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Cerebral Amyloid Angiopathy: A Systematic Review

机译:脑淀粉样血管病:系统评价

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摘要

Cerebral amyloid angiopathy (CAA) is a disorder characterized by amyloid deposition in the walls of leptomeningeal and cortical arteries, arterioles, and less often capillaries and veins of the central nervous system. CAA occurs mostly as a sporadic condition in the elderly, its incidence associating with advancing age. All sporadic CAA cases are due to deposition of amyloid-β, originating from proteolytic cleavage of the Amyloid Precursor Protein. Hereditary forms of CAA are generally familial (and therefore rare in the general population), more severe and earlier in onset. CAA-related lobar intracerebral hemorrhage is the most well-studied clinical condition associated with brain amyloid deposition. Despite ever increasing understanding of CAA pathogenesis and availability of reliable clinical and diagnostic tools, preventive and therapeutic options remain very limited. Further research efforts are required in order to identify biological targets for novel CAA treatment strategies. We present a systematic review of existing evidence regarding the epidemiology, genetics, pathogenesis, diagnosis and clinical management of CAA.
机译:脑淀粉样血管病(CAA)是一种疾病,其特征是淀粉样蛋白沉积在软脑膜和皮层动脉,小动脉的壁中,较少见于中枢神经系统的毛细血管和静脉。 CAA多半是老年人的偶发性疾病,其发病率与年龄的增长有关。所有零星的CAA病例都是由于淀粉样蛋白前体蛋白水解切割引起的淀粉样蛋白β沉积。 CAA的遗传形式通常是家族性的(因此在一般人群中很少见),病情较重且发病较早。 CAA相关的大叶脑出血是与脑淀粉样蛋白沉积相关的研究最深入的临床疾病。尽管人们对CAA的发病机理以及可靠的临床和诊断工具的可用性有了越来越多的了解,但预防和治疗的选择仍然非常有限。为了确定新的CAA治疗策略的生物学靶标,需要进一步的研究努力。我们对有关CAA的流行病学,遗传学,发病机理,诊断和临床管理的现有证据进行系统综述。

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