“Small Blood Vessels: Big Health Problems?”: Scientific Recommendations of the National Institutes of Health Workshop

Bosetti, Francesca; Galis, Zorina S.; Bynoe, Margaret S.; Charette, Marc; Cipolla, Marilyn J.; Zoppo, Gregory J. del; Gould, Douglas B.; Hatsukami, Thomas S.; Jones, Teresa L.Z.; Koenig, James I.; Lutty, Gerard A.; Maric‐Bilkan, Christine; Stevens, Troy; Tolunay, Hatice; Koroshetz, Walter J.

doi:10.1161/jaha.116.004389

Cited by 76 publications

(48 citation statements)

References 73 publications

(127 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Dysfunction of endothelial and/or pericyte cells and associated disruption of the blood–brain barrier lead to leakage and impaired local regulation of flow. Various combinations of these processes are thought to be compromised in a range of diseases . The term ‘small vessel disease’ has been proposed as a common microvasculopathy manifesting in heart (leading to ischaemic heart disease), brain (leading to stroke and dementia), retina and kidneys …”

Section: Microvasculature As a Window To Systemic And Central Nervousmentioning

confidence: 99%

“…The ultimate goal is for quick, broadly applicable, non‐invasive, high spatiotemporal resolution observation of retinal vasculature structure and function to robustly determine an individual's vascular health in its natural state . Adaptive optics extends the vessels that can be imaged to the finest capillary networks.…”

Section: Future Directionsmentioning

confidence: 99%

“…As technology has improved and enabled the microvasculature to be assessed in human disease, small vessels have indeed been observed to affect and be affected by pathological processes early in diverse conditions including diabetes, hypertension, coronary heart disease, cerebral ischaemia-reperfusion injury, stroke or brain haemorrhages, dementia, demyelinating disease, and sepsis. 7,8 The most well-understood example is diabetic vasculopathy which begins with loss of pericytes, thickening of the endothelial basement membrane 9 and eventual development of microaneurysms. Dysfunction of endothelial and/or pericyte cells and associated disruption of the blood-brain barrier lead to leakage and impaired local regulation of flow.…”

Section: Microvasculature As a Window To Systemic And Central Nervousmentioning

confidence: 99%

See 2 more Smart Citations

Adaptive optics imaging of the retinal microvasculature

Bedggood

Metha

2020

Clinical and Experimental Optometry

View full text Add to dashboard Cite

The eye has long been recognised as the window to pathological processes occurring in the brain and other organs. By imaging the vasculature of the retina we have improved the scientific understanding and clinical best practice for a diverse range of conditions, ranging from diabetes, to stroke, to dementia. Mounting evidence suggests that damage to the smallest and most delicate vessels in the body, the capillaries, is the first sign in many vasculopathies. These are the most critical vessels involved in the exchange of metabolites with tissue. Accurate assessment of retinal capillary structure and function would therefore be of great benefit across a broad range of disciplines in medical science; however, their small size does not make this an easy task. This has led to the development of high‐resolution adaptive optics imaging methods to non‐invasively explore retinal microvascular networks in living human eyes. This review describes the present state of the art in the field, the scientific breakthroughs that have been made possible in the understanding of vessel structure and function in health and disease, and future directions for this emerging technology.

show abstract

Section: Microvasculature As a Window To Systemic And Central Nervousmentioning

confidence: 99%

Section: Future Directionsmentioning

confidence: 99%

Section: Microvasculature As a Window To Systemic And Central Nervousmentioning

confidence: 99%

See 1 more Smart Citation

Adaptive optics imaging of the retinal microvasculature

Bedggood

Metha

2020

Clinical and Experimental Optometry

View full text Add to dashboard Cite

show abstract

“…Besides the discussion and on-going debate related to appropriateness of choice and dosing of anti-oxidants used in cardiovascular clinical trials, there are many potential reasons why the redox stress theory in human hypertension has not yet been proven. Among these is the paucity of sensitive and specific methods in the clinical setting to accurately quantify RONS concentrations, to evaluate oxidative/reductive stress and to measure oxidative modification of proteins (7). There is a relative lack of understanding of fundamental mechanisms that regulate Nox activity and RONS generation in the human cardiovascular system with challenges in studying human tissue in a disease-specific manner.…”

Section: Oxidative Stress and Small Artery Disease In Human Hypertensmentioning

confidence: 99%

“…To advance research in this area, a NIH white paper emphasised the importance of a greater understanding of specific phenotypes of small vessels in pathophysiological conditions including hypertension, with the goal of transforming diagnostic and therapeutic strategies to improve vascular health (7). …”

mentioning

confidence: 99%

Redox Stress Defines the Small Artery Vasculopathy of Hypertension

Touyz

Montezano

Widlansky

et al. 2017

Circulation Research

View full text Add to dashboard Cite

While convincing experimental evidence demonstrates the importance of vascular reactive oxygen and nitrogen species (RONS), oxidative stress and perturbed redox signaling as causative processes in the vasculopathy of hypertension, this has not translated to the clinic. We discuss this bench-to-bedside disparity and the urgency to progress vascular redox pathobiology from experimental models to patients by studying disease-relevant human tissues. It is only through such approaches that the unambiguous role of vascular redox stress will be defined so that mechanism-based therapies in a personalized and precise manner can be developed to prevent, slow or reverse progression of small vessel disorders and consequent hypertension.

show abstract

Retinal imaging demonstrates reduced capillary density in clinically unimpaired APOE ε4 gene carriers

Elahi

Ashimatey

Bennett

et al. 2021

Alz & Dem Diag Ass & Dis Mo

View full text Add to dashboard Cite

Introduction Apolipoprotein E ( APOE ) ε4, the strongest non‐Mendelian genetic risk factor for Alzheimer's disease (AD), has been shown to affect brain capillaries in mice, with potential implications for AD‐related neurodegenerative disease. However, human brain capillaries cannot be directly visualized in vivo. We therefore used retinal imaging to test APOE ε4 effects on human central nervous system capillaries. Methods We collected retinal optical coherence tomography angiography, cognitive testing, and brain imaging in research participants and built statistical models to test genotype–phenotype associations. Results Our analyses demonstrate lower retinal capillary densities in early disease, in cognitively normal APOE ε4 gene carriers. Furthermore, through regression modeling with a measure of brain perfusion (arterial spin labeling), we provide support for the relevance of these findings to cerebral vasculature. Discussion These results suggest that APOE ε4 affects capillary health in humans and that retinal capillary measures could serve as surrogates for brain capillaries, providing an opportunity to study microangiopathic contributions to neurodegenerative disorders directly in humans.

show abstract

“Small Blood Vessels: Big Health Problems?”: Scientific Recommendations of the National Institutes of Health Workshop

Cited by 76 publications

References 73 publications

Adaptive optics imaging of the retinal microvasculature

Adaptive optics imaging of the retinal microvasculature

Redox Stress Defines the Small Artery Vasculopathy of Hypertension

Retinal imaging demonstrates reduced capillary density in clinically unimpaired APOE ε4 gene carriers

Contact Info

Product

Resources

About