中国神经再生研究(英文版) ›› 2024, Vol. 19 ›› Issue (6): 1233-1240.doi: 10.4103/1673-5374.385864

• 综述:脑损伤修复保护与再生 • 上一篇    下一篇

脑小血管病的血脑屏障病理学

  

  • 出版日期:2024-06-15 发布日期:2023-11-17

Blood-brain barrier pathology in cerebral small vessel disease

Ruxue Jia#, Gemma Solé-Guardia#, Amanda J. Kiliaan*   

  1. Department of Medical Imaging, Anatomy, Radboud University Medical Center, Donders Institute for Brain, Cognition & Behavior, Center for Medical Neuroscience, Preclinical Imaging Center PRIME, Radboud Alzheimer Center, Nijmegen, the Netherlands
  • Online:2024-06-15 Published:2023-11-17
  • Contact: Amanda J. Kiliaan, PhD, Amanda.Kiliaan@radboudumc.nl.
  • Supported by:
    This work was supported by China Scholarship Council (202208210093, to RJ).

摘要: https://orcid.org/0000-0002-2158-6210 (Amanda J. Kiliaan)

Abstract: Cerebral small vessel disease is a neurological disease that affects the brain microvasculature and which is commonly observed among the elderly. Although at first it was considered innocuous, small vessel disease is nowadays regarded as one of the major vascular causes of dementia. Radiological signs of small vessel disease include small subcortical infarcts, white matter magnetic resonance imaging hyperintensities, lacunes, enlarged perivascular spaces, cerebral microbleeds, and brain atrophy; however, great heterogeneity in clinical symptoms is observed in small vessel disease patients. The pathophysiology of these lesions has been linked to multiple processes, such as hypoperfusion, defective cerebrovascular reactivity, and blood-brain barrier dysfunction. Notably, studies on small vessel disease suggest that blood-brain barrier dysfunction is among the earliest mechanisms in small vessel disease and might contribute to the development of the hallmarks of small vessel disease. Therefore, the purpose of this review is to provide a new foundation in the study of small vessel disease pathology. First, we discuss the main structural domains and functions of the blood-brain barrier. Secondly, we review the most recent evidence on blood-brain barrier dysfunction linked to small vessel disease. Finally, we conclude with a discussion on future perspectives and propose potential treatment targets and interventions.

Key words: blood-brain barrier dysfunction, cerebral blood flow, cerebral hypoperfusion, endothelial dysfunction, hypertension, inflammation, magnetic resonance imaging, neurovascular unit, oxidative stress, small vessel disease, tight junctions, transcytosis