Affiliations: [a] Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden | [b] Department of Clinical Sciences Lund, Diagnostic Radiology, Lund University, Lund, Sweden | [c] Department of Medical Imaging and Physiology, Skåne University Health Care Lund, Lund, Sweden
Correspondence:
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Correspondence to: Malin Wennström, Clinical Research Unit, Department of Clinical Sciences Malmö, Lund University, The Wallenberg Lab, SE-205 02 Malmö, Sweden. Tel.: +46 40 335733; E-mail: malin.wennstrom@med.lu.se.
Abstract: Hyaluronic acid (HA) has been shown to affect angiogenesis and the function of the blood-brain barrier, and a crucial role for HA in atherosclerosis has been described. We have recently demonstrated changes in the levels of HA in cerebrospinal fluid (CSF) in patients with Alzheimer's disease (AD) with documented vascular alterations. To further investigate if the level of HA in CSF can be used as a clinical diagnostic biomarker to identify vascular pathology in dementia, we analyzed the levels of HA in the CSF of patients with vascular dementia (VaD) (n = 46), AD (n = 45), and controls without dementia (n = 26). In line with our previous data, we found significantly increased levels of HA in CSF from patients with VaD compared with controls, whereas the levels of HA in patients with AD were found to be unaltered compared with controls and patients with VaD. We also detected increased levels of HA in individuals with vascular changes determined as significant white matter changes or previous infarction on cranial computed tomography or magnetic resonance imaging, compared with individuals without these findings. Furthermore, we found a significant positive correlation between the levels of HA and the CSF/serum albumin ratio, an indicator of blood-brain barrier integrity, in patients with VaD and AD, supporting the role of HA in vascular changes in the brain. Our results indicate a potential diagnostic value for the detection of vascular brain changes in dementia using CSF levels of HA, but emphasize the importance of further development of more sensitive HA assays.
