Cardiac sympathetic denervation precedes neuronal loss in the sympathetic ganglia in Lewy body disease
Cardiac sympathetic denervation precedes neuronal loss in the sympathetic ganglia in Lewy body disease
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DOI：
10.1007/s00401-005-0995-7
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发表时间：
2005-06-01
影响因子：
12.7
通讯作者：
Takahashi, H
中科院分区：
文献类型：
--
作者：
Orimo, S;Amino, T;Takahashi, H
据报道，帕金森病（PD）和路易体痴呆（DLB）患者在[I-123]MIBG心肌显像中心脏对间碘苄胍（MIBG）的摄取减少。我们推测，心脏交感神经失神经支配可能占的病理机制。为了阐明Lewy体病和相关神经退行性疾病中心脏交感神经受累的程度、频率和模式，我们对PD（n=11）、DLB（n=7）、DLB伴阿尔茨海默病（Alzheimer's disease）患者的心脏组织进行了化学检测。（DLB/AD; n=4），多系统萎缩（MSA; n=8），进行性核上性麻痹（PSP; n=5）、纯AD受试者（n=10）和对照受试者（n = 5）以及来自PD患者（n=5）和对照受试者（n=4）的交感神经节，使用针对酪氨酸羟化酶（TH）的抗体。PD、DLB和DLB/AD患者心脏TH免疫反应阳性神经纤维几乎全部消失，而PSP和单纯AD患者以及MSA患者心脏TH免疫反应阳性神经纤维均保存完好。在PD中，交感神经节中的神经元被保留在所有患者中，只有一名患者除外。路易体病中MIBG的心脏摄取减少反映了实际的心脏交感神经去神经支配，其先于交感神经节中的神经元损失。
Decreased cardiac uptake of meta-iodobenzylguanidine (MIBG) on [I-123]MIBG myocardial scintigraphy has been reported in Parkinson's disease (PD) and dementia with Lewy bodies (DLB). We hypothesized that cardiac sympathetic denervation might account for the pathomechanism. To elucidate the extent, frequency and pattern of cardiac sympathetic nerve involvement in Lewy body disease and related neurodegenerative disorders, we immunohistochemically examined heart tissues from patients with PD (n=11), DLB (n=7), DLB with Alzheimer's disease (DLB/AD; n=4), multiple system atrophy (MSA; n=8), progressive supranuclear palsy (PSP; n=5), pure AD (n=10) and control subjects (n=5) together with sympathetic ganglia from patients with PD (n=5) and control subjects (n=4), using an antibody against tyrosine hydroxylase (TH). TH-immunoreactive nerve fibers in the hearts had almost entirely disappeared in nearly all the patients with PD, DLB and DLB/AD, whereas they were well preserved in all the patients with PSP and pure AD as well as in all except for one patient with MSA. In PD, neurons in the sympathetic ganglia were preserved in all except for one patient. Decreased cardiac uptake of MIBG in Lewy body disease reflects actual cardiac sympathetic denervation, which precedes the neuronal loss in the sympathetic ganglia.