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Targeting the Neurovascular Unit: Therapeutic Potential of Traditional Chinese Medicine for the Treatment of Stroke

Overview
Journal Heliyon
Specialty Social Sciences
Date 2024 Oct 10
PMID 39386825
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Abstract

Stroke poses a significant global health challenge due to its elevated disability and mortality rates, particularly affecting developing nations like China. The neurovascular unit (NVU), a new concept encompassing neurons, brain microvascular endothelial cells, pericytes, astrocytes, microglia, and the extracellular matrix, has gained prominence in recent years. Traditional Chinese medicine (TCM), deeply rooted in Chinese history, employs a combination of acupuncture and herbal treatments, demonstrating significant efficacy across all stages of stroke, notably during recovery. The holistic approach of TCM aligns with the NVU's comprehensive view of treating stroke by addressing neurons, surrounding cells, and blood vessels collectively. This review examines the role of NVU in stroke and endeavors to elucidate the mechanisms through which traditional Chinese medicine exerts its anti-stroke effects within the NVU framework. The NVU contributes to neuroinflammation, immune infiltration, blood-brain barrier permeability, oxidative stress, and Ca overload during stroke occurs. Additionally, TCM targeting the NVU facilitates nerve repair post-stroke through various pathways and approaches. Specific herbs, including , , and , alleviate brain injury by enhancing brain-derived neurotrophic factor expression and targeting astrocytes and microglia to yield anti-inflammatory and antioxidant effects. Acupuncture, another facet of TCM, promotes brain injury repair by augmenting cerebral blood flow and improving circulation. This exploration aims to assess the viability of stroke treatment by directing TCM interventions toward the NVU, thus paving the way for its broader clinical application.

References
1.
Guo H, Yang J, Liu M, Wang L, Hou W, Zhang L . Selective activation of estrogen receptor β alleviates cerebral ischemia neuroinflammatory injury. Brain Res. 2019; 1726:146536. DOI: 10.1016/j.brainres.2019.146536. View

2.
Li W, Cao F, Takase H, Arai K, Lo E, Lok J . Blood-Brain Barrier Mechanisms in Stroke and Trauma. Handb Exp Pharmacol. 2021; 273():267-293. DOI: 10.1007/164_2020_426. View

3.
Zhuo Y, Xu M, Deng S, Zhang Y, Lu X, Wu B . Efficacy and safety of dissimilar acupuncture intervention time-points in treating stroke: a systematic review and network meta-analysis. Ann Palliat Med. 2021; 10(10):10196-10212. DOI: 10.21037/apm-21-1127. View

4.
Kugler E, Greenwood J, MacDonald R . The "Neuro-Glial-Vascular" Unit: The Role of Glia in Neurovascular Unit Formation and Dysfunction. Front Cell Dev Biol. 2021; 9:732820. PMC: 8502923. DOI: 10.3389/fcell.2021.732820. View

5.
Yemisci M, Gursoy-Ozdemir Y, Vural A, Can A, Topalkara K, Dalkara T . Pericyte contraction induced by oxidative-nitrative stress impairs capillary reflow despite successful opening of an occluded cerebral artery. Nat Med. 2009; 15(9):1031-7. DOI: 10.1038/nm.2022. View