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Interaction between cerebrovascular disease and Alzheimer pathology #MMPMID26779861
Saito S; Ihara M
Curr Opin Psychiatry 2016[Mar]; 29 (2): 168-73 PMID26779861show ga
PURPOSE OF REVIEW: Epidemiological investigations have proposed strict control of vascular risk factors as a strategy to overcome dementia, because of the close interaction between cerebrovascular disease (CVD) and Alzheimer's disease. In light of recent advances in basic, translational, and clinical research in the area, this review focuses on the significance of CVD in Alzheimer's disease pathogenesis. RECENT FINDINGS: Alzheimer's disease and CVD share several risk factors, and the coexistence of both pathologies is frequently noted. CVD and subsequent cerebral blood flow reduction would increase amyloid beta (Abeta) production by modulating beta and gamma-secretase. Furthermore, CVD impairs Abeta clearance, which is mainly driven by vascular mediated systems, including active transport across the blood-brain barrier, and perivascular lymphatic/paravascular glymphatic drainage systems. Thus, CVD may disturb homeostasis between Abeta production and clearance, thereby aggravating Alzheimer's disease. Recent translational researches in this field aim to facilitate Abeta clearance. Several candidate drugs are being tested in clinical trials. SUMMARY: Compared with Abeta pathology, little is known about the relationship between tau pathology and CVD, although some studies have shown that CVD has an influence on tau pathology. The close interrelationship between Alzheimer's disease and CVD suggests the necessity of the maintenance of cerebrovascular integrity, which may herald a new generation of dementia treatment strategies.
Curr+Opin+Psychiatry 2016 ; 29 (2): 168-73
