Neurovascular unit in ischemic stroke in older adults: a narrative review

作者：Chengyuan Wang, Yi Yang, Tianqing Xiong, Shun Li · 发表于：Aging advances. · 年份：2025 · DOI：10.4103/agingadv.agingadv-d-24-00031 · 被引用次数：12 · 研究领域：Acute Ischemic Stroke Management、Barrier Structure and Function Studies、Cerebrovascular and Carotid Artery Diseases

There is a significant global death and disability rate associated with ischemic stroke, making it one of the most prevalent disorders. With the increasing worldwide aging population, the prevalence of ischemic stroke has notably increased and has emerged as a pivotal issue in public health. The neurovascular unit primarily consists of neurons, astrocytes, microglia, and brain microvascular endothelial cells. These cells are structurally tightly connected; together, they maintain the balance of brain function and are crucial for brain function and cerebral ischemic damage. Emerging studies in recent years have demonstrated the development of associations between ischemic stroke and the vascular neural units. The neurovascular unit characterizes the whole-tissue response to stroke, encompassing the interrelationship and reciprocal impact of neurons, glial cells, and microvessels. The neurovascular unit results in compromised integrity of the microvasculature and blood–brain barrier, neuronal cell death, the glial response, the inflammatory response, and immune cell infiltration, all of which are strongly associated with the course of ischemic stroke. This narrative review explores the complex relationship between ischemic stroke and the neurovascular unit in the context of an aging population. With aging, the neurovascular unit undergoes structural and functional changes that predispose the elderly to higher risks of stroke and complicate recovery post-stroke. We explore the i...