Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, the Netherlands.
Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, the Netherlands; Neuro-immune connect and repair lab, Biomedical Research Institute, Hasselt University, Hasselt 3500, Belgium.
Pharmacol Res. 2023 Nov;197:106970. doi: 10.1016/j.phrs.2023.106970. Epub 2023 Oct 24.
Vascular cognitive impairment (VCI) describes neurodegenerative disorders characterized by a vascular component. Pathologically, it involves decreased cerebral blood flow (CBF), white matter lesions, endothelial dysfunction, and blood-brain barrier (BBB) impairments. Molecularly, oxidative stress and inflammation are two of the major underlying mechanisms. Nitric oxide (NO) physiologically stimulates soluble guanylate cyclase (sGC) to induce cGMP production. However, under pathological conditions, NO seems to be at the basis of oxidative stress and inflammation, leading to a decrease in sGC activity and expression. The native form of sGC needs a ferrous heme group bound in order to be sensitive to NO (Fe(II)sGC). Oxidation of sGC leads to the conversion of ferrous to ferric heme (Fe(III)sGC) and even heme-loss (apo-sGC). Both Fe(III)sGC and apo-sGC are insensitive to NO, and the enzyme is therefore inactive. sGC activity can be enhanced either by targeting the NO-sensitive native sGC (Fe(II)sGC), or the inactive, oxidized sGC (Fe(III)sGC) and the heme-free apo-sGC. For this purpose, sGC stimulators acting on Fe(II)sGC and sGC activators acting on Fe(III)sGC/apo-sGC have been developed. These sGC agonists have shown their efficacy in cardiovascular diseases by restoring the physiological and protective functions of the NO-sGC-cGMP pathway, including the reduction of oxidative stress and inflammation, and improvement of vascular functioning. Yet, only very little research has been performed within the cerebrovascular system and VCI pathology when focusing on sGC modulation and its potential protective mechanisms on vascular and neural function. Therefore, within this review, the potential of sGC as a target for treating VCI is highlighted.
血管性认知障碍(VCI)描述了一种具有血管成分的神经退行性疾病。从病理学角度来看,它涉及脑血流(CBF)减少、白质病变、内皮功能障碍和血脑屏障(BBB)损伤。从分子角度来看,氧化应激和炎症是两个主要的潜在机制。一氧化氮(NO)在生理上刺激可溶性鸟苷酸环化酶(sGC)诱导 cGMP 产生。然而,在病理条件下,NO 似乎是氧化应激和炎症的基础,导致 sGC 活性和表达降低。sGC 的天然形式需要结合亚铁血红素基团才能对 NO 敏感(Fe(II)sGC)。sGC 的氧化导致亚铁血红素转化为三价铁血红素(Fe(III)sGC),甚至血红素丢失(apo-sGC)。Fe(III)sGC 和 apo-sGC 均对 NO 不敏感,因此酶失活。sGC 活性可以通过靶向对 NO 敏感的天然 sGC(Fe(II)sGC)或无活性的氧化 sGC(Fe(III)sGC)和无血红素的 apo-sGC 来增强。为此,已经开发了作用于 Fe(II)sGC 的 sGC 激动剂和作用于 Fe(III)sGC/apo-sGC 的 sGC 激活剂。这些 sGC 激动剂通过恢复 NO-sGC-cGMP 通路的生理和保护功能,包括减少氧化应激和炎症,改善血管功能,在心血管疾病中显示出了其疗效。然而,当聚焦于 sGC 调节及其对血管和神经功能的潜在保护机制时,在脑血管系统和 VCI 病理学方面的研究非常少。因此,在这篇综述中,强调了 sGC 作为治疗 VCI 的靶点的潜力。
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