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Correspondence to Author:  Gernot P. Tilz , 

The Vascular Diseases of the Brain and the Heart May Have a Different Etiology

Abstract:

This is a brief comment on 55 years of clinical experience and some autopsy observations with the late pathologist Prof Hans Becker.. It is now recognized that vascular disease of the brain and coronary vessels may be of two different entities. We encounter patients with advanced disease of coronary and peripheral arteries with no perceptible evidence of “cerebral arteriosclerosis” and conversely people with advanced dementia of vascular origin despite unaffected coronary and peripheral arteries. Some observations at autopsies concerning this matter have come to the conclusion that in general coronary heart disease is mainly sclerotic and inflammatory with all the well - known risk factors of which we are aware, namely high lipids, inflammation, smoking, hypertension. Patients with “cerebral sclerosis” and sometimes renal vascular involvement seem to have often primarily a type of “angiopathy” of their brain vessels and kidneys, due to hypertension sometimes caused by linear deposition (inbibition, or absorption or filtration) of smaller proteins such as prealbumin, transthyretin, free light chains and other smaller molecules. If this hypothesis can be verified, treatment of these two distinct diseases will differ; namely antihypertensive medications for the “cerebral sclerosis” and statins, anti-inflammatory drugs and the antilipideamics for the “peripheral sclerosis”. Further evidence to this “hyalinosis-hypothesis” comes from the description of the “Amyloidosis of the brain” from radiologists. A prospective randomized study focusing specifically on these aspects may yield results that add further to our understanding of the specific etiology of these morbidities and enhances strategies for their management.

Citation:

Gernot P. Tilz . Hyalinosis : A preliminary communication regarding very interesting and provocative clinical observations. Journal of Immunology 2024.