Nizari Shereen, Romero Ignacio A, Hawkes Cheryl A
School of Life, Health and Chemical Sciences, Faculty of Science, Technology, Engineering and Mathematics, The Open University, Milton Keynes, MK7 6AA, U.K.
Clin Sci (Lond). 2017 Jun 1;131(12):1207-1214. doi: 10.1042/CS20160769.
Neuronal death is a hallmark of Alzheimer's disease (AD) and considerable work has been done to understand how the loss of interconnectivity between neurons contributes to the associated dementia. Often overlooked however, is how the loss of neuronal innervation of blood vessels, termed perivascular innervation, may also contribute to the pathogenesis of AD. There is now considerable evidence supporting a crucial role for the neurovascular unit (NVU) in mediating the clearance of the β-amyloid (Aβ) peptide, one of the main pathological constituents of AD, from the brain. Moreover, efficient removal appears to be dependent on the communication of cells within the NVU to maintain adequate vascular tone and pulsatility. This review summarizes the composition of the NVU, including the sources of perivascular innervation and how the NVU mediates Aβ clearance from the brain. It also explores evidence supporting the hypothesis that loss of neurally mediated vasoreactivity contributes to Aβ pathology in the AD brain.
神经元死亡是阿尔茨海默病（AD）的一个标志，为了解神经元之间连接性丧失如何导致相关痴呆症，人们已经开展了大量研究。然而，常常被忽视的是，血管的神经元支配丧失（称为血管周围神经支配）如何也可能促成AD的发病机制。现在有大量证据支持神经血管单元（NVU）在介导从大脑清除β-淀粉样蛋白（Aβ）肽（AD的主要病理成分之一）方面发挥关键作用。此外，有效清除似乎依赖于NVU内细胞之间的通讯，以维持足够的血管张力和搏动性。本综述总结了NVU的组成，包括血管周围神经支配的来源，以及NVU如何介导从大脑清除Aβ。它还探讨了支持以下假设的证据：神经介导的血管反应性丧失促成AD大脑中的Aβ病理变化。
