Neuropathological study of astrocytic fibrillary tangles

多年来，人们已经知道，阿尔茨海默型痴呆患者的海马体和大脑皮层神经元中存在神经原纤维缠结。类似的原纤维变化也发生在某些退行性疾病的星形胶质细胞中，特别是进行性核上性麻痹和皮质基底变性。1992年首次报道的这种星形细胞纤维缠结（AFTs）已被抗tau抗体染色。然而，我们在2例家族性帕金森病患者中发现了新的tau阴性aft。我们研究了各种疾病的大脑，以阐明AFTs的特异性和异质性。我们用甲基苯丙胺银法和galyas - braak法对脑切片进行染色，并对含有AFT的切片进行抗tau抗体免疫染色。我们在1例皮质基底变性患者中发现tau阳性的AFTs，在1例精神分裂症患者中发现tau阴性的AFTs，此外还有2例家族性帕金森病患者。我们也用电子显微镜研究了tau阴性AFTs的甲基苯丙胺银染色切片，但无法确定AFTs的确切成分。结果，我们发现2例家族性帕金森病患者大脑皮层第二至第三层神经元中存在大量神经原纤维缠结。缠结由15纳米的直小管组成，与进行性核上性麻痹相似，但呈tau阴性。这种tau阴性的神经原纤维缠结以前未见报道。在《神经病理学学报》（Acta neuropath）（95: 15- 27,1998）上发表了常见的帕金森病患者，包括2例出现新型tau阴性aft和神经原纤维缠结的患者。

Neurofibrillary tangles have been known for years to occur in the neurons of the hippocampus and cerebral cortex of patients with Alzheimer type dementia. Similar fibrillary changes also occur in the astrocytes of a certain degenerative diseases, particularly progressive supranuclear palsy and corticobasal degeneration. Such astrocytic fibrillary tangles (AFTs), first reported in 1992, have been stained with anti-tau antibodies. However, we found novel, tau-negative AFTs in 2 patients with familial Parkinson disease. We investigated the brains of various diseases to elucidate the specificity and heterogeneity of AFTs. We stained sections of the brain by methenamine silver and Gallyas-Braak methods, and the sections which contained AFT were further immunostained with anti-tau antibodies. We found tau-positive AFTs in 1 patient with corticobasal degeneration, and tau-negative AFTsin 1 patient with schizophrenia, in addition to 2 patients with the familial Parkinson disease. We also studied the methenamine silver-stained section of the tau-negative AFTs with electron microscope, but could not identify the exact constituents of the AFTs. In assition, we found numerous neurofibrillary tangles in the neurons of the second to third layrs of the cerebral cortex in the 2 patients with familial Parkinson disease. The tangles consisted of 15-nm straight tubules similar to those of progressive supranuclear palsy, but were tau-negative. Such tau-negative neurofibrillary tangles have not been reported previously. Patients with the familiar Parkinson disease has been published in Acta Neuropathologica (95 : 15-27, 1998), including the 2 patients who showed the new types of tau-negative AFTs and neurofibrillary tangles.