Inflammation and Alzheimer's disease: Relationships between pathogenic mechanisms and clinical expression

During the past 15 years a variety of inflammatory proteins has been identi fied in the brains of patients with Alzheimer's disease (AD) postmortem. Th ere is now considerable evidence that in AD the deposition of amyloid-P (AP ) protein precedes a cascade of events that ultimately leads to a local "br ain inflammatory response." Here we reviewed the evidence (i) that inflamma tory mechanisms can be a part of the relevant etiological factors for AD in patients with head trauma, ischemia, and Down's syndrome; (ii) that in cer ebral Ap disorders the clinical symptoms are determined to a great extent b y the site of inflammation; and (iii) that a brain inflammatory response ca n explain some poorly understood characteristics of the clinical picture, a mong others the susceptibility of AD patients to delirium. The present data indicate that inflammatory processes in the brain contribute to the etiolo gy, the pathogenesis, and the clinical expression of AD. (C) 1998 Academic Press.