Plasma and cerebrospinal fluid (CSF) from 20 patients with Alzheimer's dementia or senile dementia of Alzheimer type (AD/SDAT), 23 with multi-infarct dementia (MID) and 16 controls were assayed for their content of immunoglobulins (Ig) and albumin (Alb). The concentrations of IgG and Alb were used to analyze the blood-CSF barrier function in the respective group.MID patients had significantly (P < 0.001) elevated plasma IgG levels compared to controls and AD/SDAT patients. CSF concentration of Alb was significantly higher in MID (P < 0.01) and AD/SDAT (P < 0.05) patients compared to the controls. Concentration of CSF IgG was significantly (P < 0.05) lower in AD/SDAT patients compared to the MID patients; no significant differences were found when CSF concentrations of IgG of demented patients were compared to controls. These findings may indicate a blood-CSF barrier dysfunction especially in cases with MID with significantly (P < 0.001) elevated values of transudation. Also these findings indicate a non-specific and/or specific binding of IgG in CNS tissue and/or vessel walls in both forms of dementia on the basis of low IgG ratios compared to proportionally higher Alb ratios.There were no signs of local synthesis of IgG in CNS in either group of demented patients.
"oxysterols possibly reflect neuronal death with release of cell membrane cholesterol . Other factors that will affect cholesterol equilibrium include the disturbances and degeneration of the BBB which occur as part of the neuropathology in AD brains ( Claudio 1996 ; Kalaria 1996 , 2002 ) ; however , this is also seen in many non - AD aged brains ( Alafuzoff et al . 1983 ; Hampel et al . 1995 , 1997 ) . Polymorphisms in the CYP46 gene have been associated with the pathophysiology and the incidence of AD ( Kolsch et al . 2002 ; Papassotiropoulos et al . 2003 ) , and some studies have shown evidence that CYP46 and APOE polymorphisms synergistically increase the risk for AD development , and influence the "
[Show abstract][Hide abstract] ABSTRACT: Alzheimer's disease (AD) is the most common neurodegenerative disorder, affecting millions of people worldwide. Apart from age, the major risk factor identified so far for the sporadic form of AD is possession of the epsilon4 allele of apolipoprotein E (APOE), which is also a risk factor for coronary artery disease (CAD). Other apolipoproteins known to play an important role in CAD such as apolipoprotein B are now gaining attention for their role in AD as well. AD and CAD share other risk factors, such as altered cholesterol levels, particularly high levels of low density lipoproteins together with low levels of high density lipoproteins. Statins--drugs that have been used to lower cholesterol levels in CAD, have been shown to protect against AD, although the protective mechanism(s) involved are still under debate. Enzymatic production of the beta amyloid peptide, the peptide thought to play a major role in AD pathogenesis, is affected by membrane cholesterol levels. In addition, polymorphisms in several proteins and enzymes involved in cholesterol and lipoprotein transport and metabolism have been linked to risk of AD. Taken together, these findings provide strong evidence that changes in cholesterol metabolism are intimately involved in AD pathogenic processes. This paper reviews cholesterol metabolism and transport, as well as those aspects of cholesterol metabolism that have been linked with AD.
Journal of Neurochemistry 12/2009; 111(6):1275-308. DOI:10.1111/j.1471-4159.2009.06408.x · 4.28 Impact Factor
"It has been suggested that the higher levels of oxysterols possibly reflect neuronal death with release of cell membrane cholesterol. Other factors that will affect cholesterol equilibrium include the disturbances and degeneration of the BBB which occur as part of the neuropathology in AD brains (Claudio 1996; Kalaria 1996, 2002); however, this is also seen in many non-AD aged brains (Alafuzoff et al. 1983; Hampel et al. 1995, 1997). Polymorphisms in the CYP46 gene have been associated with the pathophysiology and the incidence of AD (Kolsch et al. 2002; Papassotiropoulos et al. 2003), and some studies have shown evidence that CYP46 and APOE polymorphisms synergistically increase the risk for AD development, and influence the rate of cognitive decline (Borroni et al. 2004). "
[Show abstract][Hide abstract] ABSTRACT: Delirium is a common accompaniment of physical illness in old age, affecting about one in five of those admitted to medical wards and a higher number of those with fractured femurs. Its existence has long been recognised and recorded in general literature. It is a 'final common pathway disorder', the prime feature of which is altered arousal. Historical context Before the public health measures and the advent of antibiotics, infectious diseases were rife. Consequently delirium was a common experience in survivors, as was frequently reflected in the literature of the day. The Latin verb 'delire' (to be deranged, crazy, out of one's wits) appears in the Coventry mystery plays in 1400: "God wyl be vengyd on man.... That wyl nevyr be schrevyn, but evermore doth delyre". Other accounts from literature include: (a) Shakespeare's death of Falstaff ("a babbled of green fields"). (b) Lady Macbeth sleepwalking (compounded by guilt and insomnia). (c) Tolstoy's depiction of Anna Karenina's post-partum delirium. (d) Dickens' account of Fagin's, presumably psychogenic, pre- execution fantasising. One of the best known literary deliria is that from which King Lear emerges to recognise his discarded daughter Cordelia; this is not only the most moving moment in the least sparing of Shakespeare's tragedies, but the culmination of an extraordinarily astute and perceptive series of clinical observations of madness in old age. Lear begins the play with his judgement deranged, perhaps by cerebral vascular disease. After being rejected by his daughters and exposed to the storm, he becomes delirious as a result of hypothermia, pneumonia, or both? Then (as is the best outcome of delirium) he
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