Linton Alexandria E, Weekman Erica M, Wilcock Donna M
University of Kentucky, College of Medicine, Sanders-Brown Center on Aging, Department of Physiology, Lexington KY 40536, USA.
Cereb Circ Cogn Behav. 2021 Oct 10;2:100030. doi: 10.1016/j.cccb.2021.100030. eCollection 2021.
Vascular contributions to cognitive impairment and dementia (VCID) is one of the leading causes of dementia along with Alzheimer's disease (AD) and, importantly, VCID often manifests as a comorbidity of AD(Vemuri and Knopman 2016; Schneider and Bennett 2010)(Vemuri and Knopman 2016; Schneider and Bennett 2010). Despite its common clinical manifestation, the mechanisms underlying VCID disease progression remains elusive. In this review, existing knowledge is used to propose a novel hypothesis linking well-established risk factors of VCID with the distinct neurodegenerative cascades of neuroinflammation and chronic hypoperfusion. It is hypothesized that these two synergistic signaling cascades coalesce to initiate aberrant angiogenesis and induce blood brain barrier breakdown trough a mechanism mediated by vascular growth factors and matrix metalloproteinases respectively. Finally, this review concludes by highlighting several potential therapeutic interventions along this neurodegenerative sequalae providing diverse opportunities for future translational study.
血管性认知障碍和痴呆(VCID)是导致痴呆的主要原因之一,与阿尔茨海默病(AD)并列,重要的是,VCID常表现为AD的合并症(韦穆里和克诺普曼,2016年;施奈德和贝内特,2010年)(韦穆里和克诺普曼,2016年;施奈德和贝内特,2010年)。尽管其临床表现常见,但VCID疾病进展的潜在机制仍不清楚。在本综述中,现有知识被用于提出一个新的假说,将已确定的VCID风险因素与神经炎症和慢性灌注不足这两种不同的神经退行性级联反应联系起来。据推测,这两种协同信号级联反应共同引发异常血管生成,并分别通过血管生长因子和基质金属蛋白酶介导的机制诱导血脑屏障破坏。最后,本综述通过强调沿着这种神经退行性后遗症的几种潜在治疗干预措施来结束,为未来的转化研究提供了多样的机会。