Yamagishi M, Ishizuka Y, Seki K
Department of Otolaryngology, Mizonokuchi Hospital, Teikyo University School of Medicine, Kawasaki, Japan.
Ann Otol Rhinol Laryngol. 1994 Jun;103(6):421-7. doi: 10.1177/000348949410300601.
Characteristic changes that appear in the biopsied olfactory mucosa of patients with Alzheimer's disease (AD) were examined with immunohistochemical staining. Specimens were obtained from patients with clinical diagnoses of AD. Patients with vascular dementia and age-matched patients without dementia were used for controls. In most AD cases, neurofibrillary tangle-like abnormal tau protein (Tau) immunoreactivity was seen in the dendrites and perikarya of the olfactory receptor cells and in the nerve bundles. A senile plaque-like extracellular mass was found in the olfactory epithelium, and it reacted strongly to an anti-Tau antiserum and weakly to an anti-amyloid-beta protein antiserum. Ubiquitin (Ubq) immunoreactivity was also observed in the dendrites. Tau immunoreactivity of the perikarya and extracellular mass, and Ubq immunoreactivity were especially characteristic of the olfactory mucosa of AD patients. From these results, it is clear that the same pathologic changes in the brain are also present in the olfactory mucosa of patients with AD. Not only disruption of the central olfactory pathway, but also an olfactory disturbance of AD patients is caused by peripheral changes. Furthermore, an olfactory mucosal biopsy could be a useful method for a definitive diagnosis of AD.
采用免疫组织化学染色法检查阿尔茨海默病（AD）患者活检嗅黏膜中出现的特征性变化。标本取自临床诊断为AD的患者。血管性痴呆患者和年龄匹配的非痴呆患者作为对照。在大多数AD病例中，神经原纤维缠结样异常tau蛋白（Tau）免疫反应性可见于嗅受体细胞的树突和胞体以及神经束中。在嗅上皮中发现了老年斑样细胞外团块，它对抗Tau抗血清反应强烈，对抗淀粉样β蛋白抗血清反应较弱。在树突中也观察到泛素（Ubq）免疫反应性。胞体和细胞外团块的Tau免疫反应性以及Ubq免疫反应性是AD患者嗅黏膜的特别特征。从这些结果可以清楚地看出，AD患者大脑中的相同病理变化也存在于其嗅黏膜中。AD患者不仅中枢嗅觉通路受到破坏，而且嗅觉障碍是由外周变化引起的。此外，嗅黏膜活检可能是AD确诊的一种有用方法。
