4.6 Review

Brain Ischemia as a Prelude to Alzheimer's Disease

Journal

FRONTIERS IN AGING NEUROSCIENCE
Volume 13, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fnagi.2021.636653

Keywords

brain ischemia; neurodegeneration; amyloid protein precursor; secretases; presenilins; tau protein; folding proteins; Alzheimer' s disease

Funding

  1. Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland [T3-RP]
  2. Medical University of Lublin, Lublin, Poland [DS 475/20-SC]

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Transient ischemic brain injury results in massive neuronal death in the hippocampus and progressive atrophy of brain structures. Post-ischemic brain neurodegeneration can continue well beyond the acute stage and is associated with the deposition of folding proteins like amyloid and tau protein. Studies have shown dysregulation of Alzheimer's disease-associated genes in the development of post-ischemic brain neurodegeneration, suggesting a common pathway with Alzheimer's disease.
Transient ischemic brain injury causes massive neuronal death in the hippocampus of both humans and animals. This was accompanied by progressive atrophy of the hippocampus, brain cortex, and white matter lesions. Furthermore, it has been noted that neurodegenerative processes after an episode of ischemia-reperfusion in the brain can continue well-beyond the acute stage. Rarefaction of white matter was significantly increased in animals at 2 years following ischemia. Some rats that survived 2 years after ischemia developed severe brain atrophy with dementia. The profile of post-ischemic brain neurodegeneration shares a commonality with neurodegeneration in Alzheimer's disease. Furthermore, post-ischemic brain injury is associated with the deposition of folding proteins, such as amyloid and tau protein, in the intracellular and extracellular space. Recent studies on post-ischemic brain neurodegeneration have revealed the dysregulation of Alzheimer's disease-associated genes such as amyloid protein precursor, alpha-secretase, beta-secretase, presenilin 1, presenilin 2, and tau protein. The latest data demonstrate that Alzheimer's disease-related proteins and their genes play a key role in the development of post-ischemic brain neurodegeneration with full-blown dementia in disease types such as Alzheimer's. Ongoing interest in the study of brain ischemia has provided evidence showing that ischemia may be involved in the development of the genotype and phenotype of Alzheimer's disease, suggesting that brain ischemia can be considered as a useful model for understanding the mechanisms responsible for the initiation of Alzheimer's disease.

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