Neuroinflammation, immune system and Alzheimer disease: searching for the missing link.

Due to an increasingly aging population, Alzheimer disease (AD) represents a crucial issue for the healthcare system because of its widespread prevalence and the burden of its care needs. Several hypotheses on AD pathogenesis have been proposed and current therapeutical strategies have shown limited effectiveness. In the last decade, more evidence has supported a role for neuroinflammation and immune system dysregulation in AD. It remains unclear whether astrocytes, microglia and immune cells influence disease onset, progression or both. Amyloid-ß peptides that aggregate extracellularly in the typical neuritic plaques generate a constant inflammatory environment. This causes a prolonged activation of microglial and astroglial cells that potentiate neuronal damage and provoke the alteration of the blood brain barrier (BBB), damaging the permeability of blood vessels. Recent data support the role of the BBB as a link between neuroinflammation, the immune system and AD. Hence, a thorough investigation of the neuroinflammatory and immune system pathways that impact neurodegeneration and novel exciting findings such as microglia-derived microvesicles, inflammasomes and signalosomes will ultimately enhance our understanding of the pathological process. Eventually, we should proceed with caution in defining a causal or consequential role of neuroinflammation in AD, but rather focus on identifying its exact pathological contribution.

[Cerebral ischemic disease in women. Notes on a CT-documented case series]. / La malattia ischemica cerebrale nella donna. Considerazioni su casistica TAC documentata.

Risk factors in a group of 50 women affected by CT-documented stroke have been analysed. Arterial hypertension, hypercholesterolaemia and hyperglycaemia proved the most frequent.

[Transient cerebral ischemia and the risk factors]. / Ischemia cerebrale transitoria e fattori di rischio.

A retrospective study was carried out in a general medicine ward of 100 male patients suffering from their first transient ischemic attack (TIA) in order to evaluate the incidence of different cerebrovascular risk factors. The results were then compared with those from another group of 100 patients suffering from initial cerebral ischemic softening (CIS) in order to identify a cerebrovascular risk population taking into account clinical similarities and common and divergent features. The study revealed that age is the prime risk factor in the genesis of TIA, followed by arterial hypertension and hypercholesterolemia. From a comparison with the group of patients affected by initial CIS it was clear that TIA is typical of senility and is more closer correlated to age than other risk factors; therefore, che TIA population is an expression of those who have "survived" cerebrovascular death due to the lesser exposure to risk factors.

[Cerebral ischemic malacia. A retrospective study of CAT scan-documented cases]. / Il rammollimento ischemico cerebrale. Studio retrospettivo su casistica TAC documentata.

One hundred male patients affected by ischaemic stroke were studied with the use of CT scans. A clinical-biohumoral pattern was traced for every patient, with particular regard to the incidence of risk factors for stroke of which systolic arterial hypertension, appear to be the most frequent. It would be useful to extend this research to female patients as well in order to discover any significant differences between sexes.