Dickson D W, Crystal H, Mattiace L A, Kress Y, Schwagerl A, Ksiezak-Reding H, Davies P, Yen S H
Department of Pathology (Neuropathology), Albert Einstein College of Medicine, Yeshiva University, Bronx, NY 10461.
Acta Neuropathol. 1989;78(6):572-84. doi: 10.1007/BF00691284.
The nature of senile plaques (SP) in 27 cases of diffuse Lewy body disease (LBD) was investigated using immunocytochemistry and antibodies to beta amyloid protein synthetic peptides (BetaSP), ubiquitin (UBQ), paired helical filaments (PHF; Ab39) and a 68-kDa protein in Alzheimer brains (Alz50). Lewy bodies were present in widespread areas of the neocortex of all cases and were more easily detected with ubiquitin immunocytochemistry than with conventional stains. All cases had neocortical SP, but only six cases had neocortical neurofibrillary tangles (NFT). SP were very numerous in most cases and were usually "pale", "diffuse" or "very primitive" plaques with thioflavin S fluorescent microscopy. SP in diffuse LBD were immunostained with BetaSP. Several cases had extensive amyloid angiopathy that was also immunoreactive with BetaSP. SP in diffuse LBD were characterized by amyloid deposits with few or no neuritic elements that could be detected with thioflavin S, Bielschowsky's stain or double staining with BetaSP and Bodian's silver stain. They differed from plaques in Alzheimer's disease by lack of PHF-type neurites that could be stained with Ab39. In diffuse LBD, SP contained PHF-type neurites only in areas coexistent with NFT. Some SP had round, granular neurites that were immunoreactive with UBQ, but weakly argyrophilic with Bodian's stain and nonfluorescent with thioflavin S. Diffuse LBD lacked significant neuritic change in the neuropil that could be detected with UBQ, Ab39 and Alz50. The latter finding is a characteristic feature that distinguishes Alzheimer's disease from diffuse LBD.
运用免疫细胞化学技术以及针对β淀粉样蛋白合成肽（BetaSP）、泛素（UBQ）、双螺旋丝（PHF；Ab39）和阿尔茨海默病脑中一种68 kDa蛋白（Alz50）的抗体，对27例弥漫性路易体病（LBD）患者的老年斑（SP）性质进行了研究。路易体存在于所有病例新皮质的广泛区域，与传统染色相比，泛素免疫细胞化学更易检测到路易体。所有病例均有新皮质SP，但仅有6例有新皮质神经原纤维缠结（NFT）。多数病例中SP数量众多，硫黄素S荧光显微镜下通常为“淡染”、“弥漫性”或“非常原始”的斑块。弥漫性LBD中的SP用BetaSP免疫染色。部分病例有广泛的淀粉样血管病，其对BetaSP也有免疫反应。弥漫性LBD中的SP特征为淀粉样沉积物，几乎没有或没有能用硫黄素S、 Bielschowsky染色或BetaSP与Bodian银染色双重染色检测到的神经炎性成分。它们与阿尔茨海默病中的斑块不同，缺乏能用Ab39染色的PHF型神经突。在弥漫性LBD中，SP仅在与NFT共存的区域含有PHF型神经突。一些SP有圆形、颗粒状神经突，对UBQ有免疫反应，但用Bodian染色嗜银性弱，用硫黄素S无荧光。弥漫性LBD在神经毡中缺乏能用UBQ、Ab39和Alz50检测到的明显神经炎性改变。后一发现是将阿尔茨海默病与弥漫性LBD区分开来的一个特征性表现。
