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Aging and cerebrovascular dysfunction: contribution of hypertension, cerebral amyloid angiopathy, and immunotherapy

Vitaly Vasilevko1, Giselle F Passos, Daniel Quiring

  • 1Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, California, USA.

Annals of the New York Academy of Sciences
|October 20, 2010
PubMed

Insights

Age-related cerebrovascular dysfunction contributes to stroke and cognitive decline. New strategies are needed to improve blood-brain barrier function and reduce cerebral amyloid angiopathy, a key risk factor.

Area of Science:

  • Neuroscience
  • Cerebrovascular Biology
  • Neurodegenerative Diseases

Background:

  • Age-related cerebrovascular dysfunction is implicated in stroke, hemorrhages, and cognitive decline.
  • This dysfunction plays a secondary role in neurodegenerative diseases like Alzheimer's disease.
  • Cerebral amyloid angiopathy (CAA) and amyloid beta (Aβ) accumulation are linked to blood-brain barrier (BBB) lesions and stroke.

Purpose of the Study:

  • To highlight the critical need for novel therapeutic strategies targeting cerebrovascular dysfunction.
  • To emphasize the importance of improving blood-brain barrier (BBB) function.
  • To address the challenge of limiting beta-amyloidosis in the cerebral vasculature, particularly in the context of CAA.

Main Methods:

  • Review of existing literature on age-related cerebrovascular dysfunction.
  • Analysis of the role of amyloid beta (Aβ) in cerebrovascular pathologies.
  • Examination of clinical trial data for anti-amyloid immunotherapies and associated adverse events.

Main Results:

  • Cerebrovascular dysfunction is a significant contributor to various neurological conditions, including stroke and cognitive impairment.
  • Amyloid beta (Aβ) accumulation in cerebral vasculature is a risk factor for intracerebral hemorrhage (ICH) and linked to BBB dysfunction.
  • Current anti-Aβ therapies show promise in clearing amyloid but are associated with CAA-related complications, indicating a need for safer approaches.

Conclusions:

  • Effective management of hypertension and atherosclerosis can reduce ICH incidence but does not address CAA.
  • There are currently no approved therapies specifically for attenuating cerebral amyloid angiopathy (CAA).
  • Developing new strategies to enhance BBB integrity and mitigate cerebral β-amyloidosis is crucial for preventing cerebrovascular and neurodegenerative diseases.

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