Cited by 72Alzheimer's disease research and treatmentsIntracerebral and Subarachnoid Hemorrhage ResearchDementia and Cognitive Impairment Research

Aβ immunotherapy for Alzheimer’s disease: effects on apoE and cerebral vasculopathy

Sakai, Kenji, Boche, Delphine, Carare, Roxana, Johnston, David, Holmes, Clive, Love, Seth, Nicoll, James A. R.·2014·Acta Neuropathologica

Abstract

Aβ immunotherapy for Alzheimer's disease (AD) results in the removal of Aβ plaques and increased cerebral amyloid angiopathy (CAA). In current clinical trials, amyloid-related imaging abnormalities (ARIAs), putatively due to exacerbation of CAA, are concerning side effects. We aimed to assess the role of the Aβ transporter apolipoprotein E (apoE) in the exacerbation of CAA and development of CAA-associated vasculopathy after Aβ immunotherapy. 12 Aβ42-immunized AD (iAD; AN1792, Elan Pharmaceuticals) cases were compared with 28 unimmunized AD (cAD) cases. Immunohistochemistry was quantified for Aβ42, apoE, apoE E4 and smooth muscle actin, and CAA-associated vasculopathy was analyzed. Aβ immunotherapy was associated with redistribution of apoE from cortical plaques to cerebral vessel walls, mirroring the altered distribution of Aβ42. Concentric vessel wall splitting was increased threefold in leptomeningeal vessels after immunotherapy (cAD 6.3 vs iAD 20.6 %, P < 0.001), but smooth muscle cell abnormalities did not differ. The findings suggest that apoE is involved in the removal of plaques and transport of Aβ to the cerebral vasculature induced by Aβ immunotherapy. Immunotherapy was not associated with CAA-related vascular smooth muscle damage, but was accompanied by increased splitting of the vessel wall, perhaps reflecting enhanced deposition and subsequent removal of Aβ. ARIA occurring in some current trials of Aβ immunotherapy may reflect an extreme form of these vascular ch…

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Crossref · 10.1007/s00401-014-1340-9

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  • Amyloid β antibody treatment redistributes ApoE from brain parenchyma to blood vessels in humans, mirroring the shift of amyloid β.

    “Recently, it was found that amyloid β antibody treatment redistributes ApoE from brain parenchyma to blood vessels in humans, mirroring the shift of amyloid β [29].”

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Authors
Sakai, K., Boche, D., Carare, R., Johnston, D., Holmes, C., Love, S., & Nicoll, J. A. R.
Affiliations
  • University of Southampton (GB)
  • University of Bristol (GB)
  • Southampton General Hospital (GB)
Corresponding author
Nicoll, James A. R.
Venue
Acta Neuropathologica
Published
2014-09-07
Volume
128
Issue
6
Pages
777-789
ISSN
  • 0001-6322 (ISSN-L)
  • 1432-0533
OpenAlex
W2072476769
Cited by
72
References
56
Citations by year
2026: 5 · 2025: 6 · 2024: 8 · 2023: 5 · 2022: 3 · 2021: 4 · 2020: 14 · 2019: 5 · 2018: 2 · 2017: 6 · 2016: 5 · 2015: 8
FWCI
4.21
Type
journal article
Language
en
Open access
closed
Locations
  • Acta Neuropathologica (publishedVersion)
  • PubMed (publishedVersion)
  • Explore Bristol Research (publishedVersion)
  • ePrints Soton (University of Southampton) (acceptedVersion)
  • Bristol Research (University of Bristol) (submittedVersion)
Funders
Japan Society for the Promotion of Science (26860234)
Topics
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
  • Health Sciences › Medicine › Neurology › Intracerebral and Subarachnoid Hemorrhage Research
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Keywords
Alzheimer's disease, amyloid-beta immunotherapy, apolipoprotein E, cerebral amyloid angiopathy, amyloid-related imaging abnormalities, amyloid-beta 42, APOE ε4, cerebral vasculopathy, smooth muscle actin, plaque clearance, immunotherapy side effects
MeSH terms
Actins, Aged, Aged, 80 and over, Alzheimer Disease, Apolipoproteins E, Brain, Clinical Trials as Topic, Female, Follow-Up Studies, Humans, Immunohistochemistry, Immunotherapy, Male, Meninges, Muscle, Smooth, Vascular, Peptide Fragments, Amyloid beta-Peptides, Cerebral Amyloid Angiopathy, Microscopy, Confocal, Plaque, Amyloid

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