BACKGROUND: Clinical studies of β-amyloid (Aβ) immunotherapy in Alzheimer's disease (AD) patients have demonstrated reduction of central Aβ plaque by positron emission tomography (PET) imaging and the appearance of amyloid-related imaging abnormalities (ARIA). To better understand the relationship between ARIA and the pathophysiology of AD, we undertook a series of studies in PDAPP mice evaluating vascular alterations in the context of central Aβ pathology and after anti-Aβ immunotherapy. METHODS: We analyzed PDAPP mice treated with either 3 mg/kg/week of 3D6, the murine form of bapineuzumab, or isotype control antibodies for periods ranging from 1 to 36 weeks and evaluated the vascular alterations in the context of Aβ pathology and after anti-Aβ immunotherapy. The number of mice in each treatment group ranged from 26 to 39 and a total of 345 animals were analyzed. RESULTS: The central vasculature displayed morphological abnormalities associated with vascular Aβ deposits. Treatment with 3D6 antibody induced clearance of vascular Aβ that was spatially and temporally associated with a transient increase in microhemorrhage and in capillary Aβ deposition. Microhemorrhage resolved over a time period that was associated with a recovery of vascular morphology and a decrease in capillary Aβ accumulation. CONCLUSIONS: These data suggest that vascular leakage events, such as microhemorrhage, may be related to the removal of vascular Aβ. With continued treatment, this initial susceptibility period is followed by restoration of vascular morphology and reduced vulnerability to further vascular leakage events. The data collectively suggested a vascular amyloid clearance model of ARIA, which accounts for the currently known risk factors for the incidence of ARIA in clinical studies.
BACKGROUND: Clinical studies of β-amyloid (Aβ) immunotherapy in Alzheimer's disease (AD) patients have demonstrated reduction of central Aβ plaque by positron emission tomography (PET) imaging and the appearance of amyloid-related imaging abnormalities (ARIA). To better understand the relationship between ARIA and the pathophysiology of AD, we undertook a series of studies in PDAPP mice evaluating vascular alterations in the context of central Aβ pathology and after anti-Aβ immunotherapy. METHODS: We analyzed PDAPP mice treated with either 3 mg/kg/week of 3D6, the murine form of bapineuzumab, or isotype control antibodies for periods ranging from 1 to 36 weeks and evaluated the vascular alterations in the context of Aβ pathology and after anti-Aβ immunotherapy. The number of mice in each treatment group ranged from 26 to 39 and a total of 345 animals were analyzed. RESULTS: The central vasculature displayed morphological abnormalities associated with vascular Aβ deposits. Treatment with 3D6 antibody induced clearance of vascular Aβ that was spatially and temporally associated with a transient increase in microhemorrhage and in capillary Aβ deposition. Microhemorrhage resolved over a time period that was associated with a recovery of vascular morphology and a decrease in capillary Aβ accumulation. CONCLUSIONS: These data suggest that vascular leakage events, such as microhemorrhage, may be related to the removal of vascular Aβ. With continued treatment, this initial susceptibility period is followed by restoration of vascular morphology and reduced vulnerability to further vascular leakage events. The data collectively suggested a vascular amyloid clearance model of ARIA, which accounts for the currently known risk factors for the incidence of ARIA in clinical studies.
Authors: Stephanie A Planque; Yasuhiro Nishiyama; Sari Sonoda; Yan Lin; Hiroaki Taguchi; Mariko Hara; Steven Kolodziej; Yukie Mitsuda; Veronica Gonzalez; Hameetha B R Sait; Ken-ichiro Fukuchi; Richard J Massey; Robert P Friedland; Brian O'Nuallain; Einar M Sigurdsson; Sudhir Paul Journal: J Biol Chem Date: 2015-02-27 Impact factor: 5.157
Authors: Jeff Sevigny; Ping Chiao; Thierry Bussière; Paul H Weinreb; Leslie Williams; Marcel Maier; Robert Dunstan; Stephen Salloway; Tianle Chen; Yan Ling; John O'Gorman; Fang Qian; Mahin Arastu; Mingwei Li; Sowmya Chollate; Melanie S Brennan; Omar Quintero-Monzon; Robert H Scannevin; H Moore Arnold; Thomas Engber; Kenneth Rhodes; James Ferrero; Yaming Hang; Alvydas Mikulskis; Jan Grimm; Christoph Hock; Roger M Nitsch; Alfred Sandrock Journal: Nature Date: 2016-09-01 Impact factor: 49.962
Authors: P M Cogswell; J A Barakos; F Barkhof; T S Benzinger; C R Jack; T Y Poussaint; C A Raji; V K Ramanan; C T Whitlow Journal: AJNR Am J Neuroradiol Date: 2022-08-11 Impact factor: 4.966
Authors: Stephen Salloway; Reisa Sperling; Nick C Fox; Kaj Blennow; William Klunk; Murray Raskind; Marwan Sabbagh; Lawrence S Honig; Anton P Porsteinsson; Steven Ferris; Marcel Reichert; Nzeera Ketter; Bijan Nejadnik; Volkmar Guenzler; Maja Miloslavsky; Daniel Wang; Yuan Lu; Julia Lull; Iulia Cristina Tudor; Enchi Liu; Michael Grundman; Eric Yuen; Ronald Black; H Robert Brashear Journal: N Engl J Med Date: 2014-01-23 Impact factor: 91.245