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Microglia in diffuse plaques in hereditary cerebral hemorrhage with amyloidosis (Dutch). An immunohistochemical study

M L Maat-Schieman1, A J Rozemuller, S G van Duinen

  • 1Department of Neurology, University Hospital Leiden, The Netherlands.

Insights

Microglia are involved in forming amyloid plaques in Alzheimer's disease (AD) and hereditary cerebral hemorrhage with amyloidosis (Dutch) (HCHWA-D), but do not initiate diffuse plaque formation. Activated microglia cluster in congophilic plaques in AD/DS, unlike in HCHWA-D.

Area of Science:

  • Neuroscience
  • Neuropathology
  • Immunology

Background:

  • Hereditary cerebral hemorrhage with amyloidosis (Dutch) (HCHWA-D) involves beta/A4 amyloid deposition in cerebral blood vessels and diffuse plaques.
  • The role of microglia in diffuse plaque formation, particularly in HCHWA-D, is debated, contrasting with their known association with congophilic plaques in Alzheimer's disease (AD).

Purpose of the Study:

  • To investigate the relationship between microglia and diffuse plaques in the cerebral cortex of HCHWA-D patients.
  • To compare microglial involvement in diffuse plaque formation in HCHWA-D with congophilic plaque formation in AD and Down's syndrome (DS).

Main Methods:

  • Utilized a panel of macrophage/microglia markers (mAbs LCA, LeuM5, LeuM3, LN3, KP1, OKIa, CLB54, Mac1, Ki-M6, AMC30, and RCA-1) to study brain tissue.
  • Examined cortical tissue from four HCHWA-D patients, eight AD patients, one DS patient, and four non-demented controls.

Main Results:

  • In HCHWA-D and controls, microglia exhibited a resting, ramified morphology and maintained regular spacing, even near diffuse plaques.
  • In contrast, AD/DS brains showed increased microglial cell staining, with "activated microglia" (enlarged, expressing HLA-DR and AMC30) clustering in congophilic plaques.
  • Monocyte/macrophage marker immunoreactivity was also prominent in the walls of congophilic blood vessels in HCHWA-D.

Conclusions:

  • Microglia contribute to the formation of congophilic plaques but do not initiate the formation of diffuse plaques.
  • The findings differentiate microglial roles in early (diffuse) versus later (congophilic) amyloid plaque stages.
  • HCHWA-D exhibits distinct vascular amyloid deposition with associated monocyte/macrophage markers, differing from microglial involvement in AD plaque pathology.

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