{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T22:32:51Z","timestamp":1791844371655,"version":"4.3.4"},"reference-count":87,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cereb Blood Flow Metab"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>Cerebral amyloid angiopathy (CAA) is a common age-related small vessel disease characterized by amyloid-beta (A\u03b2) accumulation in cortical and leptomeningeal blood vessel walls. Reduced A\u03b2 clearance in the vasculature elevates the risk of CAA, while increasing evidence indicates that enhanced A\u03b2 production in neurons also contributes. The impact of A\u03b2 on the diverse cell types of the neurovascular unit (NVU)\u2014including endothelial cells (ECs), pericytes, neurons, vascular smooth muscle cells (VSMCs), and astrocytes\u2014remains unclear. This narrative review proposes that A\u03b2 accumulation in NVUs during CAA drives a transcriptional response that reduces A\u03b2 clearance while activating a neuron-specific post- transcriptional response that enhances A\u03b2 production. Specifically, A\u03b2 in NVUs was found to initiate a transcriptional cascade that destabilizes endothelial cells, increases blood-brain barrier permeability, and damages pericytes, ultimately inducing inflammatory and dysfunctional changes in VSMCs. These changes cause mitochondrial dysfunction and TGF\u03b2 deregulation in neurons, activating profibrotic mechanisms. Post-transcriptional regulation by microRNA networks in neurons affects A\u03b2 processing by controlling the balance between amyloidogenic and non-amyloidogenic pathways through BACE1 and ADAM10 expression respectively. This review improves our understanding of A\u03b2 accumulation in neurovascular units in CAA, potentially leading to better diagnostics, early biomarkers, and tools for prognosis and treatment.<\/jats:p>","DOI":"10.1177\/0271678x251366082","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T06:17:24Z","timestamp":1754547444000},"page":"2063-2076","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Transcriptional and post-transcriptional responses to amyloid-\n                    <b>\u03b2<\/b>\n                    in cerebral amyloid angiopathy"],"prefix":"10.1177","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9498-049X","authenticated-orcid":false,"given":"Barend W","family":"Florijn","sequence":"first","affiliation":[{"name":"Leiden University Medical Center"},{"name":"Einthoven Laboratory for Vascular and Regenerative Medicine, Leiden University 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