Koji Ishiguro

Combination assay of CSF Tau, Aβ1-40 and Aβ1-42(43) as a biochemical marker of Alzheimer's disease

Cerebrospinal fluid samples from a total of 157 subjects consisting of 55 patients with sporadic Alzheimers disease (AD), 34 normal controls, 23 patients with non-AD dementia, and 45 with other neurological diseases were examined by ELISA of tau, Aβ1-40, and Aβ1-42(43). The AD group had a significantly higher level of tau than the normal control group (P<0.001), and the diagnostic sensitivity was 31% and specificity was 94%. CSF Aβ1-40 levels did not show any significant differences. Although the level of Aβ1-42(43) was decreased significantly in the AD group compared to the control group (P<0.005), the overlap of Aβ1-42(43) levels among all groups meant that none of the AD samples exceeded the cut-off value, the mean 2SD of normal control subjects. Reduction of Aβ1-42(43) levels in AD resulted in a significant increase in the ratio of Aβ1-40 to Aβ1-42(43) (Aβ ratio) as an improved marker. The diagnostic sensitivity and specificity of Aβ ratio were 51% and 82% respectively. The three indexes, using the tau level and Aβ ratio (tau or Aβ ratio, deviation score and tau×Aβ ratio), showed better sensitivity (58%, 67%, 69%) and specificity (82%, 86%, 88%) than previously reported methods. Combination assay for CSF tau, Aβ1-40 and Aβ1-42(43) in CSF is a biological marker of AD and may be useful to biochemically monitor subjects under treatment.

Presence of apolipoprotein E on extracellular neurofibrillary tangles and on meningeal blood vessels precedes the Alzheimer β-amyloid deposition

The localization of apolipoprotein E (ApoE) has been examined immunohistochemically in the autopsied brains of middle-aged and old-aged control subjects, with and without amyloid β protein (Aβ) deposits, and of Alzheimers disease patients. Senile plaques were consistently labeled with ApoE antiserum even in the very early stage of senile plaque formation seen in the fifth decade. In the cerebellar molecular layer, small dots of ApoE immunoreactivity, which were prominent in the Alzheimers disease subjects, were observed in addition to immunoreactivity in diffuse plaques. ApoE antisera labeled all of the extracellular neurofibrillary tangles (NFT), whereas only a small minority of extracellular NFT were positive for Aβ. A punctate pattern of ApoE immunoreactivity was seen at the media of the meningeal vessels lacking amyloid, when senile plaques were present in the nearby cortex. In the early stage of amyloid angiopathy, the distribution of ApoE immunoreactivity was much more extensive than that of Aβ positivity. These findings suggest that ApoE accumulates in the early stage of senile plaque formation and, furthermore, that ApoE accumulation precedes Aβ deposition in extracellular NFT and amyloid angiopathy.

Cerebrospinal fluid tau in dementia disorders: a large scale multicenter study by a Japanese study group

A large scale multicenter study of cerebrospinal fluid (CSF) tau levels was conducted to determine the cut-off value, sensitivity and specificity for clinical usage as a biomarker of Alzheimers disease (AD). Its use for early and differential diagnosis and the factors that increase CSF tau levels were also examined. CSF samples from a total of 1,031 subjects including 366 patients with AD, 168 patients with non-Alzheimer type dementia (NA), 316 patients with non-dementia neurological diseases (ND) and 181 normal controls (NC) were measured using ELISA for tau. The cut-off value of tau, 375 pg/ml, showed 59.1% sensitivity and 89.5% specificity for diagnosis of AD compared with the other groups. The tau levels were increased from the early to late stages of AD. Elevation of CSF tau in the non-tauopathy and tauopathy dementia groups, chronic and acute damage to the cerebrum, and meningeal disturbance were other factors that required attention for clinical practice. Measurement of CSF tau was useful as a biomarker for early and differential diagnosis of AD.

Crossed cerebellar diaschisis accompanied by hemiataxia: a PET study.

To study crossed cerebellar diaschisis (CCD), cerebellar blood flow and oxygen metabolism were measured with positron emission tomography (PET) in 12 patients who showed a minimal degree of hemiparesis due to single unilateral supratentorial lesion. Six patients presenting with mild to moderate cerebellar type hemiataxia showed CCD, that is, decreased blood flow and oxygen metabolism in the cerebellar hemisphere contralateral to the side of supratentorial lesion. Hemiataxia and reduced cerebellar blood flow and metabolism occurred in the ipsilateral side. Lesions were located in the thalamus in four patients and the parietal lobe and internal capsule in one each. The other six patients did not exhibit ataxia, and oxygen metabolism was not reduced in the contralateral cerebellar hemisphere. In two of these cases, however, reduced cerebellar perfusion was observed in the contralateral cerebellar hemisphere. These findings indicate that CCD occurs with hemiataxia and suggest that it results not only from disruption of the corticopontocerebellar pathway but also of the dentatorubrothalamic pathway. CCD associated with hemiataxia, demonstrated in patients with thalamic lesions, was presumed to result from retrograde deactivation of the cerebellar hemisphere via the dentatorubrothalamic pathway.

Ultrastructural localization of Alzheimer amyloid β/A4 protein precursor in the cytoplasm of neurons and senile plaque-associated astrocytes

SummaryThe ultrastructural localization of amyloid β/A4 protein precursor (APP) in the brains of control and Alzheimers disease patients was examined immunohistochemically using antisera against the N and C termini of APP. In both control and Alzheimer brains, immunoreaction for APP was seen in the cytoplasm of most neurons, on plasma membranes, outer membrane of mitochondria, granular substance and neurofilaments. Cell bodies and foot processes of astrocytes, containing glial filaments, were also labeled. In primitive and classic type senile plaques, APP immunoreaction products were localized in the astroglial processes that surrounded the amyloid mass of the senile plaques. Swollen degenerating neurites in the senile plaques were also labeled. Amyloid fibrils were negative with APP antisera.

Extracellular neurofibrillary tangles associated with degenerating neurites and neuropil threads in Alzheimer-type dementia

SummaryWe examined the cellular components of extracellular neurofibrillary tangles (E-NFT) in the hippocampal areas in cases with Alzheimer-type dementia. Immunohistochemically, the E-NFT were labeled for the C terminus of tau and glial fibrillary acidic protein. Moreover, the majority of the E-NFT was associated with intensely argyrophilic rods and with tau-and ubiquitin-immunoreactive dots. Ultrastructurally, the E-NFT consisted mainly of extracellular paired helical filaments (PHF) and astroglial processes. The extracellular PHF tended to be straighter and thinner. One third of the E-NFT was associated with small degenerating neurites containing many dense bodies and with neuropil threads containing PHF. These findings suggested that extracellular PHF promote both intense astroglial reaction and neuritic alteration, and that the E-NFT are continuously changing their morphology.

Amyloid β/A4 protein precursor is bound to neurofibrillary tangles in Alzheimer-type dementia

Abstract Localization of amyloid β/A4 protein precursor (APP) in Alzheimers neurofibrillary tangles (NFT) was examined immunohistochemically. Antiserum directed to N-terminal of APP intensely labeled intracellular NFT and some neuropil threads. The NFT, extracted from Alzheimer brains by detergent treatments, were also immunoreactive with this antiserum. Antisera to other parts of APP labeled NFT after the formic acid pretreatment. However, Western blot analysis of NFT demonstrated no immunoreactive bands with APP antiserum. These findings suggest that APP is a minor component of the NFT.

Amyloid β protein precursor accumulates in swollen neurites throughout rat brain with aging

We immunocytochemically studied the expression of amyloid beta protein precursor (APP) in the brains of normal aged rats, and found APP accumulation in swollen neurites, most of which were axons. These swollen neurites appeared throughout the central nervous system of aged rats; most of them were negative for neurofilament, ubiquitin, and tau. Such widely distributed APP accumulation in swollen neurites may reflect impaired fast axonal transport due to aging. APP immunostaining may be a good method to detect widely distributed age-related changes.

Light and electron microscopic and immunohistochemical observations of the Onuf's nucleus of amyotrophic lateral sclerosis

SummaryWe examined the Onufrowicz nucleus (Onufs nucleus) of ten sporadic amyotrophic lateral sclerosis (ALS) patients with light and electron microscopic and immunohistochemical methods. Neurons in the Onufs nucleus of ALS patients were better preserved than those in anterior horn cells. However, some showed morphological changes in the nucleus, namely, central chromatolytic changes, Bunina bodies, ubiquitin-positive filaments and spheroids. The Onufs neurons of ALS patients showed more argentophilia than those of non-ALS patients. Electron microscopic observations revealed that neurofilaments were relatively more numerous in the Onufs neurons of ALS patients. Bunina bodies and degenerated neurites were also seen in the Onufs nucleus. In conclusion, the Onufs nucleus in sporadic ALS patients showed some morphological changes similar to those noted in anterior horn cells.

Immunohistochemical analysis of COOH-termini of amyloid beta protein (Aβ) using end-specific antisera for Aβ40 and Aβ42 in Alzheimer's disease and normal aging

We examined by immunohistochemicistry the carboxyl (C)-terminus extent of the amyloid beta protein (Aβ) that constitutes senile plaques and amyloid angiopathy in the brains of non-demented and Alzheimers disease (AD) subjects. We developed two antisera, which selectively recognized free C-termini of Aβ: BC40 for Aβ40; and BC42 for Aβ42. BC42 labeled various types of senile plaques as well as reference Aβ antiserum, whereas only some parts of the senile plaques were positive with BC40: i.e., all of the plaque cores and some diffuse and primitive plaques. In the brains of non-demented middle-aged subjects, a majority of BC42-positive diffuse plaques were also positive with BC40, but with less intensity than that shown with BC42. The ratio of BC40-negative plaques increased with increasing plaque density. Amyloid in the meningeal vessels showed much greater immnnoreactivity with BC40 than with BC42. Some extracellular neurofibrillary tangles were positive with both BC40 and BC42, although most of them and a...