, Singh V, Dyke JP, Berk-Rauch HE, Clausen DM, Aronowitz E, Norris EH, Strickland S, Ahn HJ. Vascular endothelial growth factor associated dissimilar cerebrovascular phenotypes in two different mouse models of Alzheimer's Disease. Neurobiol Aging 2021; 107:96-108. [PMID: 34416494 PMCID: PMC8595520 DOI: 10.1016/j.neurobiolaging.2021.07.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 07/15/2021] [Accepted: 07/20/2021] [Indexed: 01/14/2023]
Abstract
Vascular perturbations and cerebral hypometabolism are emerging as important components of Alzheimer's disease (AD). While various in vivo imaging modalities have been designed to detect changes of cerebral perfusion and metabolism in AD patients and animal models, study results were often heterogenous with respect to imaging techniques and animal models. We therefore evaluated cerebral perfusion and glucose metabolism of two popular transgenic AD mouse strains, TgCRND8 and 5xFAD, at 7 and 12 months-of-age under identical conditions and analyzed possible molecular mechanisms underlying heterogeneous cerebrovascular phenotypes. Results revealed disparate findings in these two strains, displaying important aspects of AD progression. TgCRND8 mice showed significantly decreased cerebral blood flow and glucose metabolism with unchanged cerebral blood volume (CBV) at 12 months-of-age whereas 5xFAD mice showed unaltered glucose metabolism with significant increase in CBV at 12 months-of-age and a biphasic pattern of early hypoperfusion followed by a rebound to normal cerebral blood flow in late disease. Finally, immunoblotting assays suggested that VEGF dependent vascular tone change may restore normoperfusion and increase CBV in 5xFAD.
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Affiliation(s)
- Nicholas M Tataryn
- Tri-Institutional Training Program in Laboratory Animal Medicine and Science, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, and The Rockefeller University, New York, New York, USA and Center for Comparative Medicine and Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Patricia and John Rosenwald Laboratory of Neurobiology and Genetics, Rockefeller University, New York, NY, USA; Division of Comparative Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Vishal Singh
- Department of Pharmacology, Physiology and Neurosciences, Rutgers-New Jersey Medical School, Newark, NJ, USA
| | - Jonathan P Dyke
- Citigroup Biomedical Imaging Center, Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Hanna E Berk-Rauch
- Patricia and John Rosenwald Laboratory of Neurobiology and Genetics, Rockefeller University, New York, NY, USA
| | - Dana M Clausen
- Department of Pharmacology, Physiology and Neurosciences, Rutgers-New Jersey Medical School, Newark, NJ, USA
| | - Eric Aronowitz
- Citigroup Biomedical Imaging Center, Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Erin H Norris
- Patricia and John Rosenwald Laboratory of Neurobiology and Genetics, Rockefeller University, New York, NY, USA
| | - Sidney Strickland
- Patricia and John Rosenwald Laboratory of Neurobiology and Genetics, Rockefeller University, New York, NY, USA
| | - Hyung Jin Ahn
- Department of Pharmacology, Physiology and Neurosciences, Rutgers-New Jersey Medical School, Newark, NJ, USA; Brain Health Institute, Rutgers University, Piscataway, NJ, USA.
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Abstract
Apolipoprotein E (APOE) has three different isoforms, with APOE4 carriers representing a major risk factor for the development of Alzheimer’s disease (AD). AD is the most common form of dementia, and is a relentlessly progressive disorder that afflicts the aged, characterized by severe memory loss. Presently, AD does not have a cure, increasing the urgency for the development of novel therapeutics for the prevention/treatment of AD. The APOE4 isoform is associated with many pathological mechanisms, such as increased neuroinflammation and a reduction in β-amyloid (Aβ) clearance. The accumulation of Aβ plaques in the brain is a hallmark of AD. The presence of APOE4 can increase neuroinflammation via overactivation of the nuclear factor kappa B (NF-κB) pathway. The NF-κB pathway is a family of transcription factors involved with regulating over 400 genes involved with inflammation. AD is associated with sustained inflammation and an overactivation of the NF-κB pathway. Therefore, targeting the APOE4 isoform and suppressing the NF-κB pathway using anti-inflammatory compounds may result in the development of novel therapeutics for the prevention/treatment of AD.
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Reith FH, Mormino EC, Zaharchuk G. Predicting future amyloid biomarkers in dementia patients with machine learning to improve clinical trial patient selection. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2021; 7:e12212. [PMID: 34692985 PMCID: PMC8515556 DOI: 10.1002/trc2.12212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 05/11/2021] [Accepted: 07/30/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION In Alzheimer's disease, asymptomatic patients may have amyloid deposition, but predicting their progression rate remains a substantial challenge with implications for clinical trial enrollment. Here, we demonstrate an artificial intelligence approach to use baseline clinical information and images to predict changes in quantitative biomarkers of brain pathology on future images. METHODS Patients from the Alzheimer's Disease Neuroimaging Initiative (ADNI) who underwent positron emission tomography (PET) with the amyloid radiotracer 18F-AV45 (florbetapir) were included. We identified important baseline PET image features using a deep convolutional neural network based on ResNet. These were combined with eight clinical, demographic, and genetic markers using a gradient-boosted decision tree (GBDT) algorithm to predict future quantitative standardized uptake value ratio (SUVR), an established biomarker of brain amyloid deposition. We used this model to better identify individuals with the highest positive change in amyloid deposition on future images and compared this to typical inclusion criteria for clinical trials. We also compared the model's performance to other methods such as multivariate linear regression and GBDT without imaging features. FINDINGS Using 2577 PET scans from 1224 unique individuals, we showed that the GBDT with deep image features was significantly more accurate than the other approaches, reaching a root mean squared error of 0.0339 ± 0.0027 for future SUVR prediction. Using this approach, we could identify individuals with the highest 10% SUVR accumulation at rates 2- to 4-fold higher than by random pick or existing inclusion criteria. DISCUSSION Predicting quantitative biomarkers on future images using machine learning methods consisting of deep image features combined with clinical data may allow better targeting of treatments or enrollment in clinical trials.
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Affiliation(s)
- Fabian H. Reith
- Department of RadiologyStanford UniversityPalo AltoCaliforniaUSA
| | - Elizabeth C. Mormino
- Department of Neurology and Neurological SciencesStanford UniversityPalo AltoCaliforniaUSA
| | - Greg Zaharchuk
- Department of RadiologyStanford UniversityPalo AltoCaliforniaUSA
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Shi H, Koronyo Y, Rentsendorj A, Fuchs DT, Sheyn J, Black KL, Mirzaei N, Koronyo-Hamaoui M. Retinal Vasculopathy in Alzheimer's Disease. Front Neurosci 2021; 15:731614. [PMID: 34630020 PMCID: PMC8493243 DOI: 10.3389/fnins.2021.731614] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 08/26/2021] [Indexed: 12/12/2022] Open
Abstract
The retina has been increasingly investigated as a site of Alzheimer’s disease (AD) manifestation for over a decade. Early reports documented degeneration of retinal ganglion cells and their axonal projections. Our group provided the first evidence of the key pathological hallmarks of AD, amyloid β-protein (Aβ) plaques including vascular Aβ deposits, in the retina of AD and mild cognitively impaired (MCI) patients. Subsequent studies validated these findings and further identified electroretinography and vision deficits, retinal (p)tau and inflammation, intracellular Aβ accumulation, and retinal ganglion cell-subtype degeneration surrounding Aβ plaques in these patients. Our data suggest that the brain and retina follow a similar trajectory during AD progression, probably due to their common embryonic origin and anatomical proximity. However, the retina is the only CNS organ feasible for direct, repeated, and non-invasive ophthalmic examination with ultra-high spatial resolution and sensitivity. Neurovascular unit integrity is key to maintaining normal CNS function and cerebral vascular abnormalities are increasingly recognized as early and pivotal factors driving cognitive impairment in AD. Likewise, retinal vascular abnormalities such as changes in vessel density and fractal dimensions, blood flow, foveal avascular zone, curvature tortuosity, and arteriole-to-venule ratio were described in AD patients including early-stage cases. A rapidly growing number of reports have suggested that cerebral and retinal vasculopathy are tightly associated with cognitive deficits in AD patients and animal models. Importantly, we recently identified early and progressive deficiency in retinal vascular platelet-derived growth factor receptor-β (PDGFRβ) expression and pericyte loss that were associated with retinal vascular amyloidosis and cerebral amyloid angiopathy in MCI and AD patients. Other studies utilizing optical coherence tomography (OCT), retinal amyloid-fluorescence imaging and retinal hyperspectral imaging have made significant progress in visualizing and quantifying AD pathology through the retina. With new advances in OCT angiography, OCT leakage, scanning laser microscopy, fluorescein angiography and adaptive optics imaging, future studies focusing on retinal vascular AD pathologies could transform non-invasive pre-clinical AD diagnosis and monitoring.
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Affiliation(s)
- Haoshen Shi
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Yosef Koronyo
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Altan Rentsendorj
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Dieu-Trang Fuchs
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Julia Sheyn
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Keith L Black
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Nazanin Mirzaei
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Maya Koronyo-Hamaoui
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States.,Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, United States
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44
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Blood cell-produced amyloid-β induces cerebral Alzheimer-type pathologies and behavioral deficits. Mol Psychiatry 2021; 26:5568-5577. [PMID: 32681097 DOI: 10.1038/s41380-020-0842-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 07/04/2020] [Accepted: 07/08/2020] [Indexed: 12/21/2022]
Abstract
It is traditionally believed that cerebral amyloid-beta (Aβ) deposits are derived from the brain itself in Alzheimer's disease (AD). Peripheral cells such as blood cells also produce Aβ. The role of peripherally produced Aβ in the pathogenesis of AD remains unknown. In this study, we established a bone marrow transplantation model to investigate the contribution of blood cell-produced Aβ to AD pathogenesis. We found that bone marrow cells (BMCs) transplanted from APPswe/PS1dE9 transgenic mice into wild-type (Wt) mice at 3 months of age continuously expressed human Aβ in the blood, and caused AD phenotypes including Aβ plaques, cerebral amyloid angiopathy (CAA), tau hyperphosphorylation, neuronal degeneration, neuroinflammation, and behavioral deficits in the Wt recipient mice at 12 months after transplantation. Bone marrow reconstitution in APPswe/PS1dE9 mice with Wt-BMCs at 3 months of age reduced blood Aβ levels, and alleviated brain Aβ burden, neuronal degeneration, neuroinflammation, and behavioral deficits in the AD model mice at 12 months after transplantation. Our study demonstrated that blood cell-produced Aβ plays a significant role in AD pathogenesis, and the elimination of peripheral production of Aβ can decrease brain Aβ deposition and represents a novel therapeutic approach for AD.
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45
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Costa AS, Pinho J, Kučikienė D, Reich A, Schulz JB, Reetz K. Cerebral Amyloid Angiopathy in Amyloid-Positive Patients from a Memory Clinic Cohort. J Alzheimers Dis 2021; 79:1661-1672. [PMID: 33492291 DOI: 10.3233/jad-201218] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The overlap between cerebral amyloid angiopathy (CAA) and Alzheimer's disease (AD) is frequent and relevant for patients with cognitive impairment. OBJECTIVE To assess the role of the diagnosis of CAA on the phenotype of amyloid-β (Aβ) positive patients from a university-hospital memory clinic. METHODS Consecutive patients referred for suspected cognitive impairment, screened for Aβ pathological changes in cerebrospinal fluid (CSF), with available MRI and neuropsychological results were included. We determined the association between probable CAA and clinical, neuropsychological (at presentation and after a mean follow-up of 17 months in a sub-sample) and MRI (atrophy, white matter hyperintensities, perivascular spaces) characteristics. RESULTS Of 218 amyloid-positive patients, 8.3% fulfilled criteria for probable CAA. A multivariable logistic regression showed an independent association of probable CAA with lower Aβ1-42 (adjusted odds ratio [aOR] = 0.94, 95% confidence interval [95% CI] = 0.90-0.98, p = 0.003), and Aβ1-40 (aOR = 0.98, 95% CI=0.97-0.99 p = 0.017) levels in CSF, and presence of severe burden of enlarged perivascular spaces (EPVS) in the centrum semiovale (aOR = 3.67, 95% CI = 1.21-11.15, p = 0.022). Linear mixed-model analysis showed that both groups significantly deteriorated in global clinical severity, executive function and memory. Nevertheless, the presence of probable CAA did not differently affect the rate of cognitive decline. CONCLUSION The presence of probable CAA in Aβ positive patients was associated with lower Aβ1-42 and Aβ1-40 CSF levels and increased centrum semiovale EPVS burden, but did not independently influence clinical phenotype nor the rate of cognitive decline within our follow-up time window.
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Affiliation(s)
- Ana Sofia Costa
- Department of Neurology, University Hospital RWTH Aachen, Aachen, Germany.,JARA-Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich, Jülich, Germany and RWTH Aachen University, Aachen, Germany
| | - João Pinho
- Department of Neurology, University Hospital RWTH Aachen, Aachen, Germany
| | - Domantė Kučikienė
- Department of Neurology, University Hospital RWTH Aachen, Aachen, Germany
| | - Arno Reich
- Department of Neurology, University Hospital RWTH Aachen, Aachen, Germany
| | - Jörg B Schulz
- Department of Neurology, University Hospital RWTH Aachen, Aachen, Germany.,JARA-Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich, Jülich, Germany and RWTH Aachen University, Aachen, Germany
| | - Kathrin Reetz
- Department of Neurology, University Hospital RWTH Aachen, Aachen, Germany.,JARA-Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich, Jülich, Germany and RWTH Aachen University, Aachen, Germany
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46
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Skaaraas GHES, Melbye C, Puchades MA, Leung DSY, Jacobsen Ø, Rao SB, Ottersen OP, Leergaard TB, Torp R. Cerebral Amyloid Angiopathy in a Mouse Model of Alzheimer's Disease Associates with Upregulated Angiopoietin and Downregulated Hypoxia-Inducible Factor. J Alzheimers Dis 2021; 83:1651-1663. [PMID: 34459401 PMCID: PMC8609707 DOI: 10.3233/jad-210571] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background: Vascular pathology is a common feature in patients with advanced Alzheimer’s disease, with cerebral amyloid angiopathy (CAA) and microvascular changes commonly observed at autopsies and in genetic mouse models. However, despite a plethora of studies addressing the possible impact of CAA on brain vasculature, results have remained contradictory, showing reduced, unchanged, or even increased capillary densities in human and rodent brains overexpressing amyloid-β in Alzheimer’s disease and Down’s syndrome. Objective: We asked if CAA is associated with changes in angiogenetic factors or receptors and if so, whether this would translate into morphological alterations in pericyte coverage and vessel density. Methods: We utilized the transgenic mice carrying the Arctic (E693G) and Swedish (KM670/6701NL) amyloid precursor protein which develop severe CAA in addition to parenchymal plaques. Results: The main finding of the present study was that CAA in Tg-ArcSwe mice is associated with upregulated angiopoietin and downregulated hypoxia-inducible factor. In the same mice, we combined immunohistochemistry and electron microscopy to quantify the extent of CAA and investigate to which degree vessels associated with amyloid plaques were pathologically affected. We found that despite a severe amount of CAA and alterations in several angiogenetic factors in Tg-ArcSwe mice, this was not translated into significant morphological alterations like changes in pericyte coverage or vessel density. Conclusion: Our data suggest that CAA does not impact vascular density but might affect capillary turnover by causing changes in the expression levels of angiogenetic factors.
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Affiliation(s)
| | - Christoffer Melbye
- Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Maja A Puchades
- Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Doreen Siu Yi Leung
- Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | | | - Shreyas B Rao
- Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Ole Petter Ottersen
- Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Trygve B Leergaard
- Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Reidun Torp
- Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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47
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Liao C, Xu J, Chen Y, Ip NY. Retinal Dysfunction in Alzheimer's Disease and Implications for Biomarkers. Biomolecules 2021; 11:biom11081215. [PMID: 34439882 PMCID: PMC8394950 DOI: 10.3390/biom11081215] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/03/2021] [Accepted: 08/09/2021] [Indexed: 02/08/2023] Open
Abstract
Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that manifests as cognitive deficits and memory decline, especially in old age. Several biomarkers have been developed to monitor AD progression. Given that the retina and brain share some similarities including features related to anatomical composition and neurological functions, the retina is closely associated with the progression of AD. Herein, we review the evidence of retinal dysfunction in AD, particularly at the early stage, together with the underlying molecular mechanisms. Furthermore, we compared the retinal pathologies of AD and other ophthalmological diseases and summarized potential retinal biomarkers measurable by existing technologies for detecting AD, providing insights for the future development of diagnostic tools.
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Affiliation(s)
- Chunyan Liao
- Chinese Academy of Sciences Key Laboratory of Brain Connectome and Manipulation, Shenzhen Key Laboratory of Translational Research for Brain Diseases, The Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science—Shenzhen Fundamental Research Institutions, Shenzhen 518055, China; (C.L.); (J.X.)
- Guangdong Provincial Key Laboratory of Brain Science, Disease and Drug Development, Shenzhen-Hong Kong Institute of Brain Science, HKUST Shenzhen Research Institute, Shenzhen 518057, China
| | - Jinying Xu
- Chinese Academy of Sciences Key Laboratory of Brain Connectome and Manipulation, Shenzhen Key Laboratory of Translational Research for Brain Diseases, The Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science—Shenzhen Fundamental Research Institutions, Shenzhen 518055, China; (C.L.); (J.X.)
- Guangdong Provincial Key Laboratory of Brain Science, Disease and Drug Development, Shenzhen-Hong Kong Institute of Brain Science, HKUST Shenzhen Research Institute, Shenzhen 518057, China
- Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yu Chen
- Chinese Academy of Sciences Key Laboratory of Brain Connectome and Manipulation, Shenzhen Key Laboratory of Translational Research for Brain Diseases, The Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science—Shenzhen Fundamental Research Institutions, Shenzhen 518055, China; (C.L.); (J.X.)
- Guangdong Provincial Key Laboratory of Brain Science, Disease and Drug Development, Shenzhen-Hong Kong Institute of Brain Science, HKUST Shenzhen Research Institute, Shenzhen 518057, China
- Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Beijing 100049, China
- Correspondence: (Y.C.); (N.Y.I.); Tel.: +86-755-2692-5498 (Y.C.); +852-2358-6161 (N.Y.I.)
| | - Nancy Y. Ip
- Guangdong Provincial Key Laboratory of Brain Science, Disease and Drug Development, Shenzhen-Hong Kong Institute of Brain Science, HKUST Shenzhen Research Institute, Shenzhen 518057, China
- Division of Life Science, Molecular Neuroscience Center, and State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Hong Kong 999077, China
- Correspondence: (Y.C.); (N.Y.I.); Tel.: +86-755-2692-5498 (Y.C.); +852-2358-6161 (N.Y.I.)
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48
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Rice LJ, Ecroyd H, van Oijen AM. Illuminating amyloid fibrils: Fluorescence-based single-molecule approaches. Comput Struct Biotechnol J 2021; 19:4711-4724. [PMID: 34504664 PMCID: PMC8405898 DOI: 10.1016/j.csbj.2021.08.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 12/15/2022] Open
Abstract
The aggregation of proteins into insoluble filamentous amyloid fibrils is a pathological hallmark of neurodegenerative diseases that include Parkinson's disease and Alzheimer's disease. Since the identification of amyloid fibrils and their association with disease, there has been much work to describe the process by which fibrils form and interact with other proteins. However, due to the dynamic nature of fibril formation and the transient and heterogeneous nature of the intermediates produced, it can be challenging to examine these processes using techniques that rely on traditional ensemble-based measurements. Single-molecule approaches overcome these limitations as rare and short-lived species within a population can be individually studied. Fluorescence-based single-molecule methods have proven to be particularly useful for the study of amyloid fibril formation. In this review, we discuss the use of different experimental single-molecule fluorescence microscopy approaches to study amyloid fibrils and their interaction with other proteins, in particular molecular chaperones. We highlight the mechanistic insights these single-molecule techniques have already provided in our understanding of how fibrils form, and comment on their potential future use in studying amyloid fibrils and their intermediates.
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Affiliation(s)
- Lauren J. Rice
- Molecular Horizons and School of Chemistry and Molecular Bioscience, University of Wollongong, Wollongong, NSW 2522, Australia
- Illawarra Health & Medical Research Institute, Wollongong, NSW 2522, Australia
| | - Heath Ecroyd
- Molecular Horizons and School of Chemistry and Molecular Bioscience, University of Wollongong, Wollongong, NSW 2522, Australia
- Illawarra Health & Medical Research Institute, Wollongong, NSW 2522, Australia
| | - Antoine M. van Oijen
- Molecular Horizons and School of Chemistry and Molecular Bioscience, University of Wollongong, Wollongong, NSW 2522, Australia
- Illawarra Health & Medical Research Institute, Wollongong, NSW 2522, Australia
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49
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Salcedo-Arellano MJ, Wang JY, McLennan YA, Doan M, Cabal-Herrera AM, Jimenez S, Wolf-Ochoa MW, Sanchez D, Juarez P, Tassone F, Durbin-Johnson B, Hagerman RJ, Martínez-Cerdeño V. Cerebral Microbleeds in Fragile X-Associated Tremor/Ataxia Syndrome. Mov Disord 2021; 36:1935-1943. [PMID: 33760253 PMCID: PMC10929604 DOI: 10.1002/mds.28559] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/18/2021] [Accepted: 02/22/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Fragile X-associated tremor/ataxia syndrome is a neurodegenerative disease of late onset developed by carriers of the premutation in the fragile x mental retardation 1 (FMR1) gene. Pathological features of neurodegeneration in fragile X-associated tremor/ataxia syndrome include toxic levels of FMR1 mRNA, ubiquitin-positive intranuclear inclusions, white matter disease, iron accumulation, and a proinflammatory state. OBJECTIVE The objective of this study was to analyze the presence of cerebral microbleeds in the brains of patients with fragile X-associated tremor/ataxia syndrome and investigate plausible causes for cerebral microbleeds in fragile X-associated tremor/ataxia syndrome. METHODS We collected cerebral and cerebellar tissue from 15 fragile X-associated tremor/ataxia syndrome cases and 15 control cases carrying FMR1 normal alleles. We performed hematoxylin and eosin, Perls and Congo red stains, ubiquitin, and amyloid β protein immunostaining. We quantified the number of cerebral microbleeds, amount of iron, presence of amyloid β within the capillaries, and number of endothelial cells containing intranuclear inclusions. We evaluated the relationships between pathological findings using correlation analysis. RESULTS We found intranuclear inclusions in the endothelial cells of capillaries and an increased number of cerebral microbleeds in the brains of those with fragile X-associated tremor/ataxia syndrome, both of which are indicators of cerebrovascular dysfunction. We also found a suggestive association between the amount of capillaries that contain amyloid β in the cerebral cortex and the rate of disease progression. CONCLUSION We propose microangiopathy as a pathologic feature of fragile X-associated tremor/ataxia syndrome. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- María Jimena Salcedo-Arellano
- Department of Pediatrics, University of California Davis School of Medicine, Sacramento, CA, USA
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, Sacramento, CA, USA
- Institute for Pediatric Regenerative Medicine and Shriners Hospitals for Children Northern California, Sacramento, CA, USA
- Department of Pathology and Laboratory Medicine, UC Davis School of Medicine, Sacramento, CA, USA
| | - Jun Yi Wang
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, Sacramento, CA, USA
- Center for Mind and Brain, University of California Davis, Davis, CA, USA
| | - Yingratana A McLennan
- Department of Pediatrics, University of California Davis School of Medicine, Sacramento, CA, USA
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, Sacramento, CA, USA
- Institute for Pediatric Regenerative Medicine and Shriners Hospitals for Children Northern California, Sacramento, CA, USA
| | - Mai Doan
- Institute for Pediatric Regenerative Medicine and Shriners Hospitals for Children Northern California, Sacramento, CA, USA
- Department of Pathology and Laboratory Medicine, UC Davis School of Medicine, Sacramento, CA, USA
| | - Ana Maria Cabal-Herrera
- Group on Congenital Malformations and Dysmorphology, Faculty of Health, Universidad del Valle (MACOS), Cali, Colombia
| | - Sara Jimenez
- Institute for Pediatric Regenerative Medicine and Shriners Hospitals for Children Northern California, Sacramento, CA, USA
- Department of Pathology and Laboratory Medicine, UC Davis School of Medicine, Sacramento, CA, USA
| | - Marisol W Wolf-Ochoa
- Institute for Pediatric Regenerative Medicine and Shriners Hospitals for Children Northern California, Sacramento, CA, USA
- Department of Pathology and Laboratory Medicine, UC Davis School of Medicine, Sacramento, CA, USA
| | - Desiree Sanchez
- Institute for Pediatric Regenerative Medicine and Shriners Hospitals for Children Northern California, Sacramento, CA, USA
- Department of Pathology and Laboratory Medicine, UC Davis School of Medicine, Sacramento, CA, USA
| | - Pablo Juarez
- Institute for Pediatric Regenerative Medicine and Shriners Hospitals for Children Northern California, Sacramento, CA, USA
- Department of Pathology and Laboratory Medicine, UC Davis School of Medicine, Sacramento, CA, USA
| | - Flora Tassone
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, Sacramento, CA, USA
- Department of Biochemistry and Molecular Medicine, UC Davis School of Medicine, Sacramento, CA, USA
| | - Blythe Durbin-Johnson
- Division of Biostatistics, Department of Public Health Sciences, UC Davis School of Medicine, Sacramento, CA, USA
| | - Randi J Hagerman
- Department of Pediatrics, University of California Davis School of Medicine, Sacramento, CA, USA
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, Sacramento, CA, USA
| | - Verónica Martínez-Cerdeño
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, Sacramento, CA, USA
- Institute for Pediatric Regenerative Medicine and Shriners Hospitals for Children Northern California, Sacramento, CA, USA
- Department of Pathology and Laboratory Medicine, UC Davis School of Medicine, Sacramento, CA, USA
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50
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Willumsen N, Poole T, Nicholas JM, Fox NC, Ryan NS, Lashley T. Variability in the type and layer distribution of cortical Aβ pathology in familial Alzheimer's disease. Brain Pathol 2021; 32:e13009. [PMID: 34319632 PMCID: PMC9048809 DOI: 10.1111/bpa.13009] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 11/30/2022] Open
Abstract
Familial Alzheimer's disease (FAD) is caused by autosomal dominant mutations in the PSEN1, PSEN2 or APP genes, giving rise to considerable clinical and pathological heterogeneity in FAD. Here we investigate variability in clinical data and the type and distribution of Aβ pathologies throughout the cortical layers of different FAD mutation cases. Brain tissue from 20 FAD cases [PSEN1 pre-codon 200 (n = 10), PSEN1 post-codon 200 (n = 6), APP (n = 4)] were investigated. Frontal cortex sections were stained immunohistochemically for Aβ, and Nissl to define the cortical layers. The frequency of different amyloid-beta plaque types was graded for each cortical layer and the severity of cerebral amyloid angiopathy (CAA) was determined in cortical and leptomeningeal blood vessels. Comparisons were made between FAD mutations and APOE4 status, with associations between pathology, clinical and genetic data investigated. In this cohort, possession of an APOE4 allele was associated with increased disease duration but not with age at onset, after adjusting for mutation sub-group and sex. We found Aβ pathology to be heterogeneous between cases although Aβ load was highest in cortical layer 3 for all mutation groups and a higher Aβ load was associated with APOE4. The PSEN1 post-codon 200 group had a higher Aβ load in lower cortical layers, with a small number of this group having increased cotton wool plaque pathology in lower layers. Cotton wool plaque frequency was positively associated with the severity of CAA in the whole cohort and in the PSEN1 post-codon 200 group. Carriers of the same PSEN1 mutation can have differing patterns of Aβ deposition, potentially because of differences in risk factors. Our results highlight possible influences of APOE4 genotype, and PSEN1 mutation type on Aβ deposition, which may have effects on the clinical heterogeneity of FAD.
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Affiliation(s)
- Nanet Willumsen
- The Queen Square Brain Bank for Neurological Disorders, Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.,Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Teresa Poole
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK.,Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Jennifer M Nicholas
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK.,Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Nick C Fox
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK.,UK Dementia Research Institute at University College London, London, UK
| | - Natalie S Ryan
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK.,UK Dementia Research Institute at University College London, London, UK
| | - Tammaryn Lashley
- The Queen Square Brain Bank for Neurological Disorders, Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.,Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
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