Hamilton R L
University of Pittsburgh School of Medicine, Department of Pathology, PA, USA.
Brain Pathol. 2000 Jul;10(3):378-84. doi: 10.1111/j.1750-3639.2000.tb00269.x.
Antibodies to alpha-synuclein (AS) now provide a sensitive and specific method for the detection of Lewy bodies (LBs) and their use will allow a more accurate determination of the prevalence of LBs in Alzheimer's Disease (AD). Studies using AS immunohistochemistry (IHC) have found LBs in the amygdala of over 60% early onset familial AD and in 50% of Down's syndrome patients with AD, however, no studies have reported the use of AS IHC to detect LBs in a large cohort of sporadic AD. This study examined 145 sporadic AD cases diagnosed using CERAD criteria from 1995-1999 for the presence of LBs using AS IHC. AS IHC detected LBs in 88/145 (60.7%) of sporadic AD cases. Similarly, LBs were found in 56.8% of the 95 cases fulfilling the more stringent NIA-RI criteria for the diagnosis of AD (Braak stage 5-6). In all cases with LBs, the amygdala was involved and LBs were always most numerous in this area, however, in some cases LBs in the substantia nigra were rare or not present. In conclusion, this study found that AS IHC detects LBs in the majority of sporadic AD cases and that the amygdala is the most commonly affected region.
α-突触核蛋白（AS）抗体现在为路易小体（LB）的检测提供了一种灵敏且特异的方法，其应用将使我们能更准确地确定路易小体在阿尔茨海默病（AD）中的患病率。使用AS免疫组织化学（IHC）的研究在超过60%的早发性家族性AD患者的杏仁核中发现了路易小体，在50%的患有AD的唐氏综合征患者中也发现了路易小体，然而，尚无研究报道在大量散发性AD患者队列中使用AS免疫组织化学来检测路易小体。本研究使用AS免疫组织化学检查了1995年至1999年期间根据CERAD标准诊断的145例散发性AD病例中是否存在路易小体。AS免疫组织化学在145例散发性AD病例中的88例（60.7%）检测到了路易小体。同样，在符合更严格的NIA-RI AD诊断标准（Braak分期5-6期）的95例病例中，56.8%发现了路易小体。在所有存在路易小体的病例中，杏仁核均受累，且该区域的路易小体总是最多，然而，在某些病例中，黑质中的路易小体很少或不存在。总之，本研究发现AS免疫组织化学在大多数散发性AD病例中能检测到路易小体，且杏仁核是最常受累的区域。
