title: Cyclooxygenase-2-positive macrophages infiltrate the Alzheimer's disease brain and damage the blood-brain barrier.
abstract: BACKGROUND
  Monocyte/macrophages are known to infiltrate the brain of patients with HIV-1 encephalitis (HIVE). In Alzheimer's disease brain, the origin of activated microglia has not been determined.
  
  
  METHODS
  We employed the antigen retrieval technique, immunocytochemistry, immunofluorescense, and confocal microscopy to identify macrophages and microglia in relation to amyloid-beta plaques and the blood-brain barrier in autopsy brain tissues from patients with Alzheimer's disease (AD) and HIVE.
  
  
  RESULTS
  In both conditions, cyclooxygenase-2 positive macrophages and, to a lesser degree, T and B cells infiltrate brain perivascular spaces and neuropil. The macrophages are distinguishable from ramified microglia, and decorate the vessels at the sites of apparent of endothelial tight junction protein ZO-1 disruption. The macrophages also infiltrate amyloid-beta plaques, display intracellular amyloid-beta and are surrounded by amyloid-beta-free lacunae. Furthermore, the macrophages partially encircle the walls of amyloid-beta-containing vessels in amyloid angiopathy, and exhibit intracellular amyloid-beta but not paracellular lacunae. Significantly larger zones of fibrinogen leakage surround the microvessels in HIVE brain tissues compared with AD tissues (P = 0.034), and AD tissues have significantly greater leakage than control tissues (P = 0.0339). The AD group differs from a normal control age-matched group with respect to both the area occupied by CD68 (P = 0.03) and cyclooxygenase-2 immunoreactive cells (P = 0.004).
  
  
  CONCLUSIONS
  In both HIVE and AD, blood-borne activated monocyte/macrophages and lymphocytes appear to migrate through a disrupted blood-brain barrier. The lacunae around macrophages in amyloid-beta plaques but not in vessel walls are consistent with the ability of macrophages to phagocytize and clear amyloid-beta deposits in vitro.
authors.affiliation: Brain Research Institute, UCLA School of Medicine, Los Angeles, CA 90095-1760, USA. Fiala@ucla.edu
authors.forename: M
authors.initials: M
authors.lastname: Fiala
authors.forename: Q N
authors.initials: QN
authors.lastname: Liu
authors.forename: J
authors.initials: J
authors.lastname: Sayre
authors.forename: V
authors.initials: V
authors.lastname: Pop
authors.forename: V
authors.initials: V
authors.lastname: Brahmandam
authors.forename: M C
authors.initials: MC
authors.lastname: Graves
authors.forename: H V
authors.initials: HV
authors.lastname: Vinters
mesh_terms: D015526:AIDS Dementia Complex / Q000276:immunology* / Q000378:metabolism / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000276:immunology* / Q000378:metabolism / Q000473:pathology; D016229:Amyloid beta-Peptides / Q000378:metabolism; D015703:Antigens, CD / Q000276:immunology / Q000378:metabolism*; D015214:Antigens, Differentiation, Myelomonocytic / Q000276:immunology / Q000378:metabolism*; D001812:Blood-Brain Barrier; D001921:Brain / Q000378:metabolism* / Q000473:pathology; D002560:Cerebrovascular Circulation; D051546:Cyclooxygenase 2; D015497:HIV-1; D006801:Humans; D007150:Immunohistochemistry; D007527:Isoenzymes / Q000378:metabolism*; D008214:Lymphocytes / Q000502:physiology; D008264:Macrophages / Q000502:physiology*; D008297:Male; D008565:Membrane Proteins; D008875:Middle Aged; D010446:Peptide Fragments / Q000378:metabolism; D011451:Prostaglandin-Endoperoxide Synthases / Q000378:metabolism*; D019108:Tight Junctions / Q000378:metabolism; D000097382:CD68 Molecule
chemical_list: D016229:Amyloid beta-Peptides; D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D051546:Cyclooxygenase 2; D007527:Isoenzymes; D008565:Membrane Proteins; D010446:Peptide Fragments; D011451:Prostaglandin-Endoperoxide Synthases; C067980:CD68 antigen, human; D000097382:CD68 Molecule; C444321:amyloid beta-protein (1-34); C496540:PTGS2 protein, human