Cerebral Vascular Disease and Neurovascular Injury in Ischemic Stroke.
Cerebral Vascular Disease and Neurovascular Injury in Ischemic Stroke.
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DOI：
10.1161/circresaha.116.308427
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发表时间：
2017-02-03
影响因子：
20.1
通讯作者：
Faraci FM
中科院分区：
文献类型：
--
作者：
Hu X;De Silva TM;Chen J;Faraci FM
脑血管疾病的后果是世界范围内的主要健康问题之一。脑大血管和小血管疾病可引发中风，并导致其他形式的神经功能障碍和退化的血管成分。这两种形式的血管疾病都是由不同的风险因素驱动的，其中高血压是主要的贡献者。尽管缺血性事件后神经血管疾病和后续损伤的重要性，但这些领域的基础知识落后于我们目前对神经保护和血管生物学的总体理解。本综述的目的是探讨血管系统中促进低灌注和缺血的关键结构和功能变化，同时也影响损伤程度和治疗效果。此外，由于血脑屏障（BBB）的损伤是缺血的主要后果之一，我们讨论缺血引起的BBB完整性和功能变化的细胞和分子机制，包括内皮细胞的改变和周细胞，免疫细胞和基质金属蛋白酶的贡献。确定缺血前后控制血管变化的细胞类型、途径和分子可能会导致新的方法来减缓脑血管疾病的进展，并减少缺血事件的频率和影响。
The consequences of cerebrovascular disease are among the leading health issues worldwide. Large and small cerebral vessel disease can trigger stroke and contribute to the vascular component of other forms of neurological dysfunction and degeneration. Both forms of vascular disease are driven by diverse risk factors, with hypertension as the leading contributor. Despite the importance of neurovascular disease and subsequent injury following ischemic events, fundamental knowledge in these areas lag behind our current understanding of neuroprotection and vascular biology in general. The goal of this review is to address select key structural and functional changes in the vasculature that promote hypoperfusion and ischemia, while also affecting the extent of injury and effectiveness of therapy. In addition, as damage to the blood-brain barrier (BBB) is one of the major consequences of ischemia, we discuss cellular and molecular mechanisms underlying ischemia-induced changes in BBB integrity and function, including alterations in endothelial cells and the contribution of pericytes, immune cells, and matrix metalloproteinases. Identification of cell types, pathways, and molecules that control vascular changes before and after ischemia may result in novel approaches to slow the progression of cerebrovascular disease and lessen both the frequency and impact of ischemic events.