Vinters H V, Pardridge W M, Secor D L, Ishii N
Department of Pathology, UCLA Medical Center.
Am J Pathol. 1988 Oct;133(1):150-62.
Cerebral amyloid angiopathy (CAA) is a biochemically heterogeneous entity most commonly associated with stroke syndromes, Alzheimer's disease (AD), Down's syndrome, and miscellaneous neurologic conditions. The authors have applied and extended (using formic acid pretreatment of histologic sections) an immunocytochemical technique that used antibody to a synthetic 28-amino acid peptide representing a segment of the AD amyloid precursor, to study CAA and related parenchymal amyloid deposits in brain tissues originally derived from: 1) patients with CAA with or without typical clinicopathologic features of AD, cerebral hemorrhage, and infarcts; 2) a young boy with angiocentric brain amyloid; 3) patients with familial (Icelandic, Dutch) forms of cerebral hemorrhage caused by CAA; and 4) Japanese patients with nonfamilial CAA-related brain hemorrhage, sometimes associated with histopathology characteristic of AD. Formic acid pretreatment of sections resulted in markedly enhanced staining of senile plaque core and microvascular, especially capillary, amyloid, and some apparent staining of the neuritic component of senile plaques. Perivascular halos of immunoreactive material were observed frequently. Neurofibrillary tangles were not immunolabeled, nor were blood vessels or any parenchymal components within cerebral white matter. CAA in Japanese patients with nonfamilial encephalic hemorrhages appeared immunocytochemically identical to AD-related CAA. Arterioles in brains that had severe CAA frequently showed significant stenosis of their lumina by nonamyloid hyaline or cellular material.
脑淀粉样血管病（CAA）是一种生物化学性质异质性的疾病，最常与中风综合征、阿尔茨海默病（AD）、唐氏综合征及其他各种神经系统疾病相关。作者应用并扩展了一种免疫细胞化学技术（对组织切片进行甲酸预处理），该技术使用针对代表AD淀粉样前体片段的合成28氨基酸肽的抗体，来研究最初来源于以下情况的脑组织中的CAA及相关实质淀粉样沉积物：1）有或无AD、脑出血和梗死典型临床病理特征的CAA患者；2）一名患有血管中心性脑淀粉样变的小男孩；3）由CAA引起的家族性（冰岛型、荷兰型）脑出血患者；4）患有非家族性CAA相关脑出血且有时伴有AD组织病理学特征的日本患者。切片经甲酸预处理后，老年斑核心和微血管（尤其是毛细血管）淀粉样物的染色明显增强，老年斑的神经突成分也有一些明显染色。经常观察到免疫反应性物质的血管周围晕。神经原纤维缠结未被免疫标记，脑白质内的血管或任何实质成分也未被免疫标记。患有非家族性脑内出血的日本患者的CAA在免疫细胞化学上与AD相关的CAA相同。患有严重CAA的大脑中的小动脉经常显示其管腔因非淀粉样透明质或细胞物质而明显狭窄。
