冲程(发动机)
神经科学
内皮功能障碍
医学
疾病
神经影像学
痴呆
血管疾病
病理生理学
人脑
病理
生物信息学
心脏病学
心理学
生物
内科学
工程类
机械工程
作者
Joanna M. Wardlaw,Helene Benveniste,Anna Williams
出处
期刊:Annual Review of Physiology
[Annual Reviews]
日期:2022-02-10
卷期号:84 (1): 409-434
被引量:24
标识
DOI:10.1146/annurev-physiol-060821-014521
摘要
Cerebral small vessel disease (SVD) is highly prevalent and a common cause of ischemic and hemorrhagic stroke and dementia, yet the pathophysiology is poorly understood. Its clinical expression is highly varied, and prognostic implications are frequently overlooked in clinics; thus, treatment is currently confined to vascular risk factor management. Traditionally, SVD is considered the small vessel equivalent of large artery stroke (occlusion, rupture), but data emerging from human neuroimaging and genetic studies refute this, instead showing microvessel endothelial dysfunction impacting on cell–cell interactions and leading to brain damage. These dysfunctions reflect defects that appear to be inherited and secondary to environmental exposures, including vascular risk factors. Interrogation in preclinical models shows consistent and converging molecular and cellular interactions across the endothelial-glial-neural unit that increasingly explain the human macroscopic observations and identify common patterns of pathology despite different triggers. Importantly, these insights may offer new targets for therapeutic intervention focused on restoring endothelial-glial physiology.
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