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Therapeutic Opportunities and Delivery Strategies for Brain Revascularization in Stroke, Neurodegeneration, and Aging
Pharmacological Reviews ( IF 19.3 ) Pub Date : 2022-03-17
Gallego, I., Villate-Beitia, I., Saenz-del-Burgo, L., Puras, G., Pedraz, J. L.

Central nervous system (CNS) diseases, especially acute ischemic events and neurodegenerative disorders, constitute a public health problem with no effective treatments to allow a persistent solution. Failed therapies targeting neuronal recovery have revealed the multifactorial and intricate pathophysiology underlying such CNS disorders as ischemic stroke, Alzheimeŕs disease, amyotrophic lateral sclerosis, vascular Parkisonism, vascular dementia, and aging, in which cerebral microvasculature impairment seems to play a key role. In fact, a reduction in vessel density and cerebral blood flow occurs in these scenarios, contributing to neuronal dysfunction and leading to loss of cognitive function. In this review, we provide an overview of healthy brain microvasculature structure and function in health and the effect of the aforementioned cerebral CNS diseases. We discuss the emerging new therapeutic opportunities, and their delivery approaches, aimed at recovering brain vascularization in this context.

Significance Statement

The lack of effective treatments, mainly focused on neuron recovery, has prompted the search of other therapies to treat cerebral central nervous system diseases. The disruption and degeneration of cerebral microvasculature has been evidenced in neurodegenerative diseases, stroke, and aging, constituting a potential target for restoring vascularization, neuronal functioning, and cognitive capacities by the development of therapeutic pro-angiogenic strategies.



中文翻译:

中风、神经退行性变和衰老中脑血管重建的治疗机会和实施策略

中枢神经系统 (CNS) 疾病,尤其是急性缺血性事件和神经退行性疾病,构成了一个公共卫生问题,没有有效的治疗方法可以得到持久的解决方案。针对神经元恢复的失败疗法揭示了缺血性中风、阿尔茨海默病、肌萎缩性侧索硬化症、血管性帕克森症、血管性痴呆和衰老等中枢神经系统疾病背后的多因素和复杂的病理生理学,其中脑微血管损伤似乎起着关键作用。事实上,在这些情况下,血管密度和脑血流量会降低,导致神经元功能障碍并导致认知功能丧失。在本次审查中,我们概述了健康的大脑微血管结构和健康功能以及上述脑中枢神经系统疾病的影响。我们讨论了新兴的新治疗机会及其交付方法,旨在在这种情况下恢复脑血管化。

意义声明

缺乏有效的治疗方法,主要集中在神经元的恢复上,促使人们寻找其他疗法来治疗脑中枢神经系统疾病。脑微血管系统的破坏和退化已在神经退行性疾病、中风和衰老中得到证实,这构成了通过开发治疗性促血管生成策略来恢复血管形成、神经元功能和认知能力的潜在目标。

更新日期:2022-03-17
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