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Tijdschrift voor Psychiatrie 53 (2011) 9, 637 - 643

Short report

The immune system and Alzheimer’s disease

E. van Exel, P. Eikelenboom, H.C. Comijs, C. Kurniawan, M. Frölich, J.H. Smit, M.L. Stek, P. Scheltens, J.E. Eefsting, R.G.J. Westendorp

summary
background
It has still not been established unequivocally whether vascular risk factors and inflammatory reactions, determined by heredity, are a cause or a result of Alzheimer’s disease (ad). If the offspring of parents with ad have more risk factors and more frequent and severe inflammatory reactions than the offspring of parents without ad, this argues strongly in favor of a causal relationship between vascular risk factors, a pro-inflammatory cytokine response and ad .
aim To determine whether the offspring of parents with ad have more risk factors and morefrequent and severe inflammatory reactions than the offspring of parents without ad.
method Vascular risk-factors, pro-inflammatory cytokines and the apoe genotype were determined in 206 offspring of parents with ad and in 200 offspring of parents without ad.
results Offspring of parents with ad carried more apoe epsilon4 than offspring of parents without ad (47% vs 21%). Middle-aged offspring of parents with a history of ad also had higher blood pressure and a greater atherosclerotic burden than the offspring of parents without ad. Also their response to the pro-inflammatory cytokine was significantly higher.
conclusion Hypertension and an inherited pro-inflammatory cytokine profile in middle age are early risk factors that contribute to the development of ad in old age. Offspring with a parental history of ad should therefore be offered screening and treatment for hypertension and have their blood pressure checked so that the development of ad in old age can be prevented.

keywords Alzheimer’s disease, inflammation, vascular factors