title: Medullary microvessel degeneration in multiple system atrophy.
abstract: Multiple system atrophy (MSA) is a rare and fatal early-onset autonomic disorder which is characterised by Parkinsonism and orthostatic hypotension (OH). The pathophysiology of MSA is not fully understood but key features include the depletion of medullary autonomic neurons and presence of glial cellular inclusions. We hypothesise that the degeneration of medullary autonomic microvessels is an additional finding in MSA. Using digital pathology we quantified basement membrane collagen (Coll IV), smooth muscle actin (alpha-actin) and endothelial glucose transporter (Glut 1) expression in medullary autonomic nuclei of 8 MSA and 8 OH cases, compared with 12 controls with no autonomic dysfunction. We found decreased Coll IV (p=0.000) and Glut 1 (p=0.000) but not alpha-actin expression, in medullary autonomic nuclei of MSA, but not OH cases compared with control subjects. Medullary microvessel degeneration in MSA may be secondary to the primary neuro-glial pathogenesis of the disorder, and could accelerate its ageing-related progression.
authors.affiliation: Neurovascular Research Unit, Sir James Spence Institute, Royal Victoria Hospital, Newcastle upon Tyne, NE1 4LP, UK. veronica.miller@mail.dcu.ie
authors.forename: V M
authors.initials: VM
authors.lastname: Miller
authors.forename: R N
authors.initials: RN
authors.lastname: Kalaria
authors.forename: R
authors.initials: R
authors.lastname: Hall
authors.forename: A E
authors.initials: AE
authors.lastname: Oakley
authors.forename: R A
authors.initials: RA
authors.lastname: Kenny
mesh_terms: D000199:Actins / Q000032:analysis / Q000378:metabolism; D000368:Aged; D000369:Aged, 80 and over; D001160:Arterioles / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D001341:Autonomic Nervous System / Q000098:blood supply / Q000473:pathology* / Q000503:physiopathology; D001485:Basement Membrane / Q000378:metabolism / Q000473:pathology; D015415:Biomarkers / Q000032:analysis / Q000378:metabolism; D002196:Capillaries / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D024141:Collagen Type IV / Q000032:analysis / Q000378:metabolism; D018450:Disease Progression; D015536:Down-Regulation / Q000502:physiology; D005260:Female; D051272:Glucose Transporter Type 1 / Q000032:analysis / Q000378:metabolism; D006801:Humans; D007002:Hypoglossal Nerve / Q000098:blood supply / Q000473:pathology; D008297:Male; D008526:Medulla Oblongata / Q000098:blood supply / Q000473:pathology* / Q000503:physiopathology; D008833:Microcirculation / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D011903:Raphe Nuclei / Q000098:blood supply / Q000473:pathology; D012154:Reticular Formation / Q000098:blood supply / Q000473:pathology; D014630:Vagus Nerve / Q000098:blood supply / Q000473:pathology
chemical_list: D000199:Actins; D015415:Biomarkers; D024141:Collagen Type IV; D051272:Glucose Transporter Type 1; C495677:SLC2A1 protein, human