Qiu Yuemin, Cheng Lin, Xiong Yinyi, Liu Ziying, Shen Chunxiao, Wang Liangliang, Lu Yujia, Wei Shufei, Zhang Lushun, Yang Seung Bum, Zhang Xiaorong
Department of Pathology, Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi, China.
Department of Pathology, Jiujiang Clinical Precision Medicine Research Center, Jiujiang, Jiangxi, China.
CNS Neurosci Ther. 2025 Feb;31(2):e70224. doi: 10.1111/cns.70224.
Vascular dementia (VaD) includes a group of brain disorders that are characterized by cerebrovascular pathology.Neuroinflammation, disruption of the blood-brain barrier (BBB) permeability, white matter lesions, and neuronal loss are all significant pathological manifestations of VaD and play a key role in disease progression. Necroptosis, also known asprogrammed necrosis, is a mode of programmed cell death distinct from apoptosis and is closely associated with ischemic injury and neurodegenerative diseases. Recent studies have shown that necroptosis in VaD exacerbates BBB destruction, activates neuroinflammation, promotes neuronal loss, and severely affects VaD prognosis.
In this review, we outline the significant roles of necroptosis and its molecular mechanisms in the pathological process of VaD, with a particular focus on the role of necroptosis in modulating neuroinflammation and exacerbating the disruption of BBB permeability in VaD, and elaborate on the molecular regulatory mechanisms and the centrally involved cells of necroptosis mediated by tumor necrosis factor-α in neuroinflammation in VaD. We also analyze the possibility and specific strategy that targeting necroptosis would help inhibit neuroinflammation and BBB destruction in VaD. With a focus on necroptosis, this study delved into its impact on the pathological changes and prognosis of VaD to provide new treatment ideas.
血管性痴呆(VaD)包括一组以脑血管病理改变为特征的脑部疾病。神经炎症、血脑屏障(BBB)通透性破坏、白质病变和神经元丢失都是VaD的重要病理表现,并在疾病进展中起关键作用。坏死性凋亡,也称为程序性坏死,是一种不同于凋亡的程序性细胞死亡方式,与缺血性损伤和神经退行性疾病密切相关。最近的研究表明,VaD中的坏死性凋亡会加剧血脑屏障破坏,激活神经炎症,促进神经元丢失,并严重影响VaD的预后。
在本综述中,我们概述了坏死性凋亡及其分子机制在VaD病理过程中的重要作用,特别关注坏死性凋亡在调节神经炎症和加剧VaD中血脑屏障通透性破坏方面的作用,并阐述了肿瘤坏死因子-α介导的坏死性凋亡在VaD神经炎症中的分子调控机制和核心参与细胞。我们还分析了靶向坏死性凋亡有助于抑制VaD中的神经炎症和血脑屏障破坏的可能性及具体策略。本研究聚焦于坏死性凋亡,深入探讨了其对VaD病理变化和预后的影响,以提供新的治疗思路。