The blood-brain barrier and the neurovascular unit in subarachnoid hemorrhage: molecular events and potential treatments

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Authors

SOLÁR Peter ZAMANI Alemeh LAKATOSOVÁ Klaudia JOUKAL Marek

Year of publication 2022
Type Article in Periodical
Magazine / Source FLUIDS AND BARRIERS OF THE CNS
MU Faculty or unit

Faculty of Medicine

Citation
Web http://dx.doi.org/10.1186/s12987-022-00312-4
Doi http://dx.doi.org/10.1186/s12987-022-00312-4
Keywords Subarachnoid hemorrhage; Blood-brain barrier; Subarachnoid hemorrhage treatment; Neuronal injury; Neurovascular unit; Neuroinflammation
Description The response of the blood-brain barrier (BBB) following a stroke, including subarachnoid hemorrhage (SAH), has been studied extensively. The main components of this reaction are endothelial cells, pericytes, and astrocytes that affect microglia, neurons, and vascular smooth muscle cells. SAH induces alterations in individual BBB cells, leading to brain homeostasis disruption. Recent experiments have uncovered many pathophysiological cascades affecting the BBB following SAH. Targeting some of these pathways is important for restoring brain function following SAH. BBB injury occurs immediately after SAH and has long-lasting consequences, but most changes in the pathophysiological cascades occur in the first few days following SAH. These changes determine the development of early brain injury as well as delayed cerebral ischemia. SAH-induced neuroprotection also plays an important role and weakens the negative impact of SAH. Supporting some of these beneficial cascades while attenuating the major pathophysiological pathways might be decisive in inhibiting the negative impact of bleeding in the subarachnoid space. In this review, we attempt a comprehensive overview of the current knowledge on the molecular and cellular changes in the BBB following SAH and their possible modulation by various drugs and substances.
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