title: Brain Atrophy, Anti-Smooth Muscle Antibody and Cognitive Impairment: An Association Study.
abstract: Cortical atrophy, neuronal loss, beta-amyloid deposition, neuritic plaques, and neurofibrillary tangles are neuropathological key features in the Alzheimer's disease (AD). Antibodies against beta-amyloid, neurotransmitters, microvascular endothelium components and microglial cells have been detected in AD serum suggesting that AD could be another autoimmune disease and provides a link between vascular pathology, endothelium dysfunction and neuronal cells death. Aim of the present study was to evaluate the association between autoantibody profile and cognitive impairment in geriatric patients, accounting for ApoE genotype as a potential confounding factor. Three hundred and forty-four geriatric patients, attending the clinic for the cognitive decline, underwent a biochemical and immunological profile, chest X-ray, cerebral computed tomography scan and complete cognitive evaluation. All patients were also screened for the ApoE genotype. A significantly higher prevalence of Anti-Smooth Muscle Antibody (ASMA) positivity was found in 89/204 (43.63%) patients with diagnosed neuroradiological signs of cerebral atrophy compared with 15/140 (10.71%) patients without the condition (p<0.001). Multivariable logistic model evidenced that such association was independent of patient's age, gender and Mini-Mental State Examination (OR=8.25, 95%CI: 4.26-15.99) and achieved a good discriminatory power (c-statistic=0.783). Results were also independent of ApoE genotype, which resulted not associated both with the presence of brain atrophy and with the presence of ASMA positivity. Our results shows a strong association between brain atrophy and ASMA positivity and are consistent with several studies that focused attention on the mechanisms of endothelial immune response in the development of dementia.
authors: 1Gerontology-Geriatric Research Laboratory and Geriatric Unit, Department of Medical Sciences, I.R.C.C.S. "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Foggia, Italy.
authors: Paroni
authors: P
authors: Giulia
authors: 1Gerontology-Geriatric Research Laboratory and Geriatric Unit, Department of Medical Sciences, I.R.C.C.S. "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Foggia, Italy.
authors: Lauriola
authors: L
authors: Michele
authors: 2Unit of Biostatistics, I.R.C.C.S. "Casa Sollievo della Sofferenza",71013 San Giovanni Rotondo Foggia, Italy.
authors: Fontana
authors: F
authors: Andrea
authors: 1Gerontology-Geriatric Research Laboratory and Geriatric Unit, Department of Medical Sciences, I.R.C.C.S. "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Foggia, Italy.
authors: D'Onofrio
authors: D
authors: Grazia
authors: 1Gerontology-Geriatric Research Laboratory and Geriatric Unit, Department of Medical Sciences, I.R.C.C.S. "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Foggia, Italy.
authors: Ciccone
authors: C
authors: Filomena
authors: 1Gerontology-Geriatric Research Laboratory and Geriatric Unit, Department of Medical Sciences, I.R.C.C.S. "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Foggia, Italy.
authors: Paris
authors: P
authors: Francesco
authors: 1Gerontology-Geriatric Research Laboratory and Geriatric Unit, Department of Medical Sciences, I.R.C.C.S. "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Foggia, Italy.
authors: Cascavilla
authors: C
authors: Leandro
authors: 1Gerontology-Geriatric Research Laboratory and Geriatric Unit, Department of Medical Sciences, I.R.C.C.S. "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Foggia, Italy.
authors: Urbano
authors: U
authors: Maria
authors: 1Gerontology-Geriatric Research Laboratory and Geriatric Unit, Department of Medical Sciences, I.R.C.C.S. "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Foggia, Italy.
authors: Gravina
authors: G
authors: Carolina
authors: 2Unit of Biostatistics, I.R.C.C.S. "Casa Sollievo della Sofferenza",71013 San Giovanni Rotondo Foggia, Italy.
authors: Copetti
authors: C
authors: Massimiliano
authors: 1Gerontology-Geriatric Research Laboratory and Geriatric Unit, Department of Medical Sciences, I.R.C.C.S. "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Foggia, Italy.
authors: Greco
authors: G
authors: Antonio
keywords: anti-smooth muscle antibody; brain atrophy; cognitive impairment