LRP (low-density lipoprotein receptor-related protein) is linked to Alzheimer's disease (AD). Here, we report amyloid beta-peptide Abeta40 binds to immobilized LRP clusters II and IV with high affinity (Kd = 0.6-1.2 nM) compared to Abeta42 and mutant Abeta, and LRP-mediated Abeta brain capillary binding, endocytosis, and transcytosis across the mouse blood-brain barrier are substantially reduced by the high beta sheet content in Abeta and deletion of the receptor-associated protein gene. Despite low Abeta production in the brain, transgenic mice expressing low LRP-clearance mutant Abeta develop robust Abeta cerebral accumulations much earlier than Tg-2576 Abeta-overproducing mice. While Abeta does not affect LRP internalization and synthesis, it promotes proteasome-dependent LRP degradation in endothelium at concentrations > 1 microM, consistent with reduced brain capillary LRP levels in Abeta-accumulating transgenic mice, AD, and patients with cerebrovascular beta-amyloidosis. Thus, low-affinity LRP/Abeta interaction and/or Abeta-induced LRP loss at the BBB mediate brain accumulation of neurotoxic Abeta.

Neurovascular dysfunction substantially contributes to Alzheimer disease. Here, we show that transcriptional profiling of human brain endothelial cells (BECs) defines a subset of genes whose expression is age-independent but is considerably altered in Alzheimer disease, including the homeobox gene MEOX2 (also known as GAX), a regulator of vascular differentiation, whose expression is low in Alzheimer disease. By using viral-mediated MEOX2 gene silencing and transfer, we show that restoring expression of the protein it encodes, GAX, in BECs from individuals with Alzheimer disease stimulates angiogenesis, transcriptionally suppresses AFX1 forkhead transcription factor-mediated apoptosis and increases the levels of a major amyloid-beta peptide (Abeta) clearance receptor, the low-density lipoprotein receptor-related protein 1 (LRP), at the blood-brain barrier. In mice, deletion of Meox2 (also known as Gax) results in reductions in brain capillary density and resting cerebral blood flow, loss of the angiogenic response to hypoxia in the brain and an impaired Abeta efflux from brain caused by reduced LRP levels. The link of MEOX2 to neurovascular dysfunction in Alzheimer disease provides new mechanistic and therapeutic insights into this illness.

Although thrombolytic effects of tissue plasminogen activator (tPA) are beneficial, its neurotoxicity is problematic. Here, we report that tPA potentiates apoptosis in ischemic human brain endothelium and in mouse cortical neurons treated with N-methyl-D-aspartate (NMDA) by shifting the apoptotic pathways from caspase-9 to caspase-8, which directly activates caspase-3 without amplification through the Bid-mediated mitochondrial pathway. In vivo, tPA-induced cerebral ischemic injury in mice was reduced by intracerebroventricular administration of caspase-8 inhibitor, but not by caspase-9 inhibitor, in contrast to controls in which caspase-9 inhibitor, but not caspase-8 inhibitor, was protective. Activated protein C (APC), a serine protease with anticoagulant, anti-inflammatory and antiapoptotic activities, which is neuroprotective during transient ischemia and promotes activation of antiapoptotic mechanisms in brain cells by acting directly on endothelium and neurons, blocked tPA vascular and neuronal toxicities in vitro and in vivo. APC inhibited tPA-induced caspase-8 activation of caspase-3 in endothelium and caspase-3-dependent nuclear translocation of apoptosis-inducing factor in NMDA-treated neurons and reduced tPA-mediated cerebral ischemic injury in mice. Data suggest that tPA shifts the apoptotic signal in stressed brain cells from the intrinsic to the extrinsic pathway which requires caspase-8. APC blocks tPA's neurovascular toxicity and may add substantially to the effectiveness of tPA therapy for stroke.

Near-infrared imaging was used to quantify typical values of hemoglobin concentration, oxygen saturation, water fraction, scattering power, and scattering amplitude within the breast tissue of volunteer subjects. A systematic study of the menstrual variations in these parameters was carried out by measuring a group of seven premenopausal normal women (aged 41 to 47 years) in the follicular (days 7 to 14 of the cycle) and secretory phases (days 21 to 28) of the cycle, for two complete menstrual cycles. An average increase in hemoglobin concentration of 2.6 microM or 13% of the background breast values was observed in the secretory phase relative to the follicular phase (p<0.0001), but no other average near-infrared parameter changes were significant. While repeatable and systematic changes were observed in all parameters for individual subjects, large intersubject variations were present in all parameters. In a survey of thirty-nine normal subjects, the total hemoglobin varied from 9 to 45 microM, with a systematic correlation observed between total hemoglobin concentration and breast radiographic density. Scattering power and scattering amplitude were also correlated with radiographic density, but oxygen saturation and water fraction were not. Images of breast lesions indicate that total hemoglobin-based contrast can be up to 200% relative to the background in the same breast. Yet, since the background hemoglobin values vary considerably among breasts, the maximum hemoglobin concentrations observed in cancer tumors may vary considerably as well. In light of these observations, it may be important to use hemoglobin contrast values relative to the background for a given breast, rather than absolute hemoglobin contrast when trying to compare the features of breast lesions among subjects.

The contrast-to-noise ratio ͑CNR͒ was used to determine the detectability of objects within reconstructed images from diffuse near-infrared tomography. It was concluded that there was a maximal value of CNR near the location of an object within the image and that the size of the true region could be estimated from the CNR. Experimental and simulation studies led to the conclusion that objects can be automatically detected with CNR analysis and that our current system has a spatial resolution limit near 4 mm and a contrast resolution limit near 1.4. A new linear convolution method of CNR calculation was developed for automated region of interest ͑ROI͒ detection.

WNT antagonism displays marked synergy with taxane chemotherapy and reverses taxane-induced enrichment of cancer stem cells.

Three major analytical tools in imaging science are summarized and demonstrated relative to optical imaging in vivo. Standard resolution testing is optimal when infinite contrast is used and hardware evaluation is the goal. However, deep tissue imaging of absorption or fluorescent contrast agents in vivo often presents a different problem, which requires contrast-detail analysis. This analysis shows that the minimum detectable sizes are in the range of 1/10 the outer diameter, whereas minimum detectable contrast values are in the range of 10 to 20% relative to the continuous background values. This is estimated for objects being in the center of the domain being imaged, and as the heterogeneous region becomes closer to the surface, the lower limit on size and contrast can become arbitrarily low and more dictated by hardware specifications. Finally, if human observer detection of abnormalities in the images is the goal, as is standard in most radiological practice, receiver operating characteristic (ROC) curve and location receiver operating characteristic curve (LROC) are used. Each of these three major areas of image interpretation and analysis are reviewed in the context of medical imaging as well as how they are used to quantify the performance of diffuse optical imaging of tissue.

A method for estimating Mie theory scattering parameters from diffuse light tomography measurements in breast tissue is discussed. The approach provides an estimate of the mean particle size and number density given assumptions about the index of refraction change expected in lipid-membrane-bound scatterers. When using a sparse number of wavelengths in the reduced scattering spectra, the parameter extraction technique is limited to representing a continuous distribution of scatterer sizes that appears to be dominated by an exponential decrease with increasing particle size. The fitting method is tested on simulated data and then on Intralipid-based tissue-phantom data, giving a mean particle size of 93+/-17 nm, which is in excellent agreement with expectations. The approach is also applied retrospectively to breast tissue spectra acquired from normal healthy volunteers, where the average particle size and number density were found to be in the range of 20 to 1400 nm. Grouping of the data based on radiographic breast density, as a surrogate measure of tissue composition yielded values of 20 to 65, 25 to 200, 140 to 1200, and 150 to 1400 nm, respectively, for the four BI-RADS (American College of Radiology Breast Imaging Reporting and Data System) density classifications of extremely dense, heterogeneously dense, scattered, and fatty. These results are consistent with the microscopic characteristics of each breast type given the expected progression from predominantly collagenous connective tissue (extremely dense category) to increasing proportions of glandular epithelium and fat (intermediate density categories) to predominantly fat (fatty category).