Costantino Iadecola, MD: The Impact of Amyloid on Vascular Dysfunction

“Amyloid also has an effect on the blood vessels, as it does neurons, by kind of stunning them, making them unable to work—to deliver oxygen and glucose, and remove the waste. It promotes accumulation.”

The amyloid theory in Alzheimer disease and dementia has long been a targeted pathology for treatments. While many of these therapies have failed, many specialists have speculated that this may be due to the timing of therapy, often pointing to a patient being already too far along in the disease process by the time they are first treated in clinical trials. And in fact, one amyloid-targeting agent, aducanumab, is poised to become the first to gain approval from the FDA later in 2020.

For physicians like Costantino Iadecola, MD, the Ann Parish Titzell Professor of Neuroscience and director, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, the complications of treating this disease do not stop at the challenges of identifying patients earlier. There are additional challenges in the variance between those with familial Alzheimer compared to those with sporadic disease.

In this interview with NeurologyLive, Iadecola explains the differences between these 2 sects of patients and details the importance of the vascular processes in disease as it relates to amyloid buildup. He offered his insight on the how cardiovascular disease and other comorbidities can play a role in amyloid-driven disease.