Department of Biology, Emory University, Atlanta, GA, USA.
Department of Neurology and Alzheimer's Disease Research Center, Emory University, Atlanta, GA, USA.
J Alzheimers Dis. 2018;62(4):1815-1826. doi: 10.3233/JAD-170954.
Cerebral amyloid angiopathy (CAA) of the Aβ type is variably present in the brains of patients with Alzheimer's disease (AD). CAA contributes to cognitive decline and increases the risk of lobar hemorrhage; because both AD-typical dementia and lobar hemorrhage are more common in African-Americans than in Caucasians, we postulated that African-Americans with AD might be particularly susceptible to CAA. To test this hypothesis, we analyzed CAA histopathologically in the large vessels and capillaries of autopsy-derived frontal, temporal, parietal, and occipital cortical samples from African-Americans (n = 18) and Caucasians (n = 19) with end-stage AD. In the combined cohort of 37 subjects, 22% of the subjects had severe CAA in large vessels, and 11% had severe CAA in capillaries. However, the prevalence and histopathologic characteristics of CAA were similar in the African-Americans and Caucasians. This conclusion was substantiated in an independent sample from the National Alzheimer's Coordinating Center database, in which the degree of CAA was comparable in 1,554 Caucasians and 68 African-Americans with end-stage AD. These findings support a growing consensus that the fundamental histopathologic features of AD are largely impartial to the race of the afflicted.
β淀粉样蛋白（Aβ）型脑淀粉样血管病（CAA）在阿尔茨海默病（AD）患者的大脑中存在差异。CAA 导致认知能力下降并增加脑叶出血的风险；由于 AD 典型痴呆和脑叶出血在非裔美国人中比在白种人更为常见，我们假设 AD 中的非裔美国人可能特别容易受到 CAA 的影响。为了验证这一假设，我们对来自非洲裔美国人（n=18）和高加索人（n=19）的尸检获得的额、颞、顶和枕皮质样本的大血管和毛细血管中的 CAA 进行了组织病理学分析。在 37 名受试者的联合队列中，22%的受试者有严重的大血管 CAA，11%的受试者有严重的毛细血管 CAA。然而，CAA 的患病率和组织病理学特征在非裔美国人和高加索人之间相似。这一结论在国家阿尔茨海默病协调中心数据库中的一个独立样本中得到了证实，在该样本中，处于终末期 AD 的 1554 名高加索人和 68 名非裔美国人的 CAA 程度相当。这些发现支持了一个不断增长的共识，即 AD 的基本组织病理学特征在很大程度上不受受影响种族的影响。
