Vascular cognitive impairment: Modeling a critical neurologic disease in vitro and in vivo.
Vascular cognitive impairment: Modeling a critical neurologic disease in vitro and in vivo.
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DOI：
10.1016/j.bbadis.2015.12.009
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发表时间：
2016-05
期刊：
影响因子：
--
通讯作者：
Murphy MP
中科院分区：
文献类型：
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作者：
Helman AM;Murphy MP
血管性认知障碍和痴呆（VCID）是一种复杂形式的痴呆，结合了血管性疾病和其他形式的痴呆，如阿尔茨海默病。VCID包括广泛的脑血管驱动的认知障碍，从轻度认知障碍到完全发展的痴呆。代谢紊乱，如2型糖尿病和高血压，以及生活方式因素，如肥胖和高脂肪饮食，使这种疾病状态进一步复杂化。本文旨在定义VCID并回顾疾病状态的体外和体内模型。这包括体外神经血管单元模型、慢性脑灌注不足模型、NOTCH3突变动物作为小血管疾病模型、脑淀粉样血管病（CAA）大动物和混合性痴呆动物模型。人工合成微血管是研究神经血管单元的一种很有前途的技术，尽管成本高昂，但犬类是研究CAA的一个很好的模型。虽然VCID的各个方面有几个很好的模型，但疾病状态的异质性阻止了疾病的所有方面都有一个模型。因此，VCID需要进一步定义为存在于这个总括术语中的疾病状态。这包括中风计数和中风部位的具体指南，以及对导致痴呆的脑血管和AD重叠病理的进一步分类。这将有助于建立更好的模型，并更彻底地了解血管疾病是如何导致痴呆的。VCID是痴呆症的第二常见形式，预计在未来几年将会增加。VCID的异质性使其难以研究，但由于没有更好的定义和模型，VCID对我国老龄化人口构成了重大的公共卫生问题。
Vascular contributions to cognitive impairment and dementia (VCID) is a complex form of dementia, combining aspects of vascular disease and other forms of dementia, such as Alzheimer’s disease. VCID encompasses a wide spectrum of cerebrovascular-driven cognitive impairment, from mild cognitive impairment to fully developed dementia. This disease state is further complicated by metabolic disorders, such as type 2 diabetes and hypertension, and lifestyle factors, like obesity and high fat diets. This manuscript is meant to both define VCID and review the in vitro and in vivo models of the disease state. This includes in vitro models of the neurovascular unit, models of chronic cerebral hypoperfusion, animals with NOTCH3 mutations as a model of small vessel disease, large animals with cerebral amyloid angiopathy (CAA), and animal models of mixed dementia. Synthetic microvessels are a promising technique to study the neurovascular unit and canines, despite the cost, are an excellent model to study CAA. While there are several good models of individual aspects of VCID, the heterogeneity of the disease states prevents there from being a model of all aspects of the disease. Therefore, VCID needs to be further defined into disease states that exist within this umbrella term. This includes specific guidelines for stroke counts and stroke locations and further categorization of overlapping cerebrovascular and AD pathologies that contribute to dementia. This will allow for better models and a more thorough understanding of how vascular disease contributes to dementia. VCID is the second most common form of dementia and is expected to increase in coming years. The heterogeneity of VCID makes it difficult to study, but without better definitions and models, VCID presents a major public health problem for our aging population.