Immune regulation in neurovascular units after traumatic brain injury

• Published in: Neurobiology of disease Vol. 179; p. 106060
• Main Authors: Wang, Zongqi, Chen, Gang
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2023; Elsevier
• Subjects: Blood-Brain Barrier - pathology; Brain - pathology; Brain Injuries, Traumatic; Central Nervous System - pathology; Endothelial Cells - pathology; Humans; Immune activation; Immune regulation; Immune suppression; Immune therapy; Neuroinflammatory Diseases; Neurovascular units; Traumatic brain injury; Immune therapy; Immune suppression; Immune regulation; Immune activation; Traumatic brain injury; Neurovascular units
• ISSN: 0969-9961; 1095-953X
• DOI: 10.1016/j.nbd.2023.106060

Traumatic brain injury (TBI) is a major cause of death and disability worldwide. Survivors may experience movement disorders, memory loss, and cognitive deficits. However, there is a lack of understanding of the pathophysiology of TBI-mediated neuroinflammation and neurodegeneration. The immune regulation process of TBI involves changes in the peripheral and central nervous system (CNS) immunity, and intracranial blood vessels are essential communication centers. The neurovascular unit (NVU) is responsible for coupling blood flow with brain activity, and comprises endothelial cells, pericytes, astrocyte end-feet, and vast regulatory nerve terminals. A stable NVU is the basis for normal brain function. The concept of the NVU emphasizes that cell-cell interactions between different types of cells are essential for maintaining brain homeostasis. Previous studies have explored the effects of immune system changes after TBI. The NVU can help us further understand the immune regulation process. Herein, we enumerate the paradoxes of primary immune activation and chronic immunosuppression. We describe the changes in immune cells, cytokines/chemokines, and neuroinflammation after TBI. The post-immunomodulatory changes in NVU components are discussed, and research exploring immune changes in the NVU pattern is also described. Finally, we summarize immune regulation therapies and drugs after TBI. Therapies and drugs that focus on immune regulation have shown great potential for neuroprotection. These findings will help us further understand the pathological processes after TBI. •This article reviewed the immune cell changes in NVU at different periods after TBI.•This article reviewed immune interactions in the NVU after TBI.•This article summarized the immune regulation therapy and the drugs after TBI.