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Ubiquitin expression in globose tangles in the locus coeruleus in brains of patients with Alzheimer's and Parkinson's diseases.

The locus coeruleus belongs to brain areas exhibiting remarkable neuronal loss already during physiological aging and very early neurofibrillary tangles. We performed a semiquantitative, immunocytochemical study focused on the expression of ubiquitin in neurofibrillary tangles in the locus coeruleus as compared with the central superior nucleus. The locus coeruleus exhibited later ubiquitin expression in the neurofibrillary tangles, a lower percentage of ubiquitinated tangles and more frequently granular cytoplasmic staining with Tau-1 than the central superior nucleus. These results suggesting different, probably delayed, processing of Tau protein in the locus coeruleus might contribute additionally to cell injury in this area.

Aged↗

Familial progressive supranuclear palsy.

Progressive supranuclear palsy (PSP) is a degenerative neurological disease not typically associated with a family history. Two siblings developed identical clinical features consisting of supranuclear vertical ophthalmoplegia, bradykinesia, rigidity, gait disturbance, and dementia. There was no history of encephalitis or of exposure to known chemicals. L-dopa and dopamine agonist therapy were minimally effective. Autopsy of 1 patient revealed the typical pathological findings of PSP: severe neuronal loss with neurofibrillary tangles (NFTs) in the substantia nigra, subthalamic nucleus, and locus ceruleus. Prominent neurofibrillary degeneration of the amygdaloid nucleus and hippocampus was also observed. Scattered neurofibrillary tangles were seen in the cerebral cortices. Cerebellar degeneration was characterized by a loss of neurons in the dentate nucleus associated with neurofibrillary tangles. Lewy bodies and cortical neuritic plaques were notably absent. The existence of a rare familial form of PSP is supported by these 2 siblings.

Aged↗

Altered apolipoprotein D expression in the brain of patients with Alzheimer disease.

The etiology of late-onset Alzheimer disease is poorly understood. Predisposing factors such as the apolipoprotein E4 allele, as well as protective factors (e.g., antioxidants) have been proposed to play a role in the disease's process. A search for predisposing factors contributing to sporadic late-onset Alzheimer disease was initiated using the differential display technique. RNA expression profiles of the entorhinal cortex and the cerebellum of Alzheimer-diseased and normal patients were compared. The entorhinal cortex is the first brain region to accumulate neurofibrillary tangles during disease progression, whereas the cerebellum is spared. In the Alzheimer cases of this study, one signal showing preferential expression in the entorhinal cortex corresponded to the apolipoprotein D gene. This preferential expression might be genuine at the RNA level as suggested by the in situ hybridization method used. In addition, immunohistochemical experiments showed higher percentages of Apolipoprotein D reactive pyramidal neurons in the entorhinal cortex and region 1 of Ammon's horn in diseased patients. This increase correlated with the number of neurofibrillary tangles in Alzheimer as well as in normal patients. Colocalization of Apolipoprotein D proteins and neurofibrillary tangles in the same neuron was rare. Thus, these results suggest that in Alzheimer disease and aging, apolipoprotein D gene expression is increased in stressed cortical neurons before they possibly accumulate neurofibrillary tangles.

Adult↗

Lateralization of brain morphologic and cholinergic abnormalities in Alzheimer's disease.

The extent of left-right asymmetry in the densities of senile plaques and neurofibrillary tangles and the levels of the cholinergic enzymes choline acetyltransferase and acetylcholinesterase were quantified in the middle frontal and superior temporal cerebral cortex, entorhinal cortex, and prosubiculum of the hippocampus from 21 patients who died with Alzheimer's disease. Morphologic lesions were more asymmetrically distributed than deficits in the cholinergic enzymes. Neither cerebral hemisphere showed consistently higher densities of senile plaques and neurofibrillary tangles, or lower levels of choline acetyltransferase and acetylcholinesterase. Deficits in the cholinergic enzymes tended to colateralize, while asymmetries of senile plaques and neurofibrillary tangles did not. Finally, left-right asymmetry in the density of senile plaques diminished with increasing neuropathologic severity, while similar evidence for diminishing left-right asymmetry of neurofibrillary tangle density or cholinergic enzyme activity with increasing severity was not found.

Acetylcholinesterase↗

Mechanical instability of Pick bodies and their isolation in an intact form using urea solution.

Isolation of Pick bodies was attempted from an autopsied brain of a patient with Pick's disease following a modified method for isolation of senile plaques cores and neurofibrillary tangles in the brains of Alzheimer's disease. Pick bodies were mechanically less stable than senile plaque cores and neurofibrillary tangles since Pick bodies were destroyed by vigorous homogenization or treatment with 1% sodium dodecyl sulfate solution. Pick bodies were released out of mother neuronal cells in an intact form by treatment with 8 M urea solution for several hours at room temperature. Finally, fine structure of Pick filaments released from Pick bodies was compared with the filaments of neurofibrillary tangles.

Brain↗

Caspase Activation in the Alzheimer's Disease Brain: Tortuous and Torturous.

Alzheimer's disease is characterized by the presence of neurofibrillary tangles and senile plaques. Although much is known about the molecular events leading to the formation of plaques and tangles as well as their relevance in neuronal cell loss associated with Alzheimer's disease, the link between these two pathologies is presently unknown. The exact mechanism of neuronal cell death in the Alzheimer's disease brain has been a debated issue with both the necrosis and apoptosis pathways having been implicated. The activation of apoptosis in the Alzheimer's disease brain has recently gained momentum, namely because of the development of specific markers for caspase activation. These markers consist of antibodies, termed caspase-cleavage site-directed antibodies that are designed to detect either the active enzymatic fragments of caspases following their activation or protein products targeted for caspase cleavage. The use of these markers has demonstrated the widespread activation of caspases in the Alzheimer's disease brain. In addition, many of these markers have been co-localized with markers for neurofibrillary tangles, suggesting that caspases may play a role in the formation of neurofibrillary tangles and, thus, do not simply represent end-stage events associated with Alzheimer's disease. In this review, recent studies documenting the role of caspases in the Alzheimer's disease brain will be discussed, along with the methodology behind the synthesis of site-directed caspase-cleavage antibodies. A model will be presented whereby caspases serve not simply as end-game players, but may actually serve as a link between senile plaques and neurofibrillary tangles. In this context, a discussion of the therapeutic value of targeting caspase inhibition in the treatment of Alzheimer's disease will be evaluated. (c) 2002 Prous Science. All rights reserved.

Journal Article↗

Cytokine gene expression as a function of the clinical progression of Alzheimer disease dementia.

BACKGROUND: Inflammatory cytokines have been linked to Alzheimer disease (AD) neurodegeneration, but little is known about the temporal control of their expression in relationship to clinical measurements of AD dementia progression. DESIGN AND MAIN OUTCOME MEASURES: We measured inflammatory cytokine messenger RNA (mRNA) expression in postmortem brain specimens of elderly subjects at different clinical stages of dementia and neuropathological dysfunction. SETTING AND PATIENTS: Postmortem study of nursing home patients. RESULTS: In brains of cognitively normal control subjects, higher interleukin 6 (IL-6) and transforming growth factor beta1 (TGF-beta1) mRNA expression was observed in the entorhinal cortex and superior temporal gyrus compared with the occipital cortex. Compared with age-matched controls, subjects with severe/terminal dementia, but not subjects at earlier disease stages, had higher IL-6 and TGF-beta1 mRNA expression in the entorhinal cortex (P<.01) and superior temporal gyrus (P<.01). When stratified by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropathological criteria, IL-6 mRNA expression in both the entorhinal cortex (P<.05) and superior temporal gyrus (P<.01) correlated with the level of neurofibrillary tangles but not neuritic plaques. However, in the entorhinal cortex, TGF-beta1 mRNA did not correlate with the level of either neurofibrillary tangles or neuritic plaques. Interestingly, in the superior temporal gyrus, TGF-beta1 mRNA expression negatively correlated with neurofibrillary tangles (P<.01) and showed no relationship to the pathological features of neuritic plaques. CONCLUSIONS: The data are consistent with the hypothesis that cytokine expression may differentially contribute to the vulnerability of independent cortical regions during the clinical progression of AD and suggest that an inflammatory cytokine response to the pathological effects of AD does not occur until the late stages of the disease. These findings have implications for the design of anti-inflammatory treatment strategies. Arch Neurol. 2000;57:1153-1160

Aged↗

Tangle-bearing neurons show more extensive dendritic trees than tangle-free neurons in area CA1 of the hippocampus in Alzheimer's disease.

To elucidate the pathogenetic significance of neurofibrillary tangles in Alzheimer's disease, the dendritic tree of tangle-bearing and unaffected pyramidal cells of area CA1 of the hippocampus was morphometrically examined. Golgi-stained neurons were assessed which were deimpregnated and counterstained with Congo red to visualize neurofibrillary tangles. The study revealed that tangle-bearing neurons have more extensive apical dendritic trees than tangle-free neurons. It is concluded that metabolic processes associated with the formation of neurofibrillary tangles may increase neurotrophic activity on a single cell level and counteract the cellular degeneration process.

Aged↗

Solving the insoluble.

Dissection of neurofibrillary tangles has been confounded by the insolubility of their fibers. While the majority of biochemical studies have considered tau filaments equivalent to neurofibrillary tangles, they forget that the former are soluble and the latter completely resistant to solvents. What, then, accounts for the insolubility of neurofibrillary tangles while tau filaments are soluble? Investigation of these distinctions played a critical role in our findings on proteolytic abnormalities and oxidative stress.

Alzheimer Disease↗

Immunohistochemical localization of neurofilament protein in neuronal degenerations.

The immunohistochemical localization of human neurofilament proteins was studied in a variety of neuronal changes by the peroxidase-antiperoxidase method using antisera raised against each of the subunit proteins of human neurofilament. Torpedoes of the cerebellum, axonal spheroids of amyotrophic lateral sclerosis as well as of infantile neuroaxonal dystrophy, and neurofibrillary changes in a case of Pick's disease were consistently immunostained. Occasionally, a positive immunoreactivity was also observed in Lewy bodies, in neurofibrillary tangles of progressive supranuclear palsy, and in neuritic processes of senile plaques. Neurofibrillary tangles of Alzheimer type and Pick's bodies, however, did not react with the antisera. These data indicate that the human neurofilament does not share major antigenic determinants of its subunit protein with either Alzheimer's neurofibrillary tangles or Pick's bodies.

Alzheimer Disease↗

Cellular tau pathology and immunohistochemical study of tau isoforms in sporadic tauopathies.

Pathological inclusions in neurons and glial cells containing fibrillary aggregates of abnormally hyperphosphorylated tau protein are characteristic features in sporadic tauopathies. In the first part of this paper we outline the morphological features of some major sporadic tauopathies. In the second part, to better define the tau isoform composition, we report on the immunohistochemistry of tau isoforms in autopsied brains, including two cases with AD, two with diffuse neurofibrillary tangles with calcification, four with Pick's disease with Pick bodies (PiD), seven with progressive supranuclear palsy (PSP), six with corticobasal degeneration (CBD) and seven cases with argyrophilic grain disease. We used two monoclonal antibodies, RD3 and RD4, and a polyclonal antibody for exon 10 that effectively distinguish between three-repeat (3R) tau and four-repeat (4R) tau. Neuronal neurofibrillary tangles (NFT) in AD and diffuse neurofibrillary tangles with calcification contained both 3R-tau and 4R-tau. The Pick bodies were immunopositive for 3R-tau in two cases; however, in two other cases they were mainly immunopositive for 4R-tau. Thus, Pick bodies demonstrated heterogeneity. 3R-tau PiD contained 3R-tau glial inclusions, and 4R-tau PiD contained mainly 4R-tau glial inclusions. Glial inclusions were more abundant in 4R-tau PiD cases. In progressive supranuclear palsy and CBD, both neuronal and glial tau accumulation forming NFF, pretangles, tuft-shaped astrocytes, astrocytic plaques, coiled bodies and threads demonstrated 4R-tau in the cerebral cortices, although in the basal ganglia and brainstem neuronal and glial inclusions were occasionally immunopositive for 3R-tau in addition to 4R-tau. Argyrophilic grains (AG) were immunopositive for 4R-tau, although pretangles were weakly stained for 4R-tau. Thus the immunoreactivity for 4R-tau was different between AG and pretangles. Therefore, the isoform composition on immunohistochemical study showed heterogeneity in PiD, and was not uniform in the basal ganglia and brain stem in PSP and CBD. It is suggested that the isoform composition of sporadic tauopathies may have a spectrum in individual cases, and cellular isoform composition may differ in various brain regions.

Aged↗

Relationship of aluminum to Alzheimer's disease.

Alzheimer's disease is a progressive degenerative brain disease of unknown etiology, characterized by the development of large numbers of neurofibrillary tangles and senile plaques in the brain. Aluminum salts may be used experimentally to produce lesions which are similar, but not identical, to the neurofibrillary tangle. Although some studies have reported increased amounts of aluminum in the brains of Alzheimer's disease victims, these bulk analysis studies have been difficult to replicate and remain controversial. Using scanning electron microscopy with X-ray spectrometry, we have investigated this question on the cellular level. We have identified abnormal accumulations of aluminum within neurons derived from Alzheimer's disease patients containing neurofibrillary tangles. Similar accumulations have been detected in the numerous neurofibrillary tangle-bearing neurons seen in the brains of the indigenous native population of the island of Guam who suffer from amyotrophic lateral sclerosis and parkinsonism with dementia. Epidemiologic evidence strongly suggests a causal role for local environmental conditions relating to availability of aluminum, calcium, and magnesium. In view of the fact that a major consequence of acid rain is the liberation of large amounts of aluminum in bioavailable forms, concerns are raised about possible human health risks of this environmental phenomenon.

Acids↗

Olfactory-related changes in Alzheimer's disease: a quantitative neuropathologic study.

Neuropathological studies of 10 confirmed cases of Alzheimer's disease (AD) revealed increased numbers of neurofibrillary tangles and neuritic plaques in olfactory cortex compared to other brain regions. This was most evident when AD tissues were compared to tissues from seven gender- and age-matched controls. In the AD cases, examination of other brain regions which receive olfactory projections also revealed high concentrations of neuritic plaques and neurofibrillary tangles. These data also confirm previous observations that neurofibrillary tangle formation is more prevalent than neuritic plaque formation in AD. This is the first quantitative neuropathological study that demonstrates significant damage to various components of the central olfactory apparatus in AD. Our data suggest that damage to these areas may be related to the behavioral, emotional, and cognitive abnormalities commonly observed in affected patients. The use of antemortem evaluation of the olfactory system as a diagnostic tool for AD is discussed.

Aged↗

Diagnostic utility of quantitating neurofilament-immunoreactive Alzheimer's disease lesions.

The diagnosis of Alzheimer's disease (AD) neurodegeneration is based on histopathological detection of paired helical filament-associated lesions. Silver stains are routinely used but the results are fraught with intra- and interinstitutional variability. This study employed monoclonal antibodies to middle and high molecular weight neurofilament subunits in an immunohistochemical assay to assess the extent of paired helical filament-associated lesions in brains with AD, Down's syndrome plus AD lesions (AD+DN), Parkinson's disease dementia (PD), AD+PD, and normal aging changes. The densities of neurofilament-immunoreactive (NFI) cortical neurofibrillary tangles and plaques were significantly higher in AD and AD+DN than in PD and aged control brains (p < 0.001), and NFI neurofibrillary tangles and plaques were more abundant in AD and AD+DN compared with AD+PD and PD, yet all patients with AD, AD+PD, or PD died with end-stage dementia. In contrast, the densities of NFI dystrophic neurites (primarily dendrites) in cortical Layer 2 were similar among the AD, AD+DN, AD+PD, and PD groups, and all were significantly higher than control (p < 0.005). Stepwise multivariate regression analysis demonstrated significant correlations between AD diagnosis and high densities of NFI neurofibrillary tangles and plaques (p < 0.001) and between end-stage AD-type dementia and high densities of NFI dystrophic neurites (p < 0.001). This study demonstrates that the histopathological lesions correlated with AD dementia can be readily detected and quantified by immunostaining with monoclonal antibodies to phosphorylated and non-phosphorylated neurofilaments. Moreover, the findings suggest that NFI neurite pathology may be an important feature contributing to the clinically manifested AD-type dementia in individuals with Parkinson's disease.

Aged↗

Expression of calcipressin1, an inhibitor of the phosphatase calcineurin, is altered with aging and Alzheimer's disease.

Protein phosphatase 2B (calcineurin) activity has been shown to be decreased in Alzheimer's disease and is a possible mechanism(s) for the hyperphosphorylation of tau and subsequent neurofibrillary tangle formation. Recently, mRNA expression of Down's syndrome Critical Region 1 gene, which encodes the protein calcipressin (an endogenous inhibitor of calcineurin), was found to be upregulated in both Down's syndrome and Alzheimer's disease. Calcipressin is induced by oxidative stress and Abeta in vitro, further establishing a link in the pathology of both diseases. Using immunohistochemistry techniques, calcipressin protein expression in the pyramidal neurons of the temporal lobe was shown to increase with aging (r2=0.5658; p=0.0313), and also in moderate to severe Alzheimer's disease compared to control patients (t=3.872; p=0.0017). In addition, there was a positive correlation between the total number of calcipressin-positive pyramidal neurons and the number of neurofibrillary tangles in the temporal cortex (r2= 0.5955; p=0.0249). As there was an 88% increase in nuclear calcipressin in Alzheimer's disease (p=0.0001), the relationship between cellular localization of calcipressin and neurofibrillary tangle formation was investigated, which revealed a decrease in neurofibrillary tangle-bearing neurons that contain nuclear calcipressin (t=4.874; p=0.0028) and further demonstrates that the cellular regulation of calcipressin is altered in Alzheimer's disease.

Age Factors↗

Immunohistochemical study of A2B5-positive ganglioside in postmortem human brain tissue of Alzheimer disease, amyotrophic lateral sclerosis, progressive supranuclear palsy and control cases.

Localization of gangliosides positively stained by the monoclonal antibody A2B5 was investigated in postmortem brain tissue of Alzheimer disease, amyotrophic lateral sclerosis (ALS), progressive supranuclear palsy (PSP) and control cases. In control cases, A2B5-staining was granular, appearing in selective neuronal populations. In the neocortex, the A2B5-positive neurons were distributed mainly in deep cortical layers. In the cerebellum, A2B5-positive structures were detected in processes extending from the Purkinje cell layer into the molecular layer. In Alzheimer cases, many neurofibrillary tangles, neuropil threads and dystrophic neurites were strongly A2B5-positive. In addition, aggregations of A2B5-positive granules were detected in some neurons lacking neurofibrillary tangles. Alterations of A2B5-positive gangliosides were also detected in ALS and PSP cases. In ALS cases, A2B5-positive granules were aggregated in Betz cells of the precentral gyrus. In PSP cases, globose-type neurofibrillary tangles were also strongly A2B5-positive. The results indicate that A2B5-positive gangliosides are widely but selectively distributed in human brain and may be involved in several neuropathological processes.

Aged↗

Dementia in the oldest-old: quantitative analysis of 12 cases from a psychiatric hospital.

To examine the neuropathological characteristics of senile dementia of the Alzheimer type (SDAT) in very old people, we performed a quantitative analysis of the distribution of neurofibrillary tangles and senile plaques in the brains of 12 demented patients aged from 96 of 104 years. The hippocampal formation and the inferior temporal cortex displayed numerous neurofibrillary tangles in most cases, whereas the superior frontal cortex was relatively spared. The only statistically significant difference between demented and control cases was in the density of neurofibrillary tangles in the CA1 field of the hippocampus. High senile plaque densities were observed in the cerebral cortex and were correlated with the duration of SDAT. These results confirm the crucial role of the hippocampus in the neuropathological diagnosis of SDAT in oldest-old patients. Furthermore, they suggest that senile plaque formation may be a pathological hallmark of severe SDAT in this particular age group.

Aged↗

Neuropathologic correlates of activities of daily living in Alzheimer disease.

Functional status, reflected by measures of activities of daily living (ADLs), deteriorates as Alzheimer disease (AD) progresses. Decline in activities of daily living may be mediated by executive and frontal lobe dysfunction. The objective of this study was to examine the relationship between activities of daily living and pathologic burden in Alzheimer disease. Twenty two subjects with definite Alzheimer disease were selected from the UCLA ADRC neuropathology database. A total activities of daily living score was derived from the Retrospective Collateral Dementia Interview-Revised (RCDI-R) questionnaire, which was administered to caregivers of autopsied subjects included in the study. Neuritic plaque (NP) and neurofibrillary tangle (NFT) counts were performed for 8 brain regions. There was a significant positive correlation between total activities of daily living score (higher scores indicate more disability) and mean neuritic plaques and neurofibrillary tangle counts (r = 0.671, P = 0.001, and r = 0.542, P = 0.009, resp), as well as CA1 and prosubiculum neuritic plaques and neurofibrillary tangle counts, right and left orbital frontal neuritic plaques counts, and occipital neuritic plaques count. Total activities of daily living score did not correlate with age at death, age at symptom onset, dementia duration, gender, or education. Deteriorating activities of daily living in Alzheimer Disease subjects correlate with greater overall pathologic burden and possibly selectively with involvement of the medial temporal, occipital, and orbital frontal regions.

Activities of Daily Living↗