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Association of vascular amyloid beta and cells of the mononuclear phagocyte system in hereditary cerebral hemorrhage with amyloidosis (Dutch) and Alzheimer disease.
[hereditary cerebral hemorrhage with amyloidosis]
Arterial
and
arteriolar
amyloid-
beta
(
A
beta
)
deposition
in
hereditary
cerebral
hemorrhage
with
amyloidosis
(
Dutch
)
(
HCHWA-D
)
and
Alzheimer
disease
(
AD
)
cerebral
amyloid
angiopathy
(
CAA
)
were
studied
as
to
morphology
,
extent
,
and
association
with
mononuclear
phagocyte
system
(
MPS
)
cells
using
A
beta
,
a-smooth
muscle
actin
,
and
monocyte
/
macrophage
marker
(
HLA-
DR
,
CD
68
,
CD
11
c
,
CD
4
5
)
immunohistochemistry
.
The
HCHWA-D
/
AD
arterial
/
arteriolar
media
showed
compact
A
beta
deposits
,
first
appearing
at
the
media
/
adventitia
junction
,
and
concomitant
smooth
muscle
loss
.
Only
HCHWA-D
CAA
featured
(
a
)
severe
involvement
of
larger
arteries
and
(
b
)
arterioles
showing
a
single
or
double
ring
of
radial
A
beta
surrounding
compact
A
beta
.
Radial
A
beta
appeared
to
develop
at
the
media
/
adventitia
junction
.
Monocyte
/
macrophage
marker-
positive
foci
/
cells
co
-
localized
with
HCHWA-D
arterial
A
beta
.
Focal
HLA-
DR
/
CD
11
c
positivity
was
observed
at
the
media
/
adventitia
junction
of
AD
/
HCHWA-D
arteries
in
the
absence
of
local
A
beta
,
but
not
in
controls
.
Monocyte
/
macrophage
marker
positivity
co
-localizing
with
radial
A
beta
appeared
continuous
with
perivascular
cells
and
microglia
clustering
perivascularly
.
These
results
suggest
that
(
a
)
MPS
cells
are
topographically
associated
with
HCHWA-D
arterial
A
beta
and
radial
arteriolar
A
beta
,
and
(
b
)
HLA-
DR
/
CD
11
c
immunoreactivity
may
appear
at
the
media
/
adventitia
junction
prior
to
A
beta
.
The
latter
finding
and
the
assumed
formation
of
radial
A
beta
at
the
media
/
adventitia
junction
may
relate
to
involvement
of
the
abluminal
basement
membrane
in
CAA
pathogenesis
.
The
role
of
MPS
cells
in
this
process
remains
to
be
established
.
Diseases
Validation
Diseases presenting
"radial arteriolar a beta"
symptom
hereditary cerebral hemorrhage with amyloidosis
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