Thesis defense Lieke Jäkel (Donders series 530)

6 December 2021

Promotors: Dr. ir. M.M. Verbeek en Prof. dr. C.J.M. Klijn
Co-promotor: Dr. H.B. Kuiperij

On the Pathophysiology and Prevalence of Cerebral Amyloid Angiopathy

Cerebral amyloid angiopathy (CAA) is a condition in which the amyloid-β protein (Aβ) accumulates in the walls of blood vessels in the brain, which can lead to brain bleeds. CAA has a huge impact on society; this dissertation shows that almost a quarter of the world's population over 55 years has advanced CAA. Only a subset of these people experience brain bleeds. The findings in this dissertation show that people with CAA-related bleeds have a different protein composition in their blood vessel walls, which may contribute to the development of bleeds. Furthermore, almost fifty percent of patients with Alzheimer’s disease have advanced CAA. This is relevant because Aβ-immunotherapy - recently approved as Alzheimer’s treatment - has the important side effect that it can worsen CAA. This dissertation shows that immunotherapy does indeed result in increased CAA, but that a certain variant of Aβ (Aβ43) seems to be an exception to this.