Prof. Silvia Fossati. Lewis Katz School of Medicine Temple University, USA. Alzheimer's disease pathology, comorbidities and vascular contributions: mechanisms and therapeutic targets


Cerebral endothelial cell (cEC) and neurovascular stress induced by vascular amyloid β (Aβ) and tau deposits are early contributors to cerebrovascular damage, blood-brain barrier (BBB) dysfunction and clearance impairment, precipitating neurodegeneration and neuroinflammation processes in cerebral amyloid angiopathy (CAA), Alzheimer’s disease (AD) and dementias. However, the cellular and molecular mechanisms through which Aβ and tau drive cEC and BBB dysfunction remain to be fully clarified, and possible therapeutic strategies are sorely needed. Our studies aim to understand the mechanisms of aggregated Aβ and tau toxicity on the cerebral vessels, in the presence or absence of comorbid cardiovascular risk factors, while testing novel potential therapeutic strategies against cerebrovascular dysfunction and neurovascular stress in the AD and CAA brain. We revealed mitochondrial and metabolic changes mediating the detrimental effects of both amyloid and tau on cECs, which are directly and causally linked to EC inflammatory activation, BBB dysfunction, and associated to activation of the pro-apoptotic cascade. We defined how some of these pathways can be potentiated by cardiovascular risk factors. We also discovered that these toxic mitochondrial and apoptotic mechanisms are rescued by CA inhibition. Using human cECs and AD animal models, we tested the potential protective effects of carbonic anhydrase inhibitors or of the genetic deletion of a mitochondrial CA enzyme on cerebrovascular dysfunction. These findings improve the understanding of the vascular contributions to AD and dementia, while unveiling novel molecular targets with high therapeutic potential.

10 Aprile 2026



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