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Sialylation patterns in cerebral amyloid angiopathy
Caitlyn Fastenau1,2, Rebecca Crisp1, Mallory Keating1
1Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
Brain Pathology (Zurich, Switzerland)
|September 17, 2025
Summary
Sialic acid (SA) levels are significantly elevated in the blood vessels of Alzheimer's disease (AD) patients with Cerebral Amyloid Angiopathy (CAA). This finding highlights altered glycosylation in AD with CAA, potentially impacting disease severity.
Area of Science:
- Neuroscience
- Biochemistry
- Immunology
Background:
- Glycosylation, a common brain modification, is altered in neurodegeneration, often showing increased sialic acid (SA).
- Previous research linked increased sialylation to microglia in Alzheimer's disease (AD), especially near amyloid plaques.
- The relationship between SA and Cerebral Amyloid Angiopathy (CAA), common in AD, remains poorly understood.
Purpose of the Study:
- To investigate sialylation patterns in AD cases with and without CAA.
- To compare SA modifications in parenchymal and leptomeningeal vessels across different patient groups.
Main Methods:
- Analysis of 30 post-mortem frontal cortex cases with diagnoses of AD and/or CAA.
- Quantitative digital pathology to assess regional SA differences in blood vessels.
- Comparison of intravascular amyloid-beta and SA levels between AD with CAA, AD-only, and control groups.
Main Results:
- No significant difference in amyloid-beta levels within vessels of AD with CAA cases.
- Visual increase in microglia sialylation observed around parenchymal blood vessels in CAA cases.
- Significantly higher intravascular SA levels in AD with CAA cases compared to AD-only and control groups.
Conclusions:
- This study reveals elevated sialylation in cerebral blood vessels in AD with CAA.
- The findings suggest altered glycosylation contributes to pathology in AD with CAA.
- Further research into glycosylation changes is warranted for understanding AD with CAA progression.

