Immunohistochemical and immunoblotting analysis of brain tissue of Alzheimer's disease (AD) patients showed highly induced expression of the small heat-shock protein hsp 27 in affected cortex. Expression of hsp 27 was present in a large number of proliferating astrocytes. The highest expression was exhibited by degenerative astrocytes in the areas rich in senile plaques. Neurofibrillary tangles, Hirano bodies and some hippocampal neurons were also positive. Expression of hsp 27 increased with the severity of AD-specific morphological changes, and with the duration of dementia. In control brains immunoreaction was restricted to the vessels and to occasional astrocytes in the white matter. Similar patterns of immunoreactivity were present in cases without dementia (Parkinson disease, lacunar state, or focal ischemic necrosis). Patients suffering from other types of dementia (Parkinson/dementia complex, multi-infarct dementia, normal pressure hydrocephalus) showed less expression of hsp 27 in reactive astrocytes than AD, but more than controls. These results indicate that increased expression of hsp 27, especially in astrocytes showing klazmatodendrosis, is associated with AD pathology.