Qi Xue-Mei, Ma Jian-Fang
Department of Neurology & Institute of Neurology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200025 China.
Transl Neurodegener. 2017 Aug 17;6:22. doi: 10.1186/s40035-017-0091-7. eCollection 2017.
Cerebral amyloid angiopathy (CAA) is characterized by the deposition of amyloid β-protein (Aβ) in the leptomeningeal and cortical blood vessels, which is an age-dependent risk factor for intracerebral hemorrhage (ICH), ischemic stroke and contributes to cerebrovascular dysfunction leading to cognitive impairment. However clinical prevention and treatment of the disease is very difficult because of its occult onset and severity of the symptoms. In recent years, many anti-amyloid β immunotherapies have not demonstrated clinical efficacy in subjects with Alzheimer's disease (AD), and the failure may be due to the deposition of Aβ in the cerebrovascular export pathway resulting in further damage to blood vessels and aggravating CAA. So decreased clearance of Aβ in blood vessels plays a crucial role in the development of CAA and AD, and identification of the molecular pathways involved will provide new targets for treatment. In this review, we mainly describe the mechanisms of Aβ clearance through vessels, especially in terms of some proteins and receptors involved in this process.
脑淀粉样血管病(CAA)的特征是淀粉样β蛋白(Aβ)在软脑膜和皮质血管中沉积,这是脑出血(ICH)、缺血性中风的年龄依赖性危险因素,并导致脑血管功能障碍,进而引起认知障碍。然而,由于该疾病起病隐匿且症状严重,其临床预防和治疗非常困难。近年来,许多抗淀粉样β免疫疗法在阿尔茨海默病(AD)患者中未显示出临床疗效,失败的原因可能是Aβ在脑血管输出途径中的沉积导致血管进一步损伤并加重CAA。因此,血管中Aβ清除率降低在CAA和AD的发展中起关键作用,识别其中涉及的分子途径将为治疗提供新靶点。在这篇综述中,我们主要描述Aβ通过血管清除的机制,特别是涉及这一过程的一些蛋白质和受体。