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The neurovascular unit response to cerebral ischemia as a promising area for translational studies - Comments on some opened questions.

P. Kowiański,Ewelina Czuba-Pakuła,G. Lietzau

Published 2025 in Experimental Neurology

ABSTRACT

Despite the progress in diagnostics and therapy, ischemic stroke remains one of the leading causes of disability and death worldwide. The numerous publications on the basic and clinical aspects of stroke are a good measure of the developing knowledge and interest in this clinical problem. However, many issues remain unresolved. In this review, we summarize the role of the neurovascular unit (NVU) in ischemic stroke, with a particular emphasis on neuroglia and the cerebrovascular system and discuss the new research directions in the field. Among the most pressing issues that warrant investigation in the near future, we propose the following: 1) the impact of cerebral ischemia on the structure and function of the NVU, 2) the heterogeneous character of the NVU response to ischemia, 3) the role of the neuroglia proliferative potential in response to ischemia, 4) the revised criteria of reactive neuroglia classification, 5) the morphology of the cerebrovascular system in the context of ischemic consequences, and 6) the search for specific biochemical and genetic markers of ischemic stroke. In our opinion, translational research focused on a better understanding of NVU functioning may constitute a valuable starting point for more precise diagnosis and effective therapy of ischemic stroke. In this review, we summarize the most important issues of current and future research in this area.

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