The Ever-Evolving Concept of the Neurovascular Unit

Alkayed, Nabil J.; Cipolla, Marilyn J.

doi:10.1161/strokeaha.123.042705

Cited by 7 publications

(3 citation statements)

References 22 publications

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“…The NVU and the NVU coupling are now well accepted and have received great interest in the field of neurobiology. Its cells are comprised of BECs, Pcs, perivascular astrocyte endfeet (pvACef cells), vascular smooth muscle cells in arterioles and arterial microvessels, and interrogating microglia with the pvACef cells being connected to regional neurons to allow for NVU coupling in order to increase oxygen and nutrients to match neuronal excitement demand [4,[45][46][47][48]. Incidentally, the PVU cells are the same as the NVU except for the presence of the phagocytic and antigen presenting resident perivascular macrophage (rPVMΦ) cells in health and disease [7,49].…”

Section: The True Capillary Of the Nvu Deliverers Its Peripheral Bloo...mentioning

confidence: 99%

A Closer Look at the Perivascular Unit in the Development of Enlarged Perivascular Spaces in Obesity, Metabolic Syndrome, and Type 2 Diabetes Mellitus

Hayden

2024

Biomedicines

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The recently described perivascular unit (PVU) resides immediately adjacent to the true capillary neurovascular unit (NVU) in the postcapillary venule and contains the normal-benign perivascular spaces (PVS) and pathological enlarged perivascular spaces (EPVS). The PVS are important in that they have recently been identified to be the construct and the conduit responsible for the delivery of metabolic waste from the interstitial fluid to the ventricular cerebrospinal fluid for disposal into the systemic circulation, termed the glymphatic system. Importantly, the outermost boundary of the PVS is lined by protoplasmic perivascular astrocyte endfeet (pvACef) that communicate with regional neurons. As compared to the well-recognized and described neurovascular unit (NVU) and NVU coupling, the PVU is less well understood and remains an emerging concept. The primary focus of this narrative review is to compare the similarities and differences between these two units and discuss each of their structural and functional relationships and how they relate not only to brain homeostasis but also how they may relate to the development of multiple clinical neurological disease states and specifically how they may relate to obesity, metabolic syndrome, and type 2 diabetes mellitus. Additionally, the concept and importance of a perisynaptic astrocyte coupling to the neuronal synapses with pre- and postsynaptic neurons will also be considered as a perisynaptic unit to provide for the creation of the information transfer in the brain via synaptic transmission and brain homeostasis. Multiple electron microscopic images and illustrations will be utilized in order to help explain these complex units.

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Section: The True Capillary Of the Nvu Deliverers Its Peripheral Bloo...mentioning

confidence: 99%

A Closer Look at the Perivascular Unit in the Development of Enlarged Perivascular Spaces in Obesity, Metabolic Syndrome, and Type 2 Diabetes Mellitus

Hayden

2024

Biomedicines

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“…22 In addition, recent studies suggested that cSVD is a dynamic process that affects the whole brain, beginning at the cellular level that involves the components of neurovascular units, including endothelial cells, pericytes, vascular smooth muscle cells, glia, neurons, immune cells, and extracellular matrix. 23,24 These units regulate cerebral blood flow, endothelial function, BBB integrity, and neuroinflammation. 5,23,25 Endothelial dysfunction, astrocytopathy, and BBB leakage may occur when components of neurovascular units are diseased or damaged due to aging, vascular risk factors (eg, hypertension, hyperlipidemia, hyperhomocysteinemia, diabetes, smoking), 26,27 increase in pulsatile flow being transmitted to the cerebral small vessels secondary to aortic stiffness, 28 and genetic factors.…”

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confidence: 99%

“…23,24 These units regulate cerebral blood flow, endothelial function, BBB integrity, and neuroinflammation. 5,23,25 Endothelial dysfunction, astrocytopathy, and BBB leakage may occur when components of neurovascular units are diseased or damaged due to aging, vascular risk factors (eg, hypertension, hyperlipidemia, hyperhomocysteinemia, diabetes, smoking), 26,27 increase in pulsatile flow being transmitted to the cerebral small vessels secondary to aortic stiffness, 28 and genetic factors. 5,24,29,30 These pathological changes may lead to compromised cerebral…”

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confidence: 99%

Current and Future Treatments of Vascular Cognitive Impairment

Ip,

Ko,

Lam

et al. 2024

Stroke

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Nonamyloid sporadic cSVD is considered the most prevalent cause or pathological substrate of VCI. 20,21 It refers to diseased microscopic perforating cerebral arterioles, capillaries, and venules giving rise to abnormalities in the cerebral white and deep gray matter. 5 Driven by arteriosclerosis and fibrinoid necrosis, the arteriolar wall can be stenosed, occluded, dilated, or ruptured, which may result in lacunar infarcts or deep microparenchymal/macroparenchymal hemorrhages. 22 In addition, recent studies suggested that cSVD is a dynamic process that affects the whole brain, beginning at the cellular level that involves the components of neurovascular units, including endothelial cells, pericytes, vascular smooth muscle cells, glia, neurons, immune cells, and extracellular matrix. 23,24 These units regulate cerebral blood flow, endothelial function, BBB integrity, and neuroinflammation. 5,23,25 Endothelial dysfunction, astrocytopathy, and BBB leakage may occur when components of neurovascular units are diseased or damaged due to aging, vascular risk factors (eg, hypertension, hyperlipidemia, hyperhomocysteinemia, diabetes, smoking), 26,27 increase in pulsatile flow being transmitted to the cerebral small vessels secondary to aortic stiffness, 28 and genetic factors. 5,24,29,30 These pathological changes may lead to compromised cerebral

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