Interaction between cerebrovascular disease and Alzheimer pathology
Abstract
Purpose of review Epidemiological investigations have proposed strict control of vascular risk factors as a strategy to overcome dementia, because of the close interaction between cerebrovascular disease (CVD) and Alzheimer's disease. In light of recent advances in basic, translational, and clinical research in the area, this review focuses on the significance of CVD in Alzheimer's disease pathogenesis. Recent findings Alzheimer's disease and CVD share several risk factors, and the coexistence of both pathologies is frequently noted. CVD and subsequent cerebral blood flow reduction would increase amyloid β (Aβ) production by modulating β and γ-secretase. Furthermore, CVD impairs Aβ clearance, which is mainly driven by vascular mediated systems, including active transport across the blood-brain barrier, and perivascular lymphatic/paravascular glymphatic drainage systems. Thus, CVD may disturb homeostasis between Aβ production and clearance, thereby aggravating Alzheimer's disease. Recent translational researches in this field aim to facilitate Aβ clearance. Several candidate drugs are being tested in clinical trials. Summary Compared with Aβ pathology, little is known about the relationship between tau pathology and CVD, although some studies have shown that CVD has an influence on tau pathology. The close interrelationship between Alzheimer's disease and CVD suggests the necessity of the maintenance of cerebrovascular integrity, which may herald a new generation of dementia t…
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CAA is a major cause of SMC vascular degeneration that is associated with BBB breakdown at the arterial and/or arteriolar level, lobar microbleeds, infarcts, white matter changes, and cognitive impairment worsening AD pathology.
“CAA is a major cause of SMC vascular degeneration that is associated with BBB breakdown at the arterial and/or arteriolar level, lobar microbleeds, infarcts, white matter changes, and cognitive impairment worsening AD pathology (514, 640).”
From Blood-Brain Barrier: From Physiology to Disease and Back (2019) · cites this paper as [514]
Solutes diffuse across brain extracellular spaces and are cleared along the basement membranes of arterial vessel walls by perivascular interstitial fluid flow, which travels in the reverse direction of blood flow.
“Besides the major role of transvascular transport in clearance of solutes across the BBB by CMT, RMT, major facilitators, and active efflux transporters (514, 682, 693), solutes diffuse across brain ECS and are cleared along the basement membranes of the arterial vessel walls by the perivascular ISF flow, which travels in the reverse direction of the blood flow (37, 514, 581) (FIGURE 4) .”
From Blood-Brain Barrier: From Physiology to Disease and Back (2019) · cites this paper as [514]
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- Authors
- Saito, S., & Ihara, M.
- Affiliations
- National Cerebral and Cardiovascular Center (JP)
- Corresponding author
- Ihara, Masafumi
- ORCID
- Ihara, Masafumi
- Venue
- Current Opinion in Psychiatry
- Published
- 2016-03
- Volume
- 29
- Issue
- 2
- Pages
- 168-173
- ISSN
- 0951-7367 (ISSN-L)
- OpenAlex
- W2340740324
- Cited by
- 69
- References
- 10
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 3 · 2023: 6 · 2022: 11 · 2021: 12 · 2020: 6 · 2019: 5 · 2018: 7 · 2017: 8 · 2016: 5
- FWCI
- 0.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Opinion in Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Chinese Academy of Agricultural Sciences
- Japan Society for the Promotion of Science (15H04271)
- Topics
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
- Keywords
- cerebrovascular disease, Alzheimer's disease, amyloid-beta, amyloid-beta clearance, cerebral blood flow, beta-secretase, gamma-secretase, blood-brain barrier, glymphatic system, vascular risk factors, tau pathology, dementia, cerebrovascular integrity
- MeSH terms
- Alzheimer Disease, Animals, Cerebrovascular Circulation, Cerebrovascular Disorders, Clinical Trials as Topic, Dementia, Disease Models, Animal, Humans, Mice, Transgenic, Risk Factors, Amyloid beta-Peptides, Glycation End Products, Advanced
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