Molecular Pathology Of Alzheimers Disease

Alzheimer’s Disease is characterized pathologically by two principal hallmark lesions: the senile plaque and the neurofibrillary tangle. Since the identification of each over 100 years ago, the major protein components have been elucidated. This has led in turn to the elaboration of metabolic cascades involving amyloid-β production in the case of the senile plaque, and phosphorylated-tau protein in the case of the neurofibrillary tangle. The pathogenesis and histogenesis of each have been the source of extensive investigation and some controversy in recent years, as both cascades have been implicated in the pathogenesis of Alzheimer’s Disease, relied upon in the diagnostic criteria for Alzheimer’s Disease at autopsy, and targeted for therapeutic intervention. With the accumulation of data and expansion of knowledge of the molecular biology of Alzheimer’s Disease, it appears that the enthusiasm for successful intervention has been premature. In this book, we detail the discovery and characterization of the major pathological lesions, their associated molecular biology, their relationship to clinical disease, and potential fundamental errors in understanding that may be leading scientific investigators in unintended directions.

Most textbooks on neurodegenerative disorders have used a classification scheme based upon either clinical syndromes or anatomical distribution of the pathology. In contrast, this book looks to the future and uses a classification based upon molecular mechanisms, rather than clinical or anatomical boundaries. Major advances in molecular genetics and the application of biochemical and immunocytochemical techniques to neurodegenerative disorders have generated this new approach. Throughout most of the current volume, diseases are clustered according to the proteins that accumulate within cells (e.g. tau, α-synuclein and TDP-43) and in the extracellular compartments (e.g. β-amyloid and prion proteins) or according to a shared pathogenetic mechanism, such as trinucleotide repeats, that are a feature of specific genetic disorders. Chapters throughout the book conform to a standard lay-out for ease of access by the reader and are written by a panel of International Experts Since the first edition of this book, major advances have been made in the discovery of common molecular mechanisms between many neurodegenerative diseases most notably in the frontotemporal lobar degenerations (FTLD) and motor neuron disease or amyotrophic lateral sclerosis. This book will be essential reading for clinicians, neuropathologists and basic neuroscientists who require the firm up-to-date knowledge of mechanisms, diagnostic pathology and genetics of Neurodegenerative diseases that is required for progress in therapy and management.

Alzheimer's disease is the most common form of dementia in the elderly; 450,000 people in the UK and 4.5 million people in the USA suffer with this disease. This 3rd edition of Neurobiology of Alzheimer's Disease gives a comprehensive and readable introduction to the disease, from molecular pathology to clinical practice. The book is intended for readers new to the field, and it also covers an extensive range of themes for those with in-depth knowledge of Alzheimer's disease. It will therefore act either as an introduction to the whole field of neurodegeneration or it will help experienced researchers to access the latest research in specialist topics. Each chapter is written by eminent scientists leading their fields in neuropathology, clinical practice and molecular neurobiology; appendices detail disease-associated proteins, their sequences, familial mutations and known structures. It will be essential reading for students interested in neurodegeneration and for researchers and clinicians, giving a coherent and cohesive approach to the whole area of research, and allowing access at different levels. For those in the pharmaceutical industry it describes the underlying molecular mechanisms involved in the pathogenesis of Alzheimer's disease and explains how current and potential therapeutics may work.

In the past two decades there have been significant advances made in understanding the cellular and molecular alterations that occur with brain ageing, as well as with our understanding of age-related brain diseases. Ageing is associated with a mid-life decline in many cognitive domains (eg. Attention, working memory, episodic memory) that progresses with advancing age and which may be potentiated by a variety of diseases. However, despite the breadth of attempts to explain it, the underlying basis for age-related memory impairment remains poorly understood. Both normal and “pathological” ageing (as in age-related neurodegenerative disorders such as Alzheimer’s disease) may be associated with overlapping and increased levels of “abnormal” pathology, and this may be a potential mediator of cognitive decline in both populations. An emerging hypothesis in this field is that metal ion dys/homeostasis may represent a primary unifying mechanism to explain age- and disease-associated memory impairment – either indirectly via an effect on disease pathogenesis, or by a direct effect on signaling pathways relevant to learning and memory. There remains a concerted worldwide effort to deliver an effective therapeutic treatment for cognitive decline associated with ageing and/or disease, which is currently an unmet need. There have been numerous clinical trials conducted specifically testing drugs to prevent cognitive decline and progression to dementia, but to date the results have been less than impressive, highlighting the urgent need for a greater understanding of the neurobiological basis of memory impairment in ageing and disease which can then drive the search for effective therapeutics.

This revised edition of a book first published in 1995, presents an accessible overview of Alzheimer's disease, with an emphasis on research into the molecular mechanisms of neuronal degeneration. International experts have provided in-depth reviews of their areas of expertise, including coverage of the key molecules known to be involved, such as Ab, tau, apolipoprotein E and the presenilins. Other areas covered include neuropathology, genetics, neurochemical pathology, inflammation, diagnosis, models of the disease and opportunities for treatment, employing both existing and emerging drug therapies. The book will provide a readable introduction for those new to the subject, as well as covering a wide range of specialist topics for more experienced researchers and those interested in the overlap with other related specialist areas. Also included are appendices detailing gene and protein information on APP, tau, the presenilins, apolipoprotein E and the newly cloned therapeutic target, BACE.

Alzheimers disease affects 6-10% of the elderly population, causing impairment in cognitive functions and significant disability in daily living for more than ten years. Neurofibrillary tangles, amyloid deposits and neuronal loss are the three hallmarks of Alzheimers disease. Due to insolubility of these unique structures in Alzheimer brain tissue, they were very difficult to study by usual biochemical methods in the past. Active research is now going on to elucidate the pathogenesis of Alzheimers disease. Major topics of neurobiological study of Alzheimers disease include the unraveling of the molecular mechanism of neurofibrillary tangle formation in neuronal and glial cells, the molecular processing of amyloid precursor protein in intracellular organella and in extra-cellular space, and the molecular mechanism of neuronal loss. The articles in this book were selected from contributions presented by leading scientists in this field at the international symposium which took place in Osaka in 2002. This publication is essential reading for all researchers, clinicians, basic and social scientists, neurologists and psychiatrists to promote the understanding of this formidable disease.

Most textbooks on neurodegenerative disorders have used a classification scheme based upon either clinical syndromes or anatomical distribution of the pathology. In contrast, this book looks to the future and uses a classification based upon molecular mechanisms, rather than clinical or anatomical boundaries. Major advances in molecular genetics and the application of biochemical and immunocytochemical techniques to neurodegenerative disorders have generated this new approach. Throughout most of the current volume, diseases are clustered according to the proteins that accumulate within cells (e.g. tau, α-synuclein and TDP-43) and in the extracellular compartments (e.g. β-amyloid and prion proteins) or according to a shared pathogenetic mechanism, such as trinucleotide repeats, that are a feature of specific genetic disorders. Chapters throughout the book conform to a standard lay-out for ease of access by the reader and are written by a panel of International Experts Since the first edition of this book, major advances have been made in the discovery of common molecular mechanisms between many neurodegenerative diseases most notably in the frontotemporal lobar degenerations (FTLD) and motor neuron disease or amyotrophic lateral sclerosis. This book will be essential reading for clinicians, neuropathologists and basic neuroscientists who require the firm up-to-date knowledge of mechanisms, diagnostic pathology and genetics of Neurodegenerative diseases that is required for progress in therapy and management.

As indicated by its title, this monograph deals chiefly with morphologically recognizable deviations from the normal anatomical condition of the human CNS. The AD-associated pathology is illustrated from its beginnings (sometimes even in childhood) to its final form, which is reached late in life. The AD process commences much earlier than the clinically recognizable phase of the disorder, and its timeline includes an extended preclinical phase. The further the pendulum swings away from the symptomatic final stages towards the early pathology, the more obvious the lesions become, although from a standpoint of severity they are more unremarkable and thus frequently overlooked during routine neuropathological assessment. For this reason, the authors deal with the hallmark lesions in the early phases of the AD process in considerable detail