Iadecola Costantino, Anrather Josef
Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY 10065, USA.
Immunity. 2025 Jan 14;58(1):18-39. doi: 10.1016/j.immuni.2024.12.008.
Ischemic stroke and vascular cognitive impairment, caused by a sudden arterial occlusion or more subtle but protracted vascular insufficiency, respectively, are leading causes of morbidity and mortality worldwide with limited therapeutic options. Innate and adaptive immunity have long been implicated in neurovascular injury, but recent advances in methodology and new experimental approaches have shed new light on their contributions. A previously unappreciated dynamic interplay of brain-resident, meningeal, and systemic immune cells with the ischemic brain and its vasculature has emerged, and new insights into the frequent overlap between vascular and Alzheimer pathology have been provided. Here, we critically review these recent findings, place them in the context of current concepts on neurovascular pathologies and Alzheimer's disease, and highlight their impact on recent stroke and Alzheimer therapies.
缺血性中风和血管性认知障碍分别由突然的动脉闭塞或更隐匿但持久的血管供血不足引起,是全球发病率和死亡率的主要原因,治疗选择有限。固有免疫和适应性免疫长期以来一直被认为与神经血管损伤有关,但方法学的最新进展和新的实验方法为它们的作用提供了新的线索。一种以前未被重视的脑内、脑膜和全身免疫细胞与缺血性脑及其血管系统之间的动态相互作用已经出现,并且对血管病理学和阿尔茨海默病病理学之间频繁重叠有了新的认识。在这里,我们批判性地回顾这些最新发现,将它们置于当前关于神经血管病理学和阿尔茨海默病概念的背景下,并强调它们对近期中风和阿尔茨海默病治疗的影响。