Stroke. 2023 Jun;54(6):e251-e271. doi: 10.1161/STR.0000000000000431. Epub 2023 Apr 3.
Preservation of brain health has emerged as a leading public health priority for the aging world population. Advances in neurovascular biology have revealed an intricate relationship among brain cells, meninges, and the hematic and lymphatic vasculature (the neurovasculome) that is highly relevant to the maintenance of cognitive function. In this scientific statement, a multidisciplinary team of experts examines these advances, assesses their relevance to brain health and disease, identifies knowledge gaps, and provides future directions.
Authors with relevant expertise were selected in accordance with the American Heart Association conflict-of-interest management policy. They were assigned topics pertaining to their areas of expertise, reviewed the literature, and summarized the available data.
The neurovasculome, composed of extracranial, intracranial, and meningeal vessels, as well as lymphatics and associated cells, subserves critical homeostatic functions vital for brain health. These include delivering O and nutrients through blood flow and regulating immune trafficking, as well as clearing pathogenic proteins through perivascular spaces and dural lymphatics. Single-cell omics technologies have unveiled an unprecedented molecular heterogeneity in the cellular components of the neurovasculome and have identified novel reciprocal interactions with brain cells. The evidence suggests a previously unappreciated diversity of the pathogenic mechanisms by which disruption of the neurovasculome contributes to cognitive dysfunction in neurovascular and neurodegenerative diseases, providing new opportunities for the prevention, recognition, and treatment of these conditions.
These advances shed new light on the symbiotic relationship between the brain and its vessels and promise to provide new diagnostic and therapeutic approaches for brain disorders associated with cognitive dysfunction.
保护大脑健康已成为老龄化世界人口的主要公共卫生重点。神经血管生物学的进步揭示了脑细胞、脑膜以及血液和淋巴血管（神经脉管系统）之间错综复杂的关系，这与认知功能的维持密切相关。在这项科学声明中，一个多学科专家小组检查了这些进展，评估了它们与大脑健康和疾病的相关性，确定了知识空白，并提供了未来的方向。
根据美国心脏协会的利益冲突管理政策，选择了具有相关专业知识的作者。他们被分配到与其专业领域相关的主题，审查文献并总结现有数据。
神经脉管系统由颅外、颅内和脑膜血管以及淋巴管和相关细胞组成，它具有支持大脑健康的关键稳态功能。这些功能包括通过血流输送 O 和营养物质，调节免疫贩运，以及通过血管周围间隙和硬脑膜淋巴管清除致病蛋白。单细胞组学技术揭示了神经脉管系统细胞成分前所未有的分子异质性，并确定了与脑细胞的新的相互作用。证据表明，神经脉管系统的破坏导致神经血管和神经退行性疾病中的认知功能障碍的致病机制具有以前未被认识到的多样性，为这些疾病的预防、识别和治疗提供了新的机会。
这些进展揭示了大脑与其血管之间的共生关系，并有望为与认知功能障碍相关的大脑疾病提供新的诊断和治疗方法。
