Annals of Neurology: The blood-brain barrier is destroyed, and the risk of AD and vascular disease is high

Cognitive impairment and dementia affect more than 50 million people worldwide
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Recent literature indicates that the damage of the blood-brain barrier (BBB) ​​may play a key role in this process and provide a new target for therapeutic intervention

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Blood vessel

Hanzhang Lu et al.
evaluated the BBB permeability of the elderly with and without cognitive impairment on two spatial scales
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The results of the study were published in Annals of Neurology

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Hanzhang Lu et al.

The two methods used in the study are: 1.

Use a new non-contrast magnetic resonance imaging (MRI) technology, namely water extraction and phase contrast arterial spin labeling (WEPCAST) MRI, to measure the permeability of BBB to water molecules

Non-contrast Magnetic Resonance Imaging (MRI) Non-contrast Magnetic Resonance Imaging (MRI) Permeability of Albumin Permeability of Albumin

The study measured the blood-brain barrier function of patients with mild cognitive impairment (MCI) on two molecular scales, especially the permeability of the blood-brain barrier to water and albumin molecules
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Fifty-five elderly people were selected, including 33 MCI patients and 22 control groups

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The permeability of the blood-brain barrier (BBB) ​​to water and albumin was measured
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The permeability of the blood-brain barrier (BBB) ​​to water and albumin was measured
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The study found that compared with subjects with normal cognition, the permeability of the BBB of MCI patients to small molecules such as water increased, but the permeability of large molecules such as albumin did not increase

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Compared with subjects with normal cognition, the permeability of the BBB of MCI patients to small molecules such as water increased, but the permeability to large molecules such as albumin did not increase

The relationship between the permeability of the blood-brain barrier and clinical diagnosis cognition

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The relationship between the permeability of the blood-brain barrier and clinical diagnosis cognition

The relationship between the permeability of the blood-brain barrier and the pathology and vascular risk of Alzheimer's disease

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(A) Scatter plot of permeability-surface area (PS) and cerebrospinal fluid (CSF) Aβ42/Aβ40 levels
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(B) Scatter plot of PS and CSF ptau levels
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(C) Scatter plot of CSF/serum albumin ratio and vascular risk score
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(D) CSF / serum albumin ratio and high cholesterol hyperlipidemia scattergram
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The relationship between the permeability of the blood-brain barrier and the pathology and vascular risk of Alzheimer's disease
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(A) Scatter plot of permeability-surface area (PS) and cerebrospinal fluid (CSF) Aβ42/Aβ40 levels
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(B) Scatter plot of PS and CSF ptau levels
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(C) Scatter plot of CSF/serum albumin ratio and vascular risk score
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(D) CSF / serum albumin ratio and high cholesterol hyperlipidemia scattergram
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cholesterol

The permeability of BBB to water is related to the AD markers of CSF Aβ and ptau
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On the other hand, the permeability of BBB to albumin is related to vascular risk factors, especially hypercholesterolemia, but has nothing to do with AD pathology
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The permeability of BBB to small molecules, but not to large molecules, can predict cognitive function
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The figure above illustrates that the leakage of the blood-brain barrier (BBB) ​​can be specific for small and large molecules
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(A) Normal BBB
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(B) BBB that leaks to small molecules (such as water), but does not leak to large molecules
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Black dots indicate leaks
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There are a lot of small leaks in the capillaries
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(C) The blood-brain barrier is the leakage of macromolecules, such as albumin
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The number of leak points is limited, causing albumin to leak slowly, but they have little effect on water permeability, because the leak point only exists in one branch of the capillary (one-fifth in this case)
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The study found that compared with the control group, patients with MCI had higher blood-brain barrier permeability
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The increased permeability of cerebrospinal fluid to water and other small molecules is related to the decrease of Aβ42 and ptau levels and the decline of cognitive function
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On the other hand, changes in the permeability of the blood-brain barrier to albumin and other macromolecules are related to vascular risk factors
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These findings indicate that blood-brain barrier damage is related to AD and vascular risks, but its effects can be distinguished based on spatial scales
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The permeability of BBB to small molecules has a greater impact on cognitive ability
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Patients with MCI have higher blood-brain barrier permeability .
The increased permeability of cerebrospinal fluid to water and other small molecules is related to the decrease of Aβ42 and ptau levels and the decline of cognitive function .
On the other hand, changes in the permeability of the blood-brain barrier to albumin and other macromolecules are related to vascular risk factors .
These findings indicate that blood-brain barrier damage is related to AD and vascular risks, but its effects can be distinguished based on spatial scales .
The permeability of BBB to small molecules has a greater impact on cognitive ability .
Patients with MCI have higher blood-brain barrier permeability
.
The increased permeability of cerebrospinal fluid to water and other small molecules is related to the decrease of Aβ42 and ptau levels and the decline of cognitive function
.
On the other hand, changes in the permeability of the blood-brain barrier to albumin and other macromolecules are related to vascular risk factors
.
These findings indicate that blood-brain barrier damage is related to AD and vascular risks, but its effects can be distinguished based on spatial scales
.
The permeability of BBB to small molecules has a greater impact on cognitive ability
.

Original source

Blood-Brain Barrier Breakdown in Relationship to Alzheimer and Vascular Disease[J].
Annals of neurology.

Blood-Brain Barrier Breakdown in Relationship to Alzheimer and Vascular Disease[J].
Annals of neurology.
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