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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Acta+Neuropathol
2016 ; 131
(5
): 737-52
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Tau pathology-dependent remodelling of cerebral arteries precedes Alzheimer s
disease-related microvascular cerebral amyloid angiopathy
#MMPMID26988843
Merlini M
; Wanner D
; Nitsch RM
Acta Neuropathol
2016[May]; 131
(5
): 737-52
PMID26988843
show ga
Alzheimer's disease (AD) is characterised by pathologic cerebrovascular
remodelling. Whether this occurs already before disease onset, as may be
indicated by early Braak tau-related cerebral hypoperfusion and blood-brain
barrier (BBB) impairment found in previous studies, remains unknown. Therefore,
we systematically quantified Braak tau stage- and cerebral amyloid angiopathy
(CAA)-dependent alterations in the alpha-smooth muscle actin (?-SMA), collagen,
and elastin content of leptomeningeal arterioles, small arteries, and
medium-sized arteries surrounding the gyrus frontalis medialis (GFM) and
hippocampus (HIPP), including the sulci, of 17 clinically and pathologically
diagnosed AD subjects (Braak stage IV-VI) and 28 non-demented control subjects
(Braak stage I-IV). GFM and HIPP paraffin sections were stained for general
collagen and elastin with the Verhoeff-van Gieson stain; ?-SMA and CAA/amyloid ?
(A?) were detected using immunohistochemistry. Significant arterial elastin
degradation was observed from Braak stage III onward and correlated with Braak
tau pathology (? = 0.909, 95% CI 0.370 to 0.990, p < 0.05). This was accompanied
by an increase in neutrophil elastase expression by ?-SMA-positive cells in the
vessel wall. Small and medium-sized arteries exhibited significant
CAA-independent ?-SMA loss starting between Braak stage I and II-III, along with
accumulation of phosphorylated paired helical filament (PHF) tau in the
perivascular space of intraparenchymal vessels. ?-SMA remained at the decreased
level throughout the later Braak stages. In contrast, arterioles exhibited
significant ?-SMA loss only at Braak stage V and VI/in AD subjects, which was
CAA-dependent/correlated with CAA burden (? = -0.422, 95% CI -0.557 to -0.265, p
< 0.0001). Collagen content was only significantly changed in small arteries. Our
data indicate that vessel wall remodelling of leptomeningeal arteries is an
early-onset, Braak tau pathology-dependent process unrelated to CAA and AD, which
potentially may contribute to downstream CAA-dependent microvascular pathology in
AD.