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Analyzing the Virchow pioneering report on brain corpora amylacea: shedding light on recurrent controversies

Journal

BRAIN STRUCTURE & FUNCTION
Volume 228, Issue 6, Pages 1371-1378

Publisher

SPRINGER HEIDELBERG
DOI: 10.1007/s00429-023-02664-5

Keywords

Corpora amylacea; Wasteosomes; Brain; Neoepitopes; Glymphatic system; Chronic glymphatic insufficiency

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The first report of corpora amylacea (CA) was made by Morgagni in the prostate in the 18th century, and later Virchow described them in the brain. Virchow provided techniques to visualize CA but did not explain their cause, association with aging, or clinical significance. Recent data have shown that CA accumulate waste products and can be found in the cerebrospinal fluid and lymphatic nodes, leading to their renaming as wasteosomes.
The first report of corpora amylacea (CA) is attributed to Morgagni, who described them in the prostate in the eighteenth century. Nearly a hundred years later, and following the lead started by Purkinje, Virchow described them in the brain. He made a detailed description of the most useful techniques to visualize them, but he failed to describe the cause of why CA do appear, why they are mainly linked with the elderly, and which is their clinical significance. Although in the last two centuries CA have received little attention, recent data have been able to describe that CA accumulate waste products and that some of them can be found in the cerebrospinal fluid and lymphatic nodes, after being released from the brain. Indeed, CA have been renamed to wasteosomes to underline the waste products they gather and to avoid confusion with the term amyloid used by Virchow, now widely related to certain protein deposits found in the brain. Here, after providing a commented English translation of Virchow's findings, we provide a recent update on these structures and their connection with the glymphatic system insufficiency, for which wasteosomes should be considered a hallmark, and how these bodies could serve as diagnostic or prognostic markers of various brain conditions.

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