Hereditary cerebral hemorrhage with amyloidosis (Dutch): a model for congophilic plaque formation without neurofibrillary pathology
1994
Plaque-like lesions and
amyloid angiopathywere investigated in the frontal cerebral cortex of four patients with hereditary
cerebral hemorrhagewith amyloidosis (Dutch) (HCHWA-D), using immunohistochemical [antibodies to β amyloid protein (Aβ), β
protein precursor(βPP),
synaptophysin, ubiquitin (UBQ),
cathepsin D, paired helical filaments (PHF) and
glial fibrillary acidic protein(GFAP)], enzymehistochemical (
acid phosphatase) and silver [
methenaminesilver (MS) and Palmgren] staining methods. Whereas Aβ-and MS-positive diffuse plaques were found in all patients, only the three older patients showed
neuriticor congophilic plaques, which were
acid phosphataseand
cathepsin Dpositive and contained βPP-,
synaptophysin-and UBQ-positive, but PHF-negative
neurites. These plaques were surrounded by reactive astrocytes. Similar immuno-and enzymereactivity was found around congophilic blood vessels. Thus, apart from neuronal degeneration in a subset of plaque-like lesions and around blood vessels, this study shows an age-related morphology of the plaques in HCHWA-D, corresponding to that in Down's syndrome (DS), with the difference that neurofibrillary (NF) pathology is absent in HCHWA-D in contrast to DS. HCHWA-D may be considered as a model for congophilic plaque formation not associated with NF pathology.
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