The pathogenesis of
moyamoya disease is still under investigation. In this study, the authors focus on the role of
cytokines in the pathogenesis of
moyamoya disease by using immunohistochemical analyses. The authors examined two specimens in the circle of Willis obtained at autopsy from two patients with
moyamoya disease and two additional specimens obtained from control cadavers with atherosclerotic
stenosis of the intracranial carotid arteries. Immunohistochemical examinations of the sections of the major intracranial arteries were performed using antismooth muscle cells (SMCs), monocytes,
growth factor, cell
nuclear antigen, and fragmented
DNA antibodies.
Basic fibroblast growth factor (bFGF) staining was present only in the endothelial cells of the
moyamoya disease specimens and was not seen in control samples. In addition, the endothelial cells and SMCs in the media were positive for
terminal deoxynucleotidyl transferase-mediated biotinylated
deoxyuridine triphosphate nick-end labeling of fragmented
DNA method but not in the SMCs in the intima in
moyamoya disease specimens, which indicates that an apoptotic process is active in only SMCs in the media but not in the intima. In conclusion, it is suggseted that the presence of bFGF in the media specifically seen in
moyamoya disease suppresses the apoptotic process of SMCs in the intima.