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Alzheimer's disease

 Compiled By: Joe Hing Kwok Chu  

 

Neuropathology of human Alzheimer disease after immunization with amyloid-beta peptide: a case report.

Division of Clinical Neurosciences, University of Southampton, Southampton, UK. J.Nicoll@soton.ac.uk

Amyloid-beta peptide (Abeta) has a key role in the pathogenesis of Alzheimer disease (AD). Immunization with Abeta in a transgenic mouse model of AD reduces both age-related accumulation of Abeta in the brain and associated cognitive impairment. Here we present the first analysis of human neuropathology after immunization with Abeta (AN-1792). Comparison with unimmunized cases of AD (n = 7) revealed the following unusual features in the immunized case, despite diagnostic neuropathological features of AD: (i) there were extensive areas of neocortex with very few Abeta plaques; (ii) those areas of cortex that were devoid of Abeta plaques contained densities of tangles, neuropil threads and cerebral amyloid angiopathy (CAA) similar to unimmunized AD, but lacked plaque-associated dystrophic neurites and astrocyte clusters; (iii) in some regions devoid of plaques, Abeta-immunoreactivity was associated with microglia; (iv) T-lymphocyte meningoencephalitis was present; and (v) cerebral white matter showed infiltration by macrophages. Findings (i)-(iii) strongly resemble the changes seen after Abeta immunotherapy in mouse models of AD and suggest that the immune response generated against the peptide elicited clearance of Abeta plaques in this patient. The T-lymphocyte meningoencephalitis is likely to correspond to the side effect seen in some other patients who received AN-1792 (refs. 7-9).

PMID: 12640446 [PubMed - indexed for MEDLINE]

Explanation of the above treatise by Joe Hing Kwok Chu :

Amyloid-beta peptide: is a precursor of b-amyloid which is a starch-like protein which can damage the healthy cells of the body.  Abeta ( b--amyloid) plays a key role in the cause of Alzheimer's disease. Immunization with an A-beta vaccine in mice that were genetically induced Alzheimer's disease reduces the age -related accumulation of b--amyloid in the brain and associated cognitive impairment.

The researchers immunized a human patient with A-beta vaccine, using the drug called AN-1792.  ( N-1792 was developed to stimulate the immune system to "recognize" and attack the amyloid plaques that are a characteristics of Alzheimer brain abnormality).

Compared to 7 un-immunized cases, it was found that despite the diagnostic sickness of the nerves/brain of Alzheimer's disease:

  1. there were extensive areas of the top layer of the brain hemispheres (neocortex) with very few A-beta (b-amyloid) plaques;

  2. those areas of cortex that were devoid of A-beta plaques contained densities of tangles, neuropil threads and cerebral amyloid angiopathy (CAA) similar to unimmunized AD, but lacked plaque-associated dystrophic (degenerated) neurites and astrocyte clusters;

  3. in some regions devoid of plaques, Abeta-immunoreactivity was associated with microglia;

  4. T-lymphocyte meningoencephalitis (inflammation of the brain and the membrane) was present; and

  5. cerebral white matter showed infiltration by macrophages (large white cells that defend against bacteria and other foreign matters)..

Findings (1)-(3) strongly resemble the changes seen after A-beta immunotherapy in mouse models of AD and suggest that the immune response generated against the peptide elicited clearance of A-beta plaques in this patient. The T-lymphocyte meningoencephalitis is likely to correspond to the side effect seen in some other patients who received AN-1792.

Neuropil is the nervous tissue consisting of a fibrous network of nonmyelinated nerve fibers; gray matter with few nerve cell bodies; usually a region of synapses between axons and dendrites. (click here to go back)
 

Cerebral amyloid angiopathy (CAA) is also known as congophilic angiopathy or cerebrovascular amyloidosis. It is a disease of small blood vessels in the brain in which deposits of amyloid protein in the vessel walls may lead to stroke, brain hemorrhage, or dementia. Amyloid protein resembles a starch and is deposited in tissues during the course of certain chronic diseases. (answers.com)  (click here to go back)

Microglia is any of the small neuroglial cells of the central nervous system having long processes and amoeboid and phagocytic activity at sites of neural damage or inflammation. (click here to go back)

Neocortex is the top layer of the brain hemispheres that handles conscious thought and language. It is also called neopallium ("new mantle") and isocortex ("equal rind"). (click here to go back)

Neurites: Any projection from the cell body of a neuron can be referred to as a neurite. This projection can be either an axon or a dendrite. The term is frequently used when speaking of immature or developing neurons, especially of cells in culture, because it can be difficult to tell axons from dendrites in that situation.  (answers.com) (click here to go back)

Amoeboid:  characteristics of resembling an amoeba, like in changeability of form and means of locomotion. (Click here to go back)

A-beta ( b-amyloid) plaques: Are precipitations protein lumps inside and outside the nerve cells caused by abnormal protein-protein interactions.  These abnormal interactions of protein play a role in the dysfunction and death of nerve cells in diseases such as Alzheimer’s disease and Parkinson’s disease . (click here to go back)

Links:

A beta peptide vaccination prevents memory loss in an animal model of Alzheimer's disease.

http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&uid=11140686&cmd=showdetailview&indexed=google

http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&uid=12640446&cmd=showdetailview&indexed=google

 Nat Med. 2003 Apr;9(4):448-52. Epub 2003 Mar 17. Links

Comment in:

Nat Med. 2003 Apr;9(4):389-90.

Nat Med. 2004 Feb;10(2):117-8; author reply 118-9.

 
Also see: herb on memory loss due to AchE over active:
1. Chinese herb qian ceng ta; and
2. common herb Spanish sage

 

 

A Potential Treatment (from Shanghai)

 
Stimulating β2-adrenergic receptor ( β2腎上腺素受體)  can increase the activity of γ-Secretase (γ-分 泌酶)and can cause the increase of the production of  Amyloid beta-Protein (Aβ) (β澱粉樣蛋白). This discovery shows a possible cause of Alzheimer's disease and therefore γ-secretase is potential target for the treatment of Alzheimer's disease. [1]

 

中國科學院上海生命科學研究院生物化學與細胞生物學研究所裴鋼院士領導的研究小組經多年研究後發現,β2腎上腺素受體被激活後,可增強γ分泌酶的活性,進 而能夠增加導致阿爾茨海默病的β澱粉樣蛋白的產生。該發現揭示了阿爾茨海默病致病的新機制,並且提示β2腎上腺素受體有可能成為研發阿爾茨海默病治療藥物 的新靶點。11月19日,國際著名學術期刊《自然·醫學》網絡版在線發表了這項關於β澱粉樣蛋白產生過程新機制的最新研究成果。

 

[1] Reported by Pei Gang et al of Bio-chemistry and Cell Biology Department of Shanghai Life Science Research Institute of Science Institute of China. Natural Medicine, 2007, Nov 10.

 

 

Compiler's note: Stimulating β2-adrenergic receptor increases epinephrine and norepinephrine secretion. Example of drug that stimulates β2-adrenergic receptor: Salmeterol is a long-acting β2-adrenergic receptor (β2AR) agonist commonly used in the treatment of asthma and chronic obstructive pulmonary disease. Salmeterol is one of the 2 ingredients of Advair. See some of other β2 agonists.

 

Diagnosis

Note:

EEG (electroencephalogram): a graphical record of electrical activity of the brain; produced by an electroencephalograph

From reports of various studies, it can  be concluded that Alzheimer's disease is caused by beta-amyloid.

See a another study here: Pro-NGF Can Be Related to Its Increased Oxidative Modifications in Alzheimer Disease

Moderately increased homocysteine levels as well as decreased folate and vitamin B12 levels have been associated with Alzheimer's disease and vascular dementia. [1]

Back to causes of memory loss.


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