van den Brink Hilde, Voigt Sabine, Kozberg Mariel, van Etten Ellis S
J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands; Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands.
EBioMedicine. 2024 Dec;110:105466. doi: 10.1016/j.ebiom.2024.105466. Epub 2024 Nov 29.
Cerebral amyloid angiopathy (CAA) is a cerebrovascular disease characterized by vascular amyloid-β (Aβ) deposition. CAA is often seen in the brains of elderly individuals and in a majority of patients with Alzheimer's disease. The molecular pathways triggered by vascular Aβ, causing vessel wall breakdown and ultimately leading to intracerebral haemorrhage and cognitive decline, remain poorly understood. The occurrence of CAA-related inflammation (CAA-ri) and Amyloid-Related Imaging Abnormalities (ARIA) have sparked interest for a role of neuroinflammation in CAA pathogenesis. This review discusses prior studies of neuroinflammation in CAA and outlines potential future research directions targeting candidates such as matrix metalloproteinases, complement activation, microglial activation, reactive astrocytes and parenchymal border macrophages. Understanding the role of neuroinflammation in CAA pathogenesis could help identify new therapeutic strategies.
脑淀粉样血管病（CAA）是一种以血管淀粉样β蛋白（Aβ）沉积为特征的脑血管疾病。CAA常见于老年人的大脑以及大多数阿尔茨海默病患者的大脑中。由血管Aβ引发的分子途径，导致血管壁破坏并最终引发脑出血和认知衰退，目前仍知之甚少。CAA相关炎症（CAA-ri）和淀粉样蛋白相关影像学异常（ARIA）的出现引发了人们对神经炎症在CAA发病机制中作用的兴趣。本综述讨论了此前关于CAA中神经炎症的研究，并概述了未来针对基质金属蛋白酶、补体激活、小胶质细胞激活、反应性星形胶质细胞和实质边界巨噬细胞等候选靶点的潜在研究方向。了解神经炎症在CAA发病机制中的作用有助于确定新的治疗策略。
