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Vascular Considerations for Amyloid Immunotherapy

  • Dementia (K.S. Marder, Section Editor)
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Abstract

Purpose of Review

Amyloid beta (Aβ) plaque accumulation is a hallmark pathology contributing to Alzheimer’s disease (AD) and is widely hypothesized to lead to cognitive decline. Decades of research into anti-Aβ immunotherapies provide evidence for increased Aβ clearance from the brain; however, this is frequently accompanied by complicated vascular deficits. This article reviews the history of anti-Aβ immunotherapies and clinical findings and provides recommendations moving forward.

Recent Findings

In 20 years of both animal and human studies, anti-Aβ immunotherapies have been a prevalent avenue of reducing hallmark Aβ plaques. In both models and with different anti-Aβ antibody designs, amyloid-related imaging abnormalities (ARIA) indicating severe cerebrovascular compromise have been common and concerning occurrence.

Summary

ARIA caused by anti-Aβ immunotherapy has been noted since the early 2000s, and the mechanisms driving it are still unknown. Recent approval of aducanumab comes with renewed urgency to consider vascular deficits caused by anti-Aβ immunotherapy.

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  1. Sanders-Brown Center On Aging, Department of Physiology, University of Kentucky, Lexington, KY, USA

    Kate E. Foley & Donna M. Wilcock

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Foley, K.E., Wilcock, D.M. Vascular Considerations for Amyloid Immunotherapy. Curr Neurol Neurosci Rep 22, 709–719 (2022). https://doi.org/10.1007/s11910-022-01235-1

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