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000273915 1001_ $$0P:(DE-2719)2812631$$aSchreiber, Stefanie$$b0$$eFirst author
000273915 245__ $$aImmune system activation and cognitive impairment in arterial hypertension.
000273915 260__ $$aBethesda, Md.$$bAmerican Physiological Society$$c2024
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000273915 520__ $$aChronic arterial hypertension disrupts the integrity of the cerebral microvasculature, doubling the risk of age-related dementia. Despite sufficient antihypertensive therapy in still a significant proportion of individuals blood pressure lowering alone does not preserve cognitive health. Accumulating evidence highlights the role of inflammatory mechanisms in the pathogenesis of hypertension. In this review, we introduce a temporal framework to explore how early immune system activation and interactions at neurovascular-immune interfaces pave the way to cognitive impairment. The overall paradigm suggests that prohypertensive stimuli induce mechanical stress and systemic inflammatory responses that shift peripheral and meningeal immune effector mechanisms toward a proinflammatory state. Neurovascular-immune interfaces in the brain include a dysfunctional blood-brain barrier, crossed by peripheral immune cells; the perivascular space, in which macrophages respond to cerebrospinal fluid- and blood-derived immune regulators; and the meningeal immune reservoir, particularly T cells. Immune responses at these interfaces bridge peripheral and neurovascular unit inflammation, directly contributing to impaired brain perfusion, clearance of toxic metabolites, and synaptic function. We propose that deep immunophenotyping in biofluids together with advanced neuroimaging could aid in the translational determination of sequential immune and brain endotypes specific to arterial hypertension. This could close knowledge gaps on how and when immune system activation transits into neurovascular dysfunction and cognitive impairment. In the future, targeting specific immune mechanisms could prevent and halt hypertension disease progression before clinical symptoms arise, addressing the need for new interventions against one of the leading threats to cognitive health.
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000273915 650_7 $$2Other$$aarterial hypertension
000273915 650_7 $$2Other$$acerebral small vessel disease
000273915 650_7 $$2Other$$acognitive impairment
000273915 650_7 $$2Other$$acytokines
000273915 650_7 $$2Other$$aimmune system
000273915 650_2 $$2MeSH$$aHumans
000273915 650_2 $$2MeSH$$aHypertension: immunology
000273915 650_2 $$2MeSH$$aHypertension: physiopathology
000273915 650_2 $$2MeSH$$aCognitive Dysfunction: immunology
000273915 650_2 $$2MeSH$$aCognitive Dysfunction: physiopathology
000273915 650_2 $$2MeSH$$aAnimals
000273915 650_2 $$2MeSH$$aBlood-Brain Barrier: immunology
000273915 650_2 $$2MeSH$$aBrain: immunology
000273915 650_2 $$2MeSH$$aBrain: physiopathology
000273915 650_2 $$2MeSH$$aBrain: metabolism
000273915 650_2 $$2MeSH$$aBrain: pathology
000273915 650_2 $$2MeSH$$aImmune System: immunology
000273915 650_2 $$2MeSH$$aImmune System: physiopathology
000273915 650_2 $$2MeSH$$aImmune System: metabolism
000273915 650_2 $$2MeSH$$aCognition: physiology
000273915 650_2 $$2MeSH$$aInflammation: immunology
000273915 7001_ $$0P:(DE-2719)9000797$$aUlbrich, Philipp$$b1$$udzne
000273915 7001_ $$aMorton, Lorena$$b2
000273915 7001_ $$aGarza, Alejandra P$$b3
000273915 7001_ $$0P:(DE-2719)2811487$$aMüller, Patrick$$b4$$udzne
000273915 7001_ $$0P:(DE-2719)2810407$$aNeumann, Katja$$b5$$udzne
000273915 7001_ $$0P:(DE-2719)9002178$$aMattern, Hendrik$$b6$$udzne
000273915 7001_ $$0P:(DE-2719)9002951$$aDörner, Marc$$b7$$udzne
000273915 7001_ $$0P:(DE-2719)9001989$$aBernal, Jose$$b8$$udzne
000273915 7001_ $$0P:(DE-2719)2000035$$aVielhaber, Stefan$$b9$$udzne
000273915 7001_ $$aMeuth, Sven G$$b10
000273915 7001_ $$aDunay, Ildiko R$$b11
000273915 7001_ $$0P:(DE-2719)2810577$$aDityatev, Alexander$$b12$$udzne
000273915 7001_ $$0P:(DE-2719)2813348$$aHenneicke, Solveig$$b13$$eLast author$$udzne
000273915 773__ $$0PERI:(DE-600)1477334-X$$a10.1152/ajpcell.00219.2024$$gVol. 327, no. 6, p. C1577 - C1590$$n6$$pC1577 - C1590$$tAmerican journal of physiology / Cell physiology$$v327$$x0363-6143$$y2024
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