ATP-sensitive potassium channels: a promising target for protecting neurovascular unit function in stroke

1. Stroke is the second most common cause of death and a major cause of disability worldwide. Despite increasing knowledge of the cellular and molecular mechanisms that occur in stroke, there are still large gaps in our understanding that are impeding therapeutic progress. In addition, there are no drugs yet that can be used effectively in stroke patients. 2. In recent years, it has been recognized that stroke is a brain dysfunction that involves multiple cell types and that a purely neurocentric focus or targeting a single point in a single pathway fails to yield sufficient protection. Thus, the concept of the 'neurovascular unit' has emerged as a new paradigm for stroke investigation and therapy. 3. ATP-sensitive potassium (K(ATP)) channels are unique channel proteins that directly couple the metabolic state of a cell to its electrical activity. These channels are found throughout the brain, being found in neurons, glial cells and in the brain vasculature. It is well documented that K(ATP) channels play multifactorial roles in protecting against brain injury induced by hypoxia, ischaemia or metabolic inhibition. 4. In the present review, we focus on the function of the neurovascular units in stroke and review current knowledge regarding K(ATP) channels, with a focus on their potential role in the remodelling of the neurovascular units.