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<div about="/news-events/news-releases/study-breaks-blood-brain-barriers-understanding-alzheimers" typeof="sioc:Item foaf:Document" class="ds-1col node node--nih-news-release news-release featured-media-floated view-mode-full node--full node--nih-news-release--full clearfix">
<p class="publishdate"><span class="tag-term">News Release</span></p><p class="publishdate"><span property="dc:date" datatype="xsd:dateTime" content="2013-12-13T17:00:00-05:00" class="date-display-single">Friday, December 13, 2013</span></p><h1>Study breaks blood-brain barriers to understanding Alzheimers</h1><p class="subtitle">
NIH-funded study suggests brain blood vessel cells may be therapeutic targets for Alzheimers disease.</p><div class="featured-media"><div class="ds-1col file file-image file-image-jpeg view-mode-featured_media clearfix">
<picture title="Image of mouse brain blood vessels">
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<source srcset="https://www.nih.gov/sites/default/files/styles/featured_media__breakpoint-tiny_/public/news-events/news-releases/2013/20131213-zlokovic-pericyte.jpg?itok=66twQnSc&amp;timestamp=1438696923 1x" media="screen and (min-width: 0)" />
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<img src="https://www.nih.gov/sites/default/files/styles/featured_media_breakpoint-medium/public/news-events/news-releases/2013/20131213-zlokovic-pericyte.jpg?itok=tj0C4IOV&amp;timestamp=1438696923" alt="Image of mouse brain blood vessels" title="Image of mouse brain blood vessels" />
</picture><span class="caption">Studies in mice showed how brain blood vessel cells called pericytes (white) may contribute to the problems associated with Alzheimers disease. </span><span class="credit">zlokovic lab, Zilkha Neurogenetic Institute of the Keck School of Medicine at the University of Southern California.</span></div>
</div><p>A study in mice shows how a breakdown of the brains blood vessels may amplify or cause problems associated with Alzheimers disease. The results published in Nature Communications suggest that blood vessel cells called pericytes may provide novel targets for treatments and diagnoses.</p>
<p>“This study helps show how the brains vascular system may contribute to the development of Alzheimers disease,” said study leader Berislav V. Zlokovic, M.D. Ph.D., director of the Zilkha Neurogenetic Institute at the Keck School of Medicine of the University of Southern California, Los Angeles. The study was co-funded by the National Institute of Neurological Diseases and Stroke (NINDS) and the National Institute on Aging (NIA), parts of the National Institutes of Health.</p>
<p>Alzheimers disease is the leading cause of dementia. It is an age-related disease that gradually erodes a persons memory, thinking, and ability to perform everyday tasks. Brains from Alzheimers patients typically have abnormally high levels of plaques made up of accumulations of beta-amyloid protein next to brain cells, tau protein that clumps together to form neurofibrillary tangles inside neurons, and extensive neuron loss.</p>
<p>Vascular dementias, the second leading cause of dementia, are a diverse group of brain disorders caused by a range of blood vessel problems. Brains from Alzheimers patients often show evidence of vascular disease, including ischemic stroke, small hemorrhages, and diffuse white matter disease, plus a buildup of beta-amyloid protein in vessel walls. Furthermore, previous studies suggest that APOE4, a genetic risk factor for Alzheimers disease, is linked to brain blood vessel health and integrity.</p>
<p>“This study may provide a better understanding of the overlap between Alzheimers disease and vascular dementia,” said Roderick Corriveau, Ph.D., a program director at NINDS.</p>
<p>One hypothesis about Alzheimers disease states that increases in beta-amyloid lead to nerve cell damage in the brain. This is supported by genetic studies that link familial forms of the disease to mutations in amyloid precursor protein (APP), the larger protein from which plaque-forming beta-amyloid molecules are derived. Nonetheless, previous studies on mice showed that increased beta-amyloid levels reproduce some of the problems associated with Alzheimers. The animals have memory problems, beta-amyloid plaques in the brain and vascular damage but none of the neurofibrillary tangles and neuron loss that are hallmarks of the disease.</p>
<p>In this study, the researchers show that pericytes may be a key to whether increased beta-amyloid leads to tangles and neuron loss.</p>
<p>Pericytes are cells that surround the outside of blood vessels. Many are found in a brain plumbing system called the blood-brain barrier. It is a network that exquisitely controls the movement of cells and molecules between the blood and the interstitial fluid that surrounds the brains nerve cells. Pericytes work with other blood-brain barrier cells to transport nutrients and waste molecules between the blood and the interstitial brain fluid.</p>
<p>To study how pericytes influence Alzheimers disease, Dr. Zlokovic and his colleagues crossbred mice genetically engineered to have a form of APP linked to familial Alzheimers with ones that have reduced levels of platelet-derived growth factor beta receptor (PDGFR-beta), a protein known to control pericyte growth and survival. Previous studies showed that PDGFR-betamutant mice have fewer pericytes than normal, decreased brain blood flow, and damage to the blood-brain barrier.</p>
<p>“Pericytes act like the gatekeepers of the blood-brain barrier,” said Dr. Zlokovic.</p>
<p>Both the APP and PDGFR-beta mutant mice had problems with learning and memory. Crossbreeding the mice slightly enhanced these problems. The mice also had increased beta-amyloid plaque deposition near brain cells and along brain blood vessels. Surprisingly, the brains of the crossbred mice had enhanced neuronal cell death and extensive neurofibrillary tangles in the hippocampus and cerebral cortex, regions that are typically affected during Alzheimers.</p>
<p>“Our results suggest that damage to the vascular system may be a critical step in the development of full-blown Alzheimers disease pathology,” said Dr. Zlokovic.</p>
<p>Further experiments suggested that pericytes may transport beta-amyloid across the blood-brain barrier into the blood and showed that crossbreeding the mice slowed the rate at which beta-amyloid was cleared away from nerve cells in the brain.</p>
<p>Next, the researchers addressed how beta-amyloid may affect the vascular system. The crossbred mutants had more pericyte death and more damage to the blood-brain barrier than the PDGFR-betamutant mice, suggesting beta-amyloid may enhance vascular damage. The investigators also confirmed previous findings showing that beta-amyloid accumulation leads to pericyte death.</p>
<p>Dr. Zlokovic and his colleagues concluded that their results support a two-hit vascular hypothesis of Alzheimers. The hypothesis states that the toxic effects of increased beta-amyloid deposition on pericytes in aged blood vessels leads to a breakdown of the blood-brain barrier and a reduced ability to clear amyloid from the brain. In turn, the progressive accumulation of beta-amyloid in the brain and death of pericytes may become a damaging feedback loop that causes dementia. If true, then pericytes and other blood-brain barrier cells may be new therapeutic targets for treating Alzheimers disease.</p>
<p>This work was supported by grants from the NINDS (NS034467) and the NIA (AG039452, AG023084).</p>
<p>For more information about neurological disorders and the latest neuroscience research: <a href="http://www.ninds.nih.gov">www.ninds.nih.gov</a>.</p>
<p><a href="http://www.ninds.nih.gov">NINDS</a> is the nations leading funder of research on the brain and nervous system. The NINDS mission is to reduce the burden of neurological disease a burden borne by every age group, by every segment of society, by people all over the world.</p>
<p>The NIA leads the federal government effort conducting and supporting research on aging and the health and well-being of older people. It provides information on age-related cognitive change and neurodegenerative disease specifically at its Alzheimers Disease Education and Referral (ADEAR) Center at <a href="https://www.nia.nih.gov/alzheimers">https://www.nia.nih.gov/alzheimers</a>. For expanded information on Alzheimers care and resources, please visit the federal governments portal website <a href="http://www.alzheimers.gov/">http://www.alzheimers.gov</a>. Information on health and on aging generally can be found at <a href="https://www.nia.nih.gov">https://www.nia.nih.gov</a>. To sign up for e-mail alerts about new findings or publications, please visit either NIA website.</p>
<p><strong>About the National Institutes of Health (NIH):</strong>
NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit <a href="/">www.nih.gov</a>.</p>
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<h3>Reference</h3><p>Sagare et al. “Pericyte loss influences Alzheimer-like neurodegeneration in mice” <em>Nat. Commun.</em>, December 13, 2013. DOI: 10.1038/ncomms3932</p>
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