Cellular mechanisms of the protective effect of polyphenols on the neurovascular unit in strokes

Increasing evidence has suggested that our view of stroke should be integrative, and thus a concept of dynamic interaction between cells belonging to the neurovascular unit, such as endothelial cells, astrocytes and neurons, is emerging. The functionality of this unit is altered by the complex series of interconnected pathophysiological processes that damage the brain tissue during this kind of attack. The new strategies target both the preservation of endothelium integrity and the deleterious effects induced by ionic imbalance, excitotoxicity, and the generation of reactive oxygen species within the neurovascular unit. Polyphenols exert numerous biological effects that might participate in the protection of the neurovascular unit, including anti-aggregatory platelet activity, antioxidant and free radical scavenging properties. Moreover, polyphenols are powerful vasodilators through the generation of NO, and can act on the expression of genes protective of the cardiovascular system. Also, polyphenols contribute to the preservation of the integrity of cells belonging to the neurovascular unit, mainly the endothelium, by acting on the signaling cascades implicated in endothelial apoptosis. All these effects of polyphenols might interfere with atherosclerotic plaque development and stability, vascular thrombosis and occlusion and therefore might explain their vascular- and neuroprotective properties. In this review, we focus on the beneficial effects of polyphenols on the complex pathophysiological events of stroke and helpful indications for the design of an effective and well-tolerated therapy will be discussed.