http://www.sciencedirect.com/science/article/pii/S0301008213001287
- a Department of Neurological Surgery, UCSF, San Francisco, CA 94121, USA
- b SFVAMC, San Francisco, CA 94121, USA
- c Neuroscience and Neuroengineering Research Center, Med-X Research Institute, Shanghai 200030, China
- d School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China
- e Department of Neurology, Shanghai Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, China
- f Department of Neurological Surgery, Tohoku University Graduate School of Medicine 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
- g Center of Cerebrovascular Disease Research, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
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Check accessHighlights
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- Distinct mechanisms underlying arteriogenesis and angiogenesis are delineated.
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- Technology in detecting each vascular remodeling process.
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- Clinical and preclinical implications of arteriogenesis and angiogenesis.
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- Potential therapies in promoting vascular remodeling including those in trials.
Abstract
The
brain vasculature has been increasingly recognized as a key player that
directs brain development, regulates homeostasis, and contributes to
pathological processes. Following ischemic stroke, the reduction of
blood flow elicits a cascade of changes and leads to vascular
remodeling. However, the temporal profile of vascular changes after
stroke is not well understood. Growing evidence suggests that the early
phase of cerebral blood volume (CBV) increase is likely due to the
improvement in collateral flow, also known as arteriogenesis, whereas
the late phase of CBV increase is attributed to the surge of
angiogenesis. Arteriogenesis is triggered by shear fluid stress followed
by activation of endothelium and inflammatory processes, while
angiogenesis induces a number of pro-angiogenic factors and circulating
endothelial progenitor cells (EPCs). The status of collaterals in acute
stroke has been shown to have several prognostic implications, while the
causal relationship between angiogenesis and improved functional
recovery has yet to be established in patients. A number of
interventions aimed at enhancing cerebral blood flow including
increasing collateral recruitment are under clinical investigation.
Transplantation of EPCs to improve angiogenesis is also underway.
Knowledge in the underlying physiological mechanisms for improved
arteriogenesis and angiogenesis shall lead to more effective therapies
for ischemic stroke.
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