title: 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.
authors.affiliation: Departments of Radiology, Neurology and Pediatrics, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
authors.forename: Josephine
authors.initials: J
authors.lastname: Lok
authors.forename: Xiao-Shu
authors.initials: XS
authors.lastname: Wang
authors.forename: Chang-Hong
authors.initials: CH
authors.lastname: Xing
authors.forename: Taka-Kuni
authors.initials: TK
authors.lastname: Maki
authors.forename: Li-Min
authors.initials: LM
authors.lastname: Wu
authors.forename: Shu-Zhen
authors.initials: SZ
authors.lastname: Guo
authors.forename: Natan
authors.initials: N
authors.lastname: Noviski
authors.forename: Ken
authors.initials: K
authors.lastname: Arai
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Whalen
authors.forename: Eng H
authors.initials: EH
authors.lastname: Lo
authors.forename: Xiao-Ying
authors.initials: XY
authors.lastname: Wang
mesh_terms: D000818:Animals; D001812:Blood-Brain Barrier / Q000378:metabolism; D001921:Brain / Q000503:physiopathology*; D001930:Brain Injuries / Q000503:physiopathology*; D002450:Cell Communication / Q000502:physiology; D002560:Cerebrovascular Circulation / Q000502:physiology; D004730:Endothelium, Vascular / Q000378:metabolism; D006801:Humans; D009457:Neuroglia / Q000502:physiology; D009474:Neurons / Q000502:physiology
keywords: Endothelial; Glia; Neuron; Neuroprotection; Traumatic brain injury