Abstract
Cortical atrophy, neuronal loss, beta-amyloid deposition, neuritic plaques, and neurofibrillary tangles are neuropathological key features in the Alzheimer's disease (AD). Antibodies against beta-amyloid, neurotransmitters, microvascular endothelium components and microglial cells have been detected in AD serum suggesting that AD could be another autoimmune disease and provides a link between vascular pathology, endothelium dysfunction and neuronal cells death. Aim of the present study was to evaluate the association between autoantibody profile and cognitive impairment in geriatric patients, accounting for ApoE genotype as a potential confounding factor. Three hundred and forty-four geriatric patients, attending the clinic for the cognitive decline, underwent a biochemical and immunological profile, chest X-ray, cerebral computed tomography scan and complete cognitive evaluation. All patients were also screened for the ApoE genotype. A significantly higher prevalence of Anti-Smooth Muscle Antibody (ASMA) positivity was found in 89/204 (43.63%) patients with diagnosed neuroradiological signs of cerebral atrophy compared with 15/140 (10.71%) patients without the condition (p<0.001). Multivariable logistic model evidenced that such association was independent of patient's age, gender and Mini-Mental State Examination (OR=8.25, 95%CI: 4.26-15.99) and achieved a good discriminatory power (c-statistic=0.783). Results were also independent of ApoE genotype, which resulted not associated both with the presence of brain atrophy and with the presence of ASMA positivity. Our results shows a strong association between brain atrophy and ASMA positivity and are consistent with several studies that focused attention on the mechanisms of endothelial immune response in the development of dementia.
Highlights
Interaction between the immune and the nervous systems is bidirectional and occur under both physiological and pathological conditions
A great body of evidence exists about the fact that antibodies to microvascular endothelium might have a role in the BBB damage, inducing activation and/or apoptosis in endothelial cells; Delunardo et al identified rabaptin 5 (RABPT5) as a new endothelial autoantigen in Alzheimer’s disease (AD), recognized by serum IgG in 65% of patients with AD [27]
A significantly higher prevalence of Anti-Smooth Muscle Antibody (ASMA) positivity was found in patients with brain atrophy compared to those without the condition (43.63% vs. 10.71%, p
Summary
Interaction between the immune and the nervous systems is bidirectional and occur under both physiological and pathological conditions. A great body of evidence exists about the fact that antibodies to microvascular endothelium might have a role in the BBB damage, inducing activation and/or apoptosis in endothelial cells; Delunardo et al identified rabaptin 5 (RABPT5) as a new endothelial autoantigen in AD, recognized by serum IgG in 65% of patients with AD [27]. Peroxidise, thyroglobulin and myelin basic protein are significantly increased in patients with AD. These data in the context of the underlying mechanisms of many autoimmune diseases,indicated that AD could be another autoimmune disease and provides a link between vascular pathology, endothelium dysfunction and neuronal cells death [3032]. Aim of the present study was to evaluate the association between autoantibody profile and cognitive impairment according to age
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