The vascular contribution to Alzheimer's disease

Abstract

AD (Alzheimer’s disease) is a progressive neurodegenerative disease of unknown origin. Despite questions as to the underlying cause(s) of this disease, shared risk factors for both AD and atherosclerotic cardiovascular disease indicate that vascular mechanisms may critically contribute to the development and progression of both AD and atherosclerosis. An increased risk of developing AD is linked to the presence of the apoE4 (apolipoprotein E4) allele, which is also strongly associated with increased risk of developing atherosclerotic cardiovascular disease. Recent studies also indicate that cardiovascular risk factors, including elevated blood cholesterol and triacylglycerol (triglyceride), increase the likelihood of AD and vascular dementia. Lipids and lipoproteins in the circulation interact intimately with the cerebrovasculature, and may have important effects on its constituent brain microvascular endothelial cells and the adjoining astrocytes, which are components of the neurovascular unit. The present review will examine the potential mechanisms for understanding the contributions of vascular factors, including lipids, lipoproteins and cerebrovascular Aβ (amyloid β), to AD, and suggest therapeutic strategies for the attenuation of this devastating disease process. Specifically, we will focus on the actions of apoE, TGRLs (triacylglycerol-rich lipoproteins) and TGRL lipolysis products on injury of the neurovascular unit and increases in blood–brain barrier permeability.

Alzheimer’s Disease and Diabetes

“…Furthermore, perturbations in vascular hemodynamics have been observed in VaD and AD [136,137], however, AD patients had comparatively less impairment in cerebral perfusion than those with VaD [138] suggesting that hemodynamic disturbances may underlie different types of dementia [138]. While the precise mechanism that vascular risk factors initiate cognitive decline remains elusive [139], T2DM have been identified as an important contributing factor to the development of VaD.…”

Review of drugs for Alzheimer's disease

“…It can promote amyloid deposition, neurotoxicity, oxidative stress, neurofibrillary tangle formation, and increasing brain inflammation. Previous studies have shown that ApoE4 causes mitochondrial damage, microvascular generation, and neural injury (24).…”

Endovascular Application of Low-Energy Laser in the Treatment of Dyscirculatory Angiopathy of Alzheimer’s Type

“…Despite the fact that etiology and pathogenesis of AD have not been fully studied so far [5], the diagnosis of pre-clinical and early forms of the disease was named one of the major foci in AD studies at AAIC 2011. Such diagnosis will make possible an early treatment which is naturally more effective [6].…”

“…In recent years, there have been a lot of large-scale studies on the vascular factor in the development of AD [5,[22][23][24][25][26][27], cerebral blood flow disorders [28,29], and the phenomena of amyloid angiopathy [30][31][32][33].…”