Therapeutic strategy against ischemic stroke with the concept of neurovascular unit

Neurochem Int. 2019 Jun:126:246-251. doi: 10.1016/j.neuint.2019.03.022. Epub 2019 Apr 1.

Abstract

Stroke is one of the leading causes of death and disability globally. Although thrombolytic therapy by t-PA and mechanical thrombectomy have improved outcomes of ischemic stroke patients, both of these approaches are applicable to limited numbers of patients owing to their time constraints. Therefore, development of other treatment approaches such as developing neuroprotective drugs and nerve regeneration therapy is required to overcome ischemic stroke. The concept of the neurovascular unit (NVU) was formalized by the Stroke Progress Review Group of the National Institute of Neurological Disorders and Stroke in 2001. This concept emphasizes the importance not just of neurons but of the interactions between neurons, endothelial cells, astroglia, microglia and associated tissue matrix proteins to investigate the pathological condition of ischemic stroke. Many reports have been published about these interactions. This review focuses on the roles of cells that surround cerebral vasculature, especially endothelial cells, and reports therapeutic strategies against ischemic stroke from four points of view including angiogenesis, neurotrophic effects, protection of NVU components and regenerative therapy.

Keywords: Ischemic stroke; Neuron; Neurovascular unit; Vascular endothelial cell.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Blood-Brain Barrier / drug effects
  • Blood-Brain Barrier / metabolism*
  • Brain / drug effects
  • Brain / metabolism*
  • Brain Ischemia / metabolism*
  • Brain Ischemia / therapy
  • Humans
  • Neovascularization, Pathologic / metabolism
  • Neovascularization, Pathologic / therapy
  • Nerve Growth Factors / metabolism
  • Nerve Growth Factors / therapeutic use
  • Neuroprotective Agents / administration & dosage*
  • Stroke / metabolism*
  • Stroke / therapy

Substances

  • Nerve Growth Factors
  • Neuroprotective Agents