Cerebral Edema Formation After Stroke: Emphasis on Blood-Brain Barrier and the Lymphatic Drainage System of the Brain.
Cerebral Edema Formation After Stroke: Emphasis on Blood-Brain Barrier and the Lymphatic Drainage System of the Brain.
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DOI：
10.3389/fncel.2021.716825
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发表时间：
2021
影响因子：
5.3
通讯作者：
Ma L
中科院分区：
文献类型：
--
作者：
Chen S;Shao L;Ma L
脑水肿是一种严重的卒中并发症，与长期住院治疗和不良预后相关。脑内组织肿胀损害脑灌注，也可能导致脑幕疝。血脑屏障（BBB）作为外周循环与中枢神经系统（CNS）之间的物理生化屏障，对维持中枢神经系统微环境的稳定起着至关重要的作用。在病理条件下，如缺血性中风，血脑屏障功能障碍导致细胞旁通透性增加，直接导致血液成分外渗到脑内，引起脑血管源性水肿。最近的研究发现了淋巴系统和脑膜淋巴管，它们为脑脊液（CSF）进入大脑并流向附近的淋巴结提供通道，并与外周免疫系统沟通，调节免疫监视和大脑反应。对脑淋巴系统功能的深入了解，对脑卒中后脑水肿的已知机制提出了质疑。在这篇综述中，我们首先从分子和细胞病理生理学的角度讨论脑卒中后血脑屏障破坏如何导致或促成脑水肿。最后，我们讨论脑淋巴系统如何参与脑卒中后脑水肿的形成，并从血脑屏障和脑淋巴系统两个方向总结脑卒中后脑水肿形成的病理生理过程。
Brain edema is a severe stroke complication that is associated with prolonged hospitalization and poor outcomes. Swollen tissues in the brain compromise cerebral perfusion and may also result in transtentorial herniation. As a physical and biochemical barrier between the peripheral circulation and the central nervous system (CNS), the blood–brain barrier (BBB) plays a vital role in maintaining the stable microenvironment of the CNS. Under pathological conditions, such as ischemic stroke, the dysfunction of the BBB results in increased paracellular permeability, directly contributing to the extravasation of blood components into the brain and causing cerebral vasogenic edema. Recent studies have led to the discovery of the glymphatic system and meningeal lymphatic vessels, which provide a channel for cerebrospinal fluid (CSF) to enter the brain and drain to nearby lymph nodes and communicate with the peripheral immune system, modulating immune surveillance and brain responses. A deeper understanding of the function of the cerebral lymphatic system calls into question the known mechanisms of cerebral edema after stroke. In this review, we first discuss how BBB disruption after stroke can cause or contribute to cerebral edema from the perspective of molecular and cellular pathophysiology. Finally, we discuss how the cerebral lymphatic system participates in the formation of cerebral edema after stroke and summarize the pathophysiological process of cerebral edema formation after stroke from the two directions of the BBB and cerebral lymphatic system.
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影响因子：
12.7
作者：
Arbel-Ornath M;Hudry E;Eikermann-Haerter K;Hou S;Gregory JL;Zhao L;Betensky RA;Frosch MP;Greenberg SM;Bacskai BJ
通讯作者：
Bacskai BJ
影响因子：
6.2
作者：
Begum G;Song S;Wang S;Zhao H;Bhuiyan MIH;Li E;Nepomuceno R;Ye Q;Sun M;Calderon MJ;Stolz DB;St Croix C;Watkins SC;Chen Y;He P;Shull GE;Sun D
通讯作者：
Sun D
影响因子：
7.7
作者：
Absinta M;Ha SK;Nair G;Sati P;Luciano NJ;Palisoc M;Louveau A;Zaghloul KA;Pittaluga S;Kipnis J;Reich DS
通讯作者：
Reich DS
影响因子：
64.8
作者：
Ahn, Ji Hoon;Cho, Hyunsoo;Koh, Gou Young
通讯作者：
Koh, Gou Young
影响因子：
5.5
作者：
Abdullahi, Wazir;Tripathi, Dinesh;Ronaldson, Patrick T.
通讯作者：
Ronaldson, Patrick T.