PDF(Pubmed)
Abstract：
Cerebral amyloid angiopathy (CAA) is characterized by the accumulation of amyloid protein in the walls of cerebral blood vessels. This deposition of amyloid causes damage to the cerebral vasculature, resulting in blood-brain barrier disruption, cerebral hemorrhage, cognitive decline, and dementia. The role of the immune system in CAA is complex and not fully understood. While the immune system has a clear role in the rare inflammatory variants of CAA (CAA related inflammation and Abeta related angiitis), the more common variants of CAA also have immune system involvement. In a protective role, immune cells may facilitate the clearance of beta-amyloid from the cerebral vasculature. The immune system can also contribute to CAA pathology, promoting vascular injury, blood-brain barrier breakdown, inflammation, and progression of CAA. In this review, we summarize the role of the immune system in CAA, including the potential of immune based treatment strategies to slow vascular disease in CAA and associated cognitive impairment, white matter disease progression, and reduce the risk of cerebral hemorrhage. HIGHLIGHTS: The immune system has a role in cerebral amyloid angiopathy (CAA) which is summarized in this review. There is an inflammatory response to beta-amyloid that may contribute to brain injury and cognitive impairment. Immune cells may facilitate the clearance of beta-amyloid from the cerebral vasculature. Improved understanding of the immune system in CAA may afford novel treatment to improve outcomes in patients with CAA.
摘要：
脑淀粉样血管病（CAA）的特征是淀粉样蛋白在脑血管壁中的积累。这种淀粉样蛋白的沉积会对脑血管系统造成损害，导致血脑屏障破坏，脑出血,认知能力下降,和痴呆症。免疫系统在CAA中的作用是复杂的，尚未完全了解。虽然免疫系统在CAA的罕见炎症变体（CAA相关炎症和Aβ相关血管炎）中具有明确的作用，更常见的CAA变异也有免疫系统的参与。在保护作用中，免疫细胞可以促进β-淀粉样蛋白从脑血管系统的清除。免疫系统也可能导致CAA病理学，促进血管损伤，血脑屏障破坏,炎症,以及CAA的进展。在这次审查中,我们总结了免疫系统在CAA中的作用，包括基于免疫的治疗策略，以减缓CAA和相关认知障碍的血管疾病的潜力，白质疾病进展，并降低脑出血的风险。摘要：免疫系统在脑淀粉样血管病（CAA）中发挥着重要作用。存在对β-淀粉样蛋白的炎症反应,其可能导致脑损伤和认知损害。免疫细胞可以促进从脑血管系统中清除β-淀粉样蛋白。对CAA中免疫系统的理解的提高可能为改善CAA患者的预后提供新的治疗方法。
