Rosenblum W I, Haider A
Medical College of Virginia, Virginia Commonwealth University, Richmond 23298.
Am J Pathol. 1988 Mar;130(3):532-6.
Congo red was used to stain amyloid in 29 blocks of hippocampus from 17 unselected cases of Alzheimer's disease. Green birefringence under polarized light was used for evaluation of the average number of senile plaques and cross-sectional vessel profiles containing amyloid in five fields per slide, at a magnification of X100. Fields were selected that had large numbers of neurofibrillary tangles, also counted on the basis of green birefringence. The vascular involvement by amyloid was expressed as the ratio of amyloid positive to amyloid negative profiles. A negative correlation was found between Congophilic plaques or tangles on the one hand and vascular amyloid content on the other. In other words, cases with large numbers of Congophilic plaques had fewer Congophilic vessels, and vice versa: congophilic plaques = -3 (vessel amyloid) + 2.2, Spearman correlation coefficient, -0.61, P less than 0.01; tangles = -3.7 (vessel amyloid) + 15.6, Spearman correlation coefficient, -0.05, P greater than 0.05. When the slides were reexamined, using only fields with at least one Congophilic vessel, the negative correlation for plaque versus vessel amyloid remained highly significant, whereas that for tangles versus vessel amyloid became highly significant: Congophilic plaques = -1.2 (vessel amyloid) + 2.3, Spearman correlation coefficient, -0.48, P less than 0.01; tangles = -5 (vessel amyloid) + 19, Spearman correlation coefficient, -0.48, P less than 0.01. These data are most compatible with the hypothesis that amyloid is first produced in the parenchyma and is somehow cleared by the vessels. It is least compatible with the hypothesis that the amyloid precursor protein first enters the vessel wall to produce amyloid there, and then moves into the brain to produce amyloid in parenchymal sites.
刚果红用于对17例未经挑选的阿尔茨海默病患者的29个海马组织块中的淀粉样蛋白进行染色。在偏振光下观察绿色双折射，以评估每张载玻片上五个视野中平均老年斑数量以及含有淀粉样蛋白的横断面血管轮廓数量，放大倍数为100倍。选择含有大量神经原纤维缠结的视野，神经原纤维缠结也根据绿色双折射进行计数。淀粉样蛋白对血管的累及程度用淀粉样蛋白阳性与淀粉样蛋白阴性轮廓的比例来表示。结果发现，一方面嗜刚果红性斑块或缠结与另一方面血管淀粉样蛋白含量之间呈负相关。也就是说，嗜刚果红性斑块数量多的病例中嗜刚果红性血管较少，反之亦然：嗜刚果红性斑块=-3（血管淀粉样蛋白）+2.2，斯皮尔曼相关系数为-0.61，P<0.01；缠结=-3.7（血管淀粉样蛋白）+15.6，斯皮尔曼相关系数为-0.05，P>0.05。当仅使用至少有一条嗜刚果红性血管的视野重新检查载玻片时，斑块与血管淀粉样蛋白之间的负相关性仍然非常显著，而缠结与血管淀粉样蛋白之间的负相关性变得非常显著：嗜刚果红性斑块=-1.2（血管淀粉样蛋白）+2.3，斯皮尔曼相关系数为-0.48，P<0.01；缠结=-5（血管淀粉样蛋白）+19，斯皮尔曼相关系数为-0.48，P<0.01。这些数据与淀粉样蛋白首先在实质内产生并以某种方式被血管清除的假说最为相符。与淀粉样前体蛋白首先进入血管壁在那里产生淀粉样蛋白，然后进入脑实质部位产生淀粉样蛋白的假说最不相符。
