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Published on: March 7, 2019
Cerebral amyloid angiopathy: a narrative review
Natalia Motzko Noto1, Robert C Speth1,2, Lisa S Robison3
1Department of Pharmaceutical Sciences, Barry and Judy Silverman College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL, United States.
Insights
Cerebral amyloid angiopathy (CAA) lacks approved treatments. This review explores drug repurposing and lifestyle changes as potential safe and effective strategies for managing CAA and its associated neurological decline.
Area of Science:
- Neurology
- Vascular Biology
- Neurodegenerative Diseases
Background:
- Cerebral amyloid angiopathy (CAA) involves amyloid-beta (Aβ) buildup in brain vessels, leading to cognitive decline and hemorrhage.
- CAA often co-occurs with Alzheimer's disease (AD), complicating treatment due to risks associated with anti-amyloid therapies.
- Current treatment options for CAA are limited, highlighting the need for alternative therapeutic strategies.
Purpose of the Study:
- To review current knowledge on cerebral amyloid angiopathy (CAA).
- To explore the relationship between CAA and Alzheimer's disease (AD).
- To summarize emerging evidence for drug repurposing and lifestyle modifications in managing CAA.
Main Methods:
- Review of preclinical and clinical studies on CAA pathophysiology and treatment.
- Analysis of research on repurposed drugs for CAA treatment.
- Examination of lifestyle modification impacts on vascular health and amyloid burden.
Main Results:
- Animal models have advanced understanding of CAA.
- Repurposed drugs show promise for treating CAA.
- Lifestyle changes may improve vascular health, reduce amyloid burden, and enhance cognitive resilience.
Conclusions:
- There is an urgent need for safe and effective CAA treatments.
- Drug repurposing offers a promising avenue for CAA therapy.
- Lifestyle modifications may complement pharmacological approaches for managing CAA.
Abstract:
Cerebral amyloid angiopathy (CAA) is a cerebrovascular disorder characterized by the accumulation of amyloid-beta (Aβ) in the walls of cerebral vessels. It is commonly associated with cognitive decline, cerebral hemorrhage, and other neurological pathologies. Despite its prevalence and impact, there are currently no approved treatments for CAA. CAA frequently co-occurs with Alzheimer's disease (AD), but affected patients are often excluded from anti-amyloid therapies due to increased risks of cerebral edema and hemorrhage, underscoring the urgent need for alternative and safe approaches for treating individuals with CAA. Over the years, various animal models have been developed to investigate the pathophysiology of CAA and evaluate potential treatments. Recent studies have demonstrated that certain repurposed drugs, originally approved for other conditions, show promise for treating CAA. Additionally, it has been shown that positive lifestyle changes may benefit vascular health, reduce amyloid burden and neuroinflammation, and improve cognitive resilience in individuals with CAA. In this review, we summarize the current knowledge on CAA, its relationship with AD, insights from preclinical and clinical studies, and emerging evidence supporting the potential of drug repurposing and lifestyle modification in managing CAA.
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