NEUROVASCULAR UNIT DYSFUNCTION IN NEUROLOGICAL DISORDERS: MECHANISMS AND THERAPIES
Keywords:
Neurovascular unit, Blood–brain barrier, Neurovascular coupling, Cerebral microcirculation, Neuroinflammation, Pericytes, Neurodegeneration.Abstract
The neurovascular unit (NVU) is a specialized multicellular system composed of brain endothelial cells, pericytes, vascular smooth muscle cells, astrocytes, neurons, microglia, and extracellular matrix. It maintains blood–brain barrier (BBB) integrity, regulates cerebral blood flow, supports neuronal metabolism, and contributes to clearance of metabolic waste. Increasing evidence indicates that NVU dysfunction is not simply a consequence of neurological disease but may represent an early mechanism contributing to disease progression. Endothelial dysfunction, pericyte loss, impaired neurovascular coupling, astrocytic dysfunction, neuroinflammation, and extracellular matrix degradation can lead to BBB disruption, cerebral hypoperfusion, and neuronal injury. These mechanisms are implicated in ischemic stroke, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, cerebral small-vessel disease, traumatic brain injury, epilepsy, and brain tumors. This review summarizes the major structural and physiological features of the NVU, the mechanisms underlying its dysfunction, its role in neurological disorders, and emerging therapeutic approaches aimed at restoring neurovascular integrity.
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