Vascular pathology in the aged human brain.
Vascular pathology in the aged human brain.
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DOI：
10.1007/s00401-010-0652-7
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发表时间：
2010-03
影响因子：
12.7
通讯作者：
Thal DR
中科院分区：
文献类型：
--
作者：
Grinberg LT;Thal DR
脑动脉粥样硬化（AS）、小血管病（SVD）和脑淀粉样血管病（CAA）是老年大脑中最常见的动脉疾病。从发病机制上讲，AS和SVD具有相似的机制：血浆蛋白渗漏到血管壁、含脂质的巨噬细胞积聚以及血管壁纤维化。另一方面，CAA的特征是淀粉样β蛋白在血管壁沉积。尽管CAA、AS和SVD之间存在这些差异，但载脂蛋白E（apoE）与这三种疾病都有关。这种发病机制上的联系或许可以解释文献中所报道的老年人大脑中AS、SVD、CAA与阿尔茨海默病之间的相关性。此外，AS、SVD和CAA可导致组织损伤，如出血和梗死。而且，脑内SVD导致血浆蛋白渗漏到受损的血管壁以及血管周围间隙，从而导致血脑屏障（BBB）功能障碍。这种与SVD相关的BBB功能障碍被认为会导致白质病变（WMLs）和腔隙性梗死。在这篇综述中，我们阐述了AS、SVD和CAA之间的关系以及它们对血管组织损伤发展的作用，并且强调了apoE在血管疾病和血管组织损伤发病机制中的重要作用，以及血脑屏障功能障碍在白质病变和腔隙性梗死发展中的重要作用。
Cerebral atherosclerosis (AS), small vessel disease (SVD), and cerebral amyloid angiopathy (CAA) are the most prevalent arterial disorders in the aged brain. Pathogenetically, AS and SVD share similar mechanisms: plasma protein leakage into the vessel wall, accumulation of lipid-containing macrophages, and fibrosis of the vessel wall. CAA, on the other hand, is characterized by the deposition of the amyloid β-protein in the vessel wall. Despite these differences between CAA, AS and SVD, apolipoprotein E (apoE) is involved in all three disorders. Such a pathogenetic link may explain the correlations between AS, SVD, CAA, and Alzheimer’s disease in the brains of elderly individuals reported in the literature. In addition, AS, SVD, and CAA can lead to tissue lesions such as hemorrhage and infarction. Moreover, intracerebral SVD leads to plasma protein leakage into the damaged vessel wall and into the perivascular space resulting in a blood–brain barrier (BBB) dysfunction. This SVD-related BBB dysfunction is considered to cause white matter lesions (WMLs) and lacunar infarcts. In this review, we demonstrate the relationship between AS, SVD, and CAA as well as their contribution to the development of vascular tissue lesions and we emphasize an important role for apoE in the pathogenesis of vessel disorders and vascular tissue lesions as well as for BBB dysfunction on WML and lacunar infarct development.
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影响因子：
2.4
作者：
Englund, E
通讯作者：
Englund, E
影响因子：
37.8
作者：
Dollery, CM;Owen, CA;Libby, P
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Libby, P
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FAZEKAS, F;KLEINERT, R;LECHNER, H
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作者：
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通讯作者：
Roher, Alex E.
DOI：
10.1073/pnas.96.24.14088
发表时间：
1999-11-23
影响因子：
11.1
作者：
Calhoun, ME;Burgermeister, P;Jucker, M
通讯作者：
Jucker, M