Developmental aspects of the intracerebral microvasculature and perivascular spaces: insights into brain response to late-life diseases.
Developmental aspects of the intracerebral microvasculature and perivascular spaces: insights into brain response to late-life diseases.
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DOI：
10.1097/nen.0b013e31823ac627
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发表时间：
2011-12
影响因子：
3.2
通讯作者：
Knopman DS
中科院分区：
文献类型：
--
作者：
Marín-Padilla M;Knopman DS
人类大脑皮层微血管的发育可以深入了解大脑皮层对晚年脑损伤的反应。我们描述了大脑皮层微血管系统发育解剖学的 3 个基本且不同的组成部分。第一个隔室是脑膜内的，因此是脑外的。除了主要的静脉窦、蛛网膜动脉和静脉外，覆盖发育中和成人大脑皮层表面的软脑膜吻合毛细血管丛代表了成为第二个组成部分的穿透血管的来源，即脑内外在微血管室。在胚胎发生过程中，软脑膜毛细血管发芽的血管成分刺穿大脑外部神经胶质限制膜并穿透皮质。这些血管最终分化为小动脉和小静脉，通过内部血管和外部胶质基底层之间形成的血管外 Virchow-Robin 室 (V-RC) 将其与皮质组织分开。 V-RC 保持对脑膜间质空间和血脑屏障 (BBB) 外部开放，并充当淋巴前引流系统，用于清除不能转运到血液中或在细胞内分解代谢的物质。第三个要素是致密的脑内固有微血管室。脑内毛细血管从穿支血管中萌发，穿过 Virchow-Robin 胶质膜进入神经毡。脑内毛细血管缺乏平滑肌和 V-RC，仅由通过基底层与脑内空间隔开的内皮细胞组成。它们作为生理血脑屏障的作用是交换氧气、葡萄糖和小分子。这一发展观点强调了 3 个原则：(a) V-RC 与皮质穿透小动脉和小静脉密切相关，代表一种低效的原淋巴系统，缺乏身体其他部位淋巴床中发现的解剖和生理成分； (b) V-RC 和穿透血管室（小动脉和小静脉）在解剖学上的连续性意味着 1 个室的病理可能导致其他室的功能障碍； (c) 免疫 BBB 在穿透小静脉水平的解剖定位可能会对涉及 V-RC 的免疫介导的运输施加限制。
The development of the microvasculature of the human cerebral cortex offers insight into the response of the cerebral cortex to later-life brain injury. We describe the 3 basic and distinct components of the developmental anatomy of the cerebral cortical microvascular system. The first compartment is meningeal and, therefore, extracerebral. In addition to the major venous sinuses, arachnoidal arteries and veins, the pial anastomotic capillary plexus that covers the surface of the developing and adult cerebral cortex represents the source of the penetrating vessels that become the second component, the intracerebral extrinsic microvascular compartment. During embryogenesis, sprouting vascular elements from pial capillaries pierce the brain external glial limiting membrane and penetrate the cortex. These vessels, which eventually differentiate into arterioles and venules, are separated from the cortical tissue by the extravascular Virchow-Robin compartment (V-RC) formed between the internal vascular and the external glial basal laminae. The V-RC remains open to the meningeal interstitial spaces and outside of the blood-brain barrier (BBB), and acts as a prelymphatic drainage system for removal of substances that cannot be transported into the blood or catabolized intracellularly. The third element is the dense intracerebral intrinsic microvascular compartment. Intracerebral capillary vessels sprout from the perforating vessels, penetrate through the Virchow-Robin glial membrane and enter the neuropil. Intracerebral capillaries lack smooth muscle and a V-RC and consist only of endothelial cells separated from the intracerebral space by a basal lamina. Their role as the physiological BBB is the exchange of oxygen, glucose and small molecules. This developmental perspective highlights 3 principles: (a) the V-RC is intimately related to the cortical penetrating arterioles and venules and represents an inefficient proto-lymphatic system that lacks the anatomic and physiological constituents found in lymphatic beds elsewhere in the body; (b) the anatomic contiguity of the V-RC and the penetrating vascular compartment (arterioles and venules) implies that pathology in 1 compartment could lead to dysfunction in the others; and (c) the anatomic localization of the immunological BBB at the level of the penetrating venules might impose constraints on immunologically-mediated transport involving the V-RC.