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@ARTICLE{Schreiber:273915,
author = {Schreiber, Stefanie and Ulbrich, Philipp and Morton, Lorena
and Garza, Alejandra P and Müller, Patrick and Neumann,
Katja and Mattern, Hendrik and Dörner, Marc and Bernal,
Jose and Vielhaber, Stefan and Meuth, Sven G and Dunay,
Ildiko R and Dityatev, Alexander and Henneicke, Solveig},
title = {{I}mmune system activation and cognitive impairment in
arterial hypertension.},
journal = {American journal of physiology / Cell physiology},
volume = {327},
number = {6},
issn = {0363-6143},
address = {Bethesda, Md.},
publisher = {American Physiological Society},
reportid = {DZNE-2024-01389},
pages = {C1577 - C1590},
year = {2024},
abstract = {Chronic 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.},
subtyp = {Review Article},
keywords = {Humans / Hypertension: immunology / Hypertension:
physiopathology / Cognitive Dysfunction: immunology /
Cognitive Dysfunction: physiopathology / Animals /
Blood-Brain Barrier: immunology / Brain: immunology / Brain:
physiopathology / Brain: metabolism / Brain: pathology /
Immune System: immunology / Immune System: physiopathology /
Immune System: metabolism / Cognition: physiology /
Inflammation: immunology / arterial hypertension (Other) /
cerebral small vessel disease (Other) / cognitive impairment
(Other) / cytokines (Other) / immune system (Other)},
cin = {AG Schreiber / AG Dityatev / AG Düzel},
ddc = {000},
cid = {I:(DE-2719)1310010 / I:(DE-2719)1310007 /
I:(DE-2719)5000006},
pnm = {353 - Clinical and Health Care Research (POF4-353) / 351 -
Brain Function (POF4-351)},
pid = {G:(DE-HGF)POF4-353 / G:(DE-HGF)POF4-351},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:39495252},
doi = {10.1152/ajpcell.00219.2024},
url = {https://pub.dzne.de/record/273915},
}