Acta Neuropathol Commun. 2015 Mar 24;3:14. doi: 10.1186/s40478-015-0199-x.
In early stages of Alzheimer's disease (AD), neurofibrillary tangles (NFT) are largely restricted to the entorhinal cortex and medial temporal lobe. At later stages, when clinical symptoms generally occur, NFT involve widespread limbic and association cortices. At this point in the disease, amyloid plaques are also abundantly distributed in the cortex. This observation from human neuropathological studies led us to pose two alternative hypotheses: that amyloid in the cortex is permissive for the spread of tangles from the medial temporal lobe, or that these are co-occurring but not causally related events simply reflecting progression of AD pathology.
We now directly test the hypothesis that cortical amyloid acts as an accelerant for spreading of tangles beyond the medial temporal lobe. We crossed rTgTauEC transgenic mice that demonstrate spread of tau from entorhinal cortex to other brain structures at advanced age with APP/PS1 mice, and examined mice with either NFTs, amyloid pathology, or both. We show that concurrent amyloid deposition in the cortex 1) leads to a dramatic increase in the speed of tau propagation and an extraordinary increase in the spread of tau to distal brain regions, and 2) significantly increases tau-induced neuronal loss.
These data strongly support the hypothesis that cortical amyloid accelerates the spread of tangles throughout the cortex and amplifies tangle-associated neural system failure in AD.
在阿尔茨海默病(AD)的早期阶段,神经纤维缠结(NFT)主要局限于内侧颞叶的内嗅皮层和海马旁回。在后期,当临床症状普遍出现时,NFT 涉及广泛的边缘和联合皮质。此时,皮质中也大量分布淀粉样斑块。这些来自人类神经病理学研究的观察结果使我们提出了两种替代假设:皮质中的淀粉样蛋白允许 NFT 从内侧颞叶扩散,或者这些是同时发生但没有因果关系的事件,只是反映了 AD 病理的进展。
我们现在直接检验了这样一个假设,即皮质中的淀粉样蛋白作为 NFT 从内侧颞叶扩散的加速剂。我们将在老年时表现出 tau 从内嗅皮层扩散到其他大脑结构的 rTgTauEC 转基因小鼠与 APP/PS1 小鼠杂交,并检查了具有 NFT、淀粉样蛋白病理或两者兼有的小鼠。我们发现,皮质中的淀粉样蛋白沉积 1)导致 tau 传播速度显著加快,tau 向远端脑区的扩散显著增加,以及 2)显著增加 tau 诱导的神经元丢失。
这些数据强烈支持这样一个假设,即皮质中的淀粉样蛋白加速了 NFT 在整个皮质中的扩散,并放大了 AD 中与 NFT 相关的神经网络衰竭。