Targeting the Neurovascular Unit in Brain Trauma

Abstract

Although the neurovascular unit was originally developed as a conceptual framework for stroke, it is now recognized that these cell-cell interactions play critical roles in many other CNS disorders as well. In brain trauma, perturbations within the neurovascular unit may be especially important. Changes in neurovascular coupling may disrupt blood flow and metabolic regulation. Disruption of transmitter release-reuptake kinetics in neurons and astrocytes may augment excitotoxicity. Alterations in gliovascular signaling may underlie blood-brain barrier disruptions and traumatic edema. Perturbations in cell-cell signaling between all neuronal, glial, and vascular compartments may increase susceptibility to cell death. Finally, repairing the brain after trauma requires the integrated restoration of all neural, glial, and vascular connectivity for effective functional recovery. Just as in stroke, saving neurons alone may also be insufficient for treating brain trauma. In this minireview, we attempt to briefly highlight some of these pathways to underscore the importance of rescuing the entire neurovascular unit in brain trauma.

Current Stage and Future Perspective of Stem Cell Therapy in Ischemic Stroke

“…For the first time the neuroprotection was focused to save only neuronal cells. Today, our better understanding of the neurovascular unit concept has changed the focus from single cell to multi-cells protection in order to achieve optimal response following a cerebral ischemia [13,14]. Neurons are most vulnerable to ischemia, followed by endothelial cells, pericytes, microglia, and after that the astrocytes.…”

Angiogenesis in brain contusion

“…jednostki neurowaskularnej, którą tworzą trzy kompartmenty/przedziały -neurony, glej (głównie astroglej) i naczynia [24,25].…”

“…Recent years have seen an increased interest in the analysis of repair processes occurring in the CNS in the context of the so-called neurovascular unit which is composed of three compartments: neurons, glia (mainly astroglia) and blood vessels [24,25].…”

miR‐30a‐5p inhibition promotes interaction of Fas+endothelial cells and FasL+microglia to decrease pathological neovascularization and promote physiological angiogenesis

“…Being highly vascular, the central nervous system (CNS) is susceptible to ischemic injury due to changes in blood vessels caused by age, genetics, lifestyle or a combination of these (Lok et al, ). Subsequent neuronal cell death leads to significant morbidity and mortality.…”