Department of Neurosurgery, Shengzhou People's Hospital (the First Affiliated Hospital of Zhejiang University Shengzhou Branch), Shengzhou, China.
Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, China.
CNS Neurosci Ther. 2021 Jan;27(1):7-16. doi: 10.1111/cns.13561. Epub 2021 Jan 2.
Ischemic stroke (IS), a common cerebrovascular disease, results from a sudden blockage of a blood vessel in the brain, thereby restricting blood supply to the area in question, and making a significantly negative impact on human health. Unfortunately, current treatments, that are mainly based on a recanalization of occluded blood vessels, are insufficient or inaccessible to many stroke patients. Recently, the profound influence of the neurovascular unit (NVU) on recanalization and the prognosis of IS have become better understood; in-depth studies of the NVU have also provided novel approaches for IS treatment. In this article, we review the intimate connections between the changes in the NVU and IS outcomes, and discuss possible new management strategies having practical significance to IS. We discuss the concept of the NVU, as well as its roles in IS blood-brain barrier regulation, cell preservation, inflammatory immune response, and neurovascular repair. Besides, we also summarize the influence of noncoding RNAs in NVU, and IS therapies targeting the NVU. We conclude that both the pathophysiological and neurovascular repair processes of IS are strongly associated with the homeostatic state of the NVU and that further research into therapies directed at the NVU could expand the range of treatments available for IS.
缺血性脑卒中(IS)是一种常见的脑血管疾病,由脑部血管突然阻塞引起,从而限制了受影响区域的血液供应,对人类健康造成了重大负面影响。不幸的是,目前的治疗方法主要基于阻塞血管的再通,但许多脑卒中患者无法接受或无法获得这些治疗方法。最近,神经血管单元(NVU)对再通和 IS 预后的深远影响已经得到更好的理解;对 NVU 的深入研究也为 IS 的治疗提供了新的方法。本文综述了 NVU 的变化与 IS 结果之间的密切关系,并讨论了可能具有实际意义的 IS 新的管理策略。我们讨论了 NVU 的概念及其在 IS 血脑屏障调节、细胞保护、炎症免疫反应和神经血管修复中的作用。此外,我们还总结了非编码 RNA 在 NVU 中的作用以及针对 NVU 的 IS 治疗方法。我们得出结论,IS 的病理生理和神经血管修复过程与 NVU 的内稳态状态密切相关,进一步研究针对 NVU 的治疗方法可能会扩大 IS 的治疗选择范围。