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Effects of cerebrovascular disease on amyloid precursor protein metabolites in cerebrospinal fluid.

Selnes P, Blennow K, Zetterberg H, Grambaite R, Rosengren L, Johnsen L, Stenset V, Fladby T - Cerebrospinal Fluid Res (2010)

Bottom Line: AD is associated with metabolism of amyloid precursor protein (APP) and low levels of amyloid-beta peptide (Abeta) X-42 in the cerebrospinal fluid (CSF).Chronic and acute WML volumes, infarct volume, age, and sex were used as predictors for CSF biomarker levels in linear regression analysis.CSF levels of sAPP-alpha, sAPP-beta, AbetaX-38, AbetaX-40 and AbetaX-42 were inversely correlated with chronic WML volume (p </= 0.005; p </= 0.01; p </= 0.01; p </= 0.05; p </= 0.05 respectively), but not with acute WML or infarct volumes.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neurology, Akershus University Hospital, Norway. per.selnes@medisin.uio.no.

ABSTRACT

Background: Alzheimer's disease (AD) and cerebrovascular disease (CVD) including chronic small vessel disease of the brain (SVD) are the most frequent causes of dementia. AD is associated with metabolism of amyloid precursor protein (APP) and low levels of amyloid-beta peptide (Abeta) X-42 in the cerebrospinal fluid (CSF). CVD and SVD are established risk factors for AD, brain white matter lesions (WML) are established surrogate markers for SVD and are also associated with reduced CSF AbetaX-42.A cohort survey was performed to examine whether SVD or acute CVD affects APP metabolism and to explore a potential association between WML and APP metabolism in two groups; cognitively impaired patients, subjective and mild (SCI and MCI) and stroke patients. Through measurements of CSF APP metabolite levels in patients with a wide range of WML volumes, this study aimed to determine how SVD influences APP metabolism.

Methods: Sixty-three patients were included: 37 with subjective cognitive impairment (SCI) or mild cognitive impairment (MCI) without stroke, and 26 after acute stroke. Chronic and acute WML volume and infarct volume were determined by magnetic resonance imaging (MRI) post-scan processing, and CSF levels of alpha- and beta-cleaved soluble APP (sAPP-alpha and sAPP-beta, AbetaX-38, AbetaX-40 and AbetaX-42) were determined. The Mann-Whitney test was used to compare the patient groups. Chronic and acute WML volumes, infarct volume, age, and sex were used as predictors for CSF biomarker levels in linear regression analysis.

Results: CSF levels of sAPP-alpha and sAPP-beta were strongly correlated (r = 0.95, p < 0.001) and lower levels of these biomarkers were found in the stroke group than in the SCI/MCI group; median sAPP-alpha 499.5 vs. 698.0 ng/mL (p < 0.001), sAPP-beta 258.0 vs. 329.0 ng/mL (p < 0.005). CSF levels of sAPP-alpha, sAPP-beta, AbetaX-38, AbetaX-40 and AbetaX-42 were inversely correlated with chronic WML volume (p

Conclusions: Lower CSF levels of sAPP-alpha and sAPP-beta in the stroke group than in the SCI/MCI group and an inverse correlation with chronic WML indicate that ischemia lowers the levels of CSF sAPP metabolites and suggests that APP axonal transport or metabolism may be affected in SVD of the brain.

No MeSH data available.


Related in: MedlinePlus

Graph showing the correlation between the CSF levels of sAPP-α and sAPP-β in both groups of subjects.
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Figure 2: Graph showing the correlation between the CSF levels of sAPP-α and sAPP-β in both groups of subjects.

Mentions: After regressing out age and sex from the biomarkers, the median CSF sAPP-α and sAPP-β levels were significantly lower (p < 0.001 for sAPP-α and p < 0.005 for sAPP-β) in the post-stroke patients than in the SCI/MCI patients. There were no significant differences in CSF levels of Aβ X-38, X-40 and X-42 between the two groups. The volume of chronic WML was higher in the stroke group than in the SCI/MCI group, but this difference was not significant (Table 2). The volume of acute post-stroke changes (infarct volume and surrounding WML halo) did not correlate with levels of CSF APP metabolites (data not shown). sAPP-α and sAPP-β levels were linearly related in both the stroke (r = 0.942, p < 0.001) and the SCI/MCI (r = 0.955, p < 0.001) groups (Fig 2).


Effects of cerebrovascular disease on amyloid precursor protein metabolites in cerebrospinal fluid.

Selnes P, Blennow K, Zetterberg H, Grambaite R, Rosengren L, Johnsen L, Stenset V, Fladby T - Cerebrospinal Fluid Res (2010)

Graph showing the correlation between the CSF levels of sAPP-α and sAPP-β in both groups of subjects.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2921347&req=5

Figure 2: Graph showing the correlation between the CSF levels of sAPP-α and sAPP-β in both groups of subjects.
Mentions: After regressing out age and sex from the biomarkers, the median CSF sAPP-α and sAPP-β levels were significantly lower (p < 0.001 for sAPP-α and p < 0.005 for sAPP-β) in the post-stroke patients than in the SCI/MCI patients. There were no significant differences in CSF levels of Aβ X-38, X-40 and X-42 between the two groups. The volume of chronic WML was higher in the stroke group than in the SCI/MCI group, but this difference was not significant (Table 2). The volume of acute post-stroke changes (infarct volume and surrounding WML halo) did not correlate with levels of CSF APP metabolites (data not shown). sAPP-α and sAPP-β levels were linearly related in both the stroke (r = 0.942, p < 0.001) and the SCI/MCI (r = 0.955, p < 0.001) groups (Fig 2).

Bottom Line: AD is associated with metabolism of amyloid precursor protein (APP) and low levels of amyloid-beta peptide (Abeta) X-42 in the cerebrospinal fluid (CSF).Chronic and acute WML volumes, infarct volume, age, and sex were used as predictors for CSF biomarker levels in linear regression analysis.CSF levels of sAPP-alpha, sAPP-beta, AbetaX-38, AbetaX-40 and AbetaX-42 were inversely correlated with chronic WML volume (p </= 0.005; p </= 0.01; p </= 0.01; p </= 0.05; p </= 0.05 respectively), but not with acute WML or infarct volumes.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neurology, Akershus University Hospital, Norway. per.selnes@medisin.uio.no.

ABSTRACT

Background: Alzheimer's disease (AD) and cerebrovascular disease (CVD) including chronic small vessel disease of the brain (SVD) are the most frequent causes of dementia. AD is associated with metabolism of amyloid precursor protein (APP) and low levels of amyloid-beta peptide (Abeta) X-42 in the cerebrospinal fluid (CSF). CVD and SVD are established risk factors for AD, brain white matter lesions (WML) are established surrogate markers for SVD and are also associated with reduced CSF AbetaX-42.A cohort survey was performed to examine whether SVD or acute CVD affects APP metabolism and to explore a potential association between WML and APP metabolism in two groups; cognitively impaired patients, subjective and mild (SCI and MCI) and stroke patients. Through measurements of CSF APP metabolite levels in patients with a wide range of WML volumes, this study aimed to determine how SVD influences APP metabolism.

Methods: Sixty-three patients were included: 37 with subjective cognitive impairment (SCI) or mild cognitive impairment (MCI) without stroke, and 26 after acute stroke. Chronic and acute WML volume and infarct volume were determined by magnetic resonance imaging (MRI) post-scan processing, and CSF levels of alpha- and beta-cleaved soluble APP (sAPP-alpha and sAPP-beta, AbetaX-38, AbetaX-40 and AbetaX-42) were determined. The Mann-Whitney test was used to compare the patient groups. Chronic and acute WML volumes, infarct volume, age, and sex were used as predictors for CSF biomarker levels in linear regression analysis.

Results: CSF levels of sAPP-alpha and sAPP-beta were strongly correlated (r = 0.95, p < 0.001) and lower levels of these biomarkers were found in the stroke group than in the SCI/MCI group; median sAPP-alpha 499.5 vs. 698.0 ng/mL (p < 0.001), sAPP-beta 258.0 vs. 329.0 ng/mL (p < 0.005). CSF levels of sAPP-alpha, sAPP-beta, AbetaX-38, AbetaX-40 and AbetaX-42 were inversely correlated with chronic WML volume (p

Conclusions: Lower CSF levels of sAPP-alpha and sAPP-beta in the stroke group than in the SCI/MCI group and an inverse correlation with chronic WML indicate that ischemia lowers the levels of CSF sAPP metabolites and suggests that APP axonal transport or metabolism may be affected in SVD of the brain.

No MeSH data available.


Related in: MedlinePlus