Open Access
Article
Insights into the pathogenesis and pathogenicity of cerebral amyloid angiopathy
Seth Love1,Scott Miners1,Jen Palmer1,Katy Chalmers1,Patrick Kehoe1
1
Dementia Research Group, University of Bristol Institute of Clinical Neurosciences, Frenchay Hospital, Bristol BS16 1LE, UK. seth.love@bris.ac.uk
DOI: 10.2741/3567 Volume 14 Issue 12, pp.4778-4792
Published: 01 January 2009
Abstract

Amyloid-beta (Abeta) cerebral amyloid angiopathy (CAA) affects most Alzheimer's disease (AD) patients and ~30% of otherwise-normal elderly people. APOE epsilon 4 is a major risk factor for CAA in AD. Neurons are probably the source of the vascular Abeta. CAA develops when Abeta is deposited in the vessel walls along or across which it normally passes into the CSF and bloodstream. Vascular deposition is facilitated by factors that increase Abeta40:Abeta42, impede perivascular passage of Abeta or raise its concentration. The levels of some Abeta-degrading enzymes are reduced in AD patients with CAA. However, angiotensin-converting enzyme activity is increased and may act via angiotensin II to increase transforming growth factor beta1, a potent inducer of ECM synthesis. CAA is a cause of intracerebral haemorrhage and cerebral ischaemic damage. In AD, neuritic degeneration is accentuated around Abeta-laden vessels. Rarely, CAA is associated with angiitis. The balance between parenchymal and cerebrovascular degradation of Abeta, and regulation of perivascular extracellular matrix production, are likely to be key determinants of Abeta distribution and pathogenicity within the brain.

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Seth Love, Scott Miners, Jen Palmer, Katy Chalmers, Patrick Kehoe. Insights into the pathogenesis and pathogenicity of cerebral amyloid angiopathy. Frontiers in Bioscience-Landmark. 2009. 14(12); 4778-4792.