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Cerebral amyloid angiopathy: subtypes, treatment and role in cognitive impairment

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Accumulation of β amyloid in leptomeningeal vessels and cortical arterioles is the hallmark of cerebral amyloid angiopathy, this causes vessel stiffening, and vessel wall rupture. Alzheimer’s disease amyloid plaques are… Click to show full abstract

Accumulation of β amyloid in leptomeningeal vessels and cortical arterioles is the hallmark of cerebral amyloid angiopathy, this causes vessel stiffening, and vessel wall rupture. Alzheimer’s disease amyloid plaques are composed of β-amyloid 42, whilst CAA results from accumulation of the β-amyloid 40, although β-amyloid 40 may migrate to the vasculature from parenchymal plaques. Recent work has shown that inefficient clearance of amyloid, rather than excess production is the primary contributor to β amyloid accumulation. Early work using a variety of approaches to increase clearance of β-amyloid, suggested a possible excess of micro-haemorrhages in animal models. A recent study from this group showed that chronic administration of high dose Ponezumab (a monoclonal antibody targeting β-amyloid) in an older group of transgenic mice did not increase micro-haemorrhage. This study tested the efficiency of β-amyloid clearance from the vasculature, and the consequences of β-amyloid clearance on vascular reactivity. Transgenic mice between 6 and 22 months were used. These were from a variety of strains—APP knock-in, compound knock-in APP-PS1 and APP PSdE9 compound knockin animals. Multi-photon imaging used methoxy x-034 to label amyloid and pre-imaging rhodamine injection to track blood vessels. Animals were imaged on a monthly basis. The brains were then removed and lysed, using centrifugation, the vascular tissue was separated from cortical regions and myelin. ELISA was used to measure β-amyloid Introduction

Keywords: amyloid angiopathy; cerebral amyloid; amyloid; clearance; angiopathy subtypes; subtypes treatment

Journal Title: Journal of Neurology
Year Published: 2017

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