Astrocytes: Orchestrators of brain gas exchange and oxygen homeostasis

If we consider neurons like muscles during exercise, the demand for oxygen (O₂) and carbon dioxide (CO₂) elimination is constantly changing. This review summarises the evidence that astrocytes are essential for homeostasis of the respiratory gases in the brain, with a particular focus on oxygen homeostasis. Astrocytes surround cerebral blood vessels and sense changes in oxygen availability in the milieu. They contribute to pH homeostasis and are increasingly recognized for their contribution to central chemosensitivity, particularly in detecting changes in CO₂ and proton (H⁺) concentrations. They are one of the cell types that govern changes in cerebral perfusion rate. Cerebral perfusion dynamically matches tissue metabolism, to balance O₂ delivery and CO₂ removal. By examining the role of astrocytes as both sensors and effectors in this homeostatic balancing act, this review argues that astrocytes influence the metabolic environment of neural networks with profound implications for cognitive function.