Vascular aspects of neuroprotection.
It is being increasingly suggested that the microcirculation, which is known to be in a large part responsible for maintaining an adequate and constant microenvironment for function of the central nervous system, functions as part of a neurovascular unit. The neurovascular unit includes neurons, astrocytes and elements of capillaries. The cerebral circulation exhibits unique functional characteristics and critical elements for the pathogenesis of cerebrovascular disease. For example, the blood-brain barrier formed by epithelial-like high resistance tight junctions within the endothelium is a key feature of microvessels of the central nervous system. Alterations in the microcirculation after ischemia/reperfusion include disruption of the blood-brain barrier, edema and swelling of perivascular astrocyte foot processes, decrease in arteriole endothelium-dependent relaxation and reduced inwardly-rectifying potassium channel function, altered expression of proteases and matrix metalloproteinases, increased inflammatory mediators and inflammation. Experiments studying the microcirculation in ischemia are few compared with those examining neuroprotection, although the two overlap because protection of the microcirculation might achieve some degree of neuroprotection and both processes may be mediated by at least some mechanisms in common.
Takahashi
Masataka
M
Section of Neurosurgery, Department of Surgery, University of Chicago Medical Center and Pritzker School of Medicine, Chicago, IL 60637, USA.
Macdonald
R Loch
RL
D000818:Animals; D001812:Blood-Brain Barrier / Q000502:physiology; D002545:Brain Ischemia / Q000188:drug therapy / Q000503:physiopathology; D002490:Central Nervous System / Q000502:physiology; D002560:Cerebrovascular Circulation / Q000187:drug effects* / Q000502:physiology; D002561:Cerebrovascular Disorders / Q000503:physiopathology / Q000517:prevention & control*; D042783:Endothelial Cells / Q000502:physiology; D005109:Extracellular Matrix; D006801:Humans; D008833:Microcirculation / Q000502:physiology; D018919:Neovascularization, Physiologic; D018696:Neuroprotective Agents / Q000494:pharmacology / Q000627:therapeutic use*
D018696:Neuroprotective Agents