Institute of Translational Medicine, Yangzhou University Medical College, Yangzhou 225009, Jiangsu Province, China.
Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou 225009, Jiangsu Province, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2023 Oct 25;52(5):662-672. doi: 10.3724/zdxbyxb-2023-0144.
A complex pathophysiological mechanism is involved in brain injury following cerebral infarction. The neurovascular unit (NVU) is a complex multi-cellular structure consisting of neurons, endothelial cells, pericyte, astrocyte, microglia and extracellular matrix, etc. The dyshomeostasis of NVU directly participates in the regulation of inflammatory immune process. The components of NVU promote inflammatory overreaction and synergize with the overactivation of autonomic nervous system to initiate stroke-induced immunodepression (SIID). SIID can alleviate the damage caused by inflammation, however, it also makes stroke patients more susceptible to infection, leading to systemic damage. This article reviews the mechanism of SIID and the roles of NVU in SIID, to provide a perspective for reperfusion, prognosis and immunomodulatory therapy of cerebral infarction.
脑梗死后脑损伤涉及复杂的病理生理机制。神经血管单元(NVU)是一个由神经元、内皮细胞、周细胞、星形胶质细胞、小胶质细胞和细胞外基质等组成的复杂多细胞结构。NVU 的稳态失衡直接参与炎症免疫过程的调节。NVU 的组成部分促进炎症的过度反应,并与自主神经系统的过度激活协同作用,引发卒中诱导的免疫抑制(SIID)。SIID 可以减轻炎症引起的损伤,但也使卒中患者更容易感染,导致全身损伤。本文综述了 SIID 的机制和 NVU 在 SIID 中的作用,为脑梗死再灌注、预后和免疫调节治疗提供了新视角。