TY - JOUR
T1 - Angiotensin-converting enzyme in cerebrospinal fluid and risk of brain atrophy
AU - Jochemsen, Hadassa M.
AU - Van Der Flier, Wiesje M.
AU - Ashby, Emma L.
AU - Teunissen, Charlotte E.
AU - Jones, Ruth E.
AU - Wattjes, Mike P.
AU - Scheltens, Philip
AU - Geerlings, Mirjam I.
AU - Kehoe, Patrick G.
AU - Muller, Majon
PY - 2015
Y1 - 2015
N2 - Background: Higher angiotensin-converting enzyme (ACE) activity might increase the risk of Alzheimer's disease by increasing blood pressure, and subsequent development of cerebral small vessel disease (CSVD). Yet, it may also decrease this risk, as it functions to degrade amyloid-β, thereby reducing brain atrophy. Objective: To examine the cross-sectional associations of serum and cerebrospinal fluid (CSF) ACE protein levels and activity with brain atrophy and CSVD in a memory clinic cohort. Methods: In 118 subjects from the memory clinic based Amsterdam Dementia Cohort (mean age 66±8 years), ACE protein levels (ng/ml) and activity in CSF and serum were investigated. Poisson regression analyses were used to associate ACE measurements with rated global cortical atrophy, medial temporal lobe atrophy, lacunar infarcts, white matter hyperintensities, and microbleeds on brain MRI. Results: Higher CSF ACE activity was associated with a reduced risk of global brain atrophy. The relative risk (95% CI) of having global cortical atrophy ≥2 per SD increase in CSF ACE activity was 0.67 (0.49; 0.93). ACE levels were not significantly related to measures of CSVD. Conclusions: These results show that high ACE might have protective effects on the brain. This could suggest that ACE inhibitors, which may lower CSF ACE levels, are not preferred as antihypertensive treatment in patients at risk for Alzheimer's disease.
AB - Background: Higher angiotensin-converting enzyme (ACE) activity might increase the risk of Alzheimer's disease by increasing blood pressure, and subsequent development of cerebral small vessel disease (CSVD). Yet, it may also decrease this risk, as it functions to degrade amyloid-β, thereby reducing brain atrophy. Objective: To examine the cross-sectional associations of serum and cerebrospinal fluid (CSF) ACE protein levels and activity with brain atrophy and CSVD in a memory clinic cohort. Methods: In 118 subjects from the memory clinic based Amsterdam Dementia Cohort (mean age 66±8 years), ACE protein levels (ng/ml) and activity in CSF and serum were investigated. Poisson regression analyses were used to associate ACE measurements with rated global cortical atrophy, medial temporal lobe atrophy, lacunar infarcts, white matter hyperintensities, and microbleeds on brain MRI. Results: Higher CSF ACE activity was associated with a reduced risk of global brain atrophy. The relative risk (95% CI) of having global cortical atrophy ≥2 per SD increase in CSF ACE activity was 0.67 (0.49; 0.93). ACE levels were not significantly related to measures of CSVD. Conclusions: These results show that high ACE might have protective effects on the brain. This could suggest that ACE inhibitors, which may lower CSF ACE levels, are not preferred as antihypertensive treatment in patients at risk for Alzheimer's disease.
KW - Alzheimer's disease
KW - Angiotensin-converting enzyme
KW - Brain atrophy
KW - Cerebral small vessel disease
KW - Hypertension
UR - http://www.scopus.com/inward/record.url?scp=84920831883&partnerID=8YFLogxK
U2 - 10.3233/JAD-131496
DO - 10.3233/JAD-131496
M3 - Comment/debate (Academic Journal)
C2 - 25201786
SN - 1387-2877
VL - 44
SP - 153
EP - 162
JO - Journal of Alzheimer's Disease
JF - Journal of Alzheimer's Disease
IS - 1
ER -