The vesicular monoamine transporter (VMAT2) has been suggested to be an excellent marker of presynaptic dopaminergic nerve terminals in the striatum of Parkinson's disease patients based on its high level of expression and insensitivity to drugs used to treat the disease. Previous in vivo imaging and postmortem binding studies have detected a loss in striatal VMAT2 binding in Parkinson's diseased (PD) brain; however, these techniques have poor spatial resolution and may suffer from nonspecific binding of some ligands. In this study, we use novel polyclonal antibodies to distinct regions of human VMAT2 to quantify and localize the protein. Western blot analysis demonstrated marked reductions in VMAT2 immunoreactivity in putamen, caudate, and nucleus accumbens of PD brain compared to control cases. Immunohistochemistry revealed VMAT2 immunoreactive fibers and puncta that were dense throughout the striatum of control brains, but which were drastically reduced in putamen of PD brains. In PD brains the caudate showed a significant degree of sparing along the border of the lateral ventricle and the nucleus accumbens was relatively preserved. The distribution of VMAT2 in striatum and its loss in PD paralleled that of the dopamine transporter (DAT), a phenotypic marker of dopamine neurons. Thus, immunochemical analysis of VMAT2 protein provides novel and sensitive means for localizing and quantifying VMAT2 protein and nigrostriatal dopamine terminals in PD. Furthermore, the relative expression of VMAT2 compared to that of DAT may predict the differential vulnerability of dopamine neurons in PD.
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