Small Vessel Disease: Ancient Description, Novel Biomarkers

Area of Science:

• Neurology
• Vascular Biology
• Biochemistry

Background:

• Small vessel disease (SVD) is a primary pathological contributor to dementia.
• SVD involves microvascular alterations with shared origins, cognitive impacts, and vascular risk factors.
• The arteriolosclerosis process in SVD, though not fully understood, involves chronic hypoperfusion and neuroinflammation.

Purpose of the Study:

• To explore novel biomarkers reflecting endothelial dysfunction and oxidative damage in SVD.
• To identify potential markers for SVD progression and therapeutic targets.
• To review current understanding of SVD pathophysiology, including genetic factors and comorbidities.

Main Methods:

• Review of existing literature on SVD pathophysiology and biomarkers.
• Description of altered responses to endothelium-derived mediators (ENOV, prostacyclin, C-reactive proteins, EDHF).
• Examination of hypoxia-endothelial markers (HIF 1 alpha, VEGFR2, neuroglobin, MMPs) and blood-brain barrier disruption indicators.

Main Results:

• Identified key biomarkers related to endothelial dysfunction, oxidative stress, and neuroinflammation in SVD.
• Highlighted markers associated with hypoxia and endothelial activation.
• Discussed biomarkers for blood-brain barrier integrity and perivascular space changes.

Conclusions:

• Novel biomarkers offer potential for monitoring SVD progression and guiding therapy.
• Further research is needed to translate these findings into clinical benefits for dementia patients.
• Understanding SVD mechanisms, including endothelial dysfunction and neuroinflammation, is crucial for effective treatment.