Chu C T, Caruso J L, Cummings T J, Ervin J, Rosenberg C, Hulette C M
Department of Pathology, University of Pittsburgh Medical Center, Pennsylvania, USA.
Mod Pathol. 2000 Apr;13(4):420-6. doi: 10.1038/modpathol.3880072.
Alzheimer's disease is the most common cause of dementia It is associated with genetic risk factors and at least three autosomal dominant mutations. Community pathologists are frequently asked by families to evaluate autopsy material for Alzheimer's disease. Neuropathologic diagnosis is based on technically difficult silver impregnation stains that may not be readily available to community-based pathologists. Because immunohistochemical techniques are more widely accessible, we evaluated the practical utility of using a single immunohistochemical stain for diagnosing Alzheimer's disease. The ubiquitin antigen was selected because of its presence in morphologically distinct deposits characteristic of several neurodegenerative diseases. Paraffin blocks were obtained from the Bryan Alzheimer's Disease Research Center Brain Bank, a repository of approximately 900 brains. Tissues from 16 individuals who exhibited the entire range of Alzheimer's-type neuropathology were selected. Ubiquitin immunostains, evaluated blindly and independently by four pathologists ranging from first-year resident trainee to experienced neuropathologist, reliably stained both neuritic plaques and neurofibrillary tangles essential for diagnosing and staging Alzheimer's disease. Nondemented controls with early Alzheimer's-type changes were easily distinguished from cases of definitive Alzheimer's disease. The stains also highlighted characteristic inclusions of Parkinson's disease or Lewy body dementia Ubiquitin immunohistochemistry is a reliable, reproducible, and readily available diagnostic aid for distinguishing Alzheimer's disease from other causes of dementia.
阿尔茨海默病是痴呆最常见的病因，它与遗传风险因素以及至少三种常染色体显性突变相关。患者家属经常要求社区病理学家评估用于诊断阿尔茨海默病的尸检材料。神经病理学诊断基于技术上难度较大的银浸染染色，而社区病理学家可能无法轻易获得这种染色方法。由于免疫组织化学技术更容易获取，我们评估了使用单一免疫组织化学染色诊断阿尔茨海默病的实际效用。选择泛素抗原是因为它存在于几种神经退行性疾病特有的形态学上不同的沉积物中。石蜡块取自布莱恩阿尔茨海默病研究中心脑库，该脑库储存了约900个大脑。从16名表现出阿尔茨海默病类型神经病理学全貌的个体中选取组织。由四名病理学家（从第一年住院实习医生到经验丰富的神经病理学家）进行盲法独立评估，泛素免疫染色可靠地对诊断和分期阿尔茨海默病所需的神经炎性斑块和神经原纤维缠结进行了染色。具有早期阿尔茨海默病类型变化的非痴呆对照很容易与确诊的阿尔茨海默病病例区分开来。这些染色还突出了帕金森病或路易体痴呆的特征性包涵体。泛素免疫组织化学是一种可靠、可重复且易于获得的诊断辅助手段，可用于区分阿尔茨海默病与其他痴呆病因。
