脑小血管疾病中神经炎症和内皮功能障碍之间的相互作用
The interplay between neuroinflammation and endothelial dysfunction in cerebral small vessel disease.
摘要(中文译文)
脑小血管病（CSVD）是缺血性卒中和血管性认知障碍的主要原因。尽管其神经影像学特征已较为明确且临床负担沉重，但CSVD的潜在病理机制仍知之甚少，有效干预手段也仍然缺乏。现有的人类和实验证据提示，内皮功能障碍与神经炎症密切相关，并可能在多种CSVD相关情境中形成相互强化的过程。本综述将现有证据整合为一个工作框架，即血管危险因素促进内皮表型转换和血脑屏障（BBB）功能障碍，从而促进神经炎症激活。神经血管单元内的周细胞、星形胶质细胞和小胶质细胞随后可通过情境依赖性的反馈相互作用（包括基质金属蛋白酶介导的蛋白水解）放大屏障损伤和炎症信号传导。反过来，慢性炎症环境可能维持持续的内皮功能障碍或改变内皮对后续炎症刺激的反应性，从而可能使病理过程在原始触发因素减弱后仍继续存在。基于这一证据指导的框架，我们还评估了针对内皮功能障碍-神经炎症网络不同节点的治疗策略。
Abstract
Cerebral small vessel disease (CSVD) is a leading cause of ischemic stroke and vascular cognitive impairment. Despite well-defined neuroimaging features and a substantial clinical burden, the underlying pathological mechanisms of CSVD remain poorly understood, and effective interventions are still lacking. Current human and experimental evidence suggest that endothelial dysfunction and neuroinflammation are closely coupled and may form a mutually reinforcing process in many CSVD-relevant settings. This review synthesizes available evidence into a working framework in which vascular risk factors promote endothelial phenotypic switching and blood-brain barrier (BBB) dysfunction, thereby facilitating neuroinflammatory activation. Pericytes, astrocytes, and microglia within the neurovascular unit can then amplify barrier injury and inflammatory signaling through context-dependent feedback interactions, including matrix metalloproteinase-mediated proteolysis. In turn, the chronic inflammatory milieu may sustain persistent endothelial dysfunction or alter endothelial responsiveness to subsequent inflammatory stimuli, potentially allowing pathological processes to continue even after the original triggers are attenuated. Based on this evidence-guided framework, we also evaluate therapeutic strategies directed at distinct nodes of the endothelial dysfunction-neuroinflammation network.
如何引用
AMA
Cong Jin, Yang Zhao. The interplay between neuroinflammation and endothelial dysfunction in cerebral small vessel disease.. Frontiers in immunology. 2026; doi:10.3389/fimmu.2026.1809556.
APA
Cong Jin, Yang Zhao (2026). The interplay between neuroinflammation and endothelial dysfunction in cerebral small vessel disease.. Frontiers in immunology. https://doi.org/10.3389/fimmu.2026.1809556
GB/T 7714
Cong Jin, Yang Zhao. The interplay between neuroinflammation and endothelial dysfunction in cerebral small vessel disease.[J]. Frontiers in immunology, 2026 doi:10.3389/fimmu.2026.1809556.
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