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Neurovascular Mechanisms of Ischemia Tolerance Against Brain Injury

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Vascular Mechanisms in CNS Trauma

Part of the book series: Springer Series in Translational Stroke Research ((SSTSR,volume 5))

Abstract

Traumatic brain injury (TBI) can result in secondary ischemia. This secondary ischemic insult is implicated in post-TBI pathophysiology. Pharmacological intervention to elevate cerebral blood flow can improve outcomes following TBI. The brain and other organ systems have an innate ability to induce protection against ischemic injury, limiting the severity of the ischemia-induced damage. This “self” protection can be initiated by exposing the brain to a stimulus before ischemia called “preconditioning,” such as exposure to a mild episode(s) of ischemia, hypoxia, anesthesia, or pharmacologically induced mild cell stressors. Current efforts to reduce ischemia-induced brain damage have been the focus in determining the mechanisms of preconditioning-induced ischemia tolerance as findings may help lower cerebral ischemia-induced brain damage in at-risk patients including TBI patients. Different preconditioning paradigms have been shown to lower TBI-induced damage. Although not all of the mechanisms of preconditioning are confirmed in models of TBI, basic mechanisms of preconditioning applies here as ischemia is a major part of TBI. Ischemic preconditioning, in part, confers protection by modulating regulators of cerebral blood flow, increase angiogenesis, and prevent cerebral ischemia-induced increase in blood–brain barrier permeability. This chapter highlights preconditioning-induced changes in components of the neurovascular system involved in ischemia tolerance. Understanding of these pathways may aid in the development of novel therapies to protect the brain from TBI-induced secondary ischemic insult.

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Authors and Affiliations

  1. The Cerebral Vascular Disease Research Laboratories, Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, 33136, USA

    Miguel A. Perez-Pinzon

  2. The Cerebral Vascular Disease Research Laboratories, Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA

    Kunjan R. Dave, John W. Thompson, Jake T. Neumann & Hung W. Lin

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  1. Kunjan R. Dave
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  2. John W. Thompson
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  3. Jake T. Neumann
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  4. Miguel A. Perez-Pinzon
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  5. Hung W. Lin
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Correspondence to Miguel A. Perez-Pinzon .

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  1. Departments of Neurology and Radiology, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA

    Eng H. Lo

  2. Department of Pediatrics, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA

    Josephine Lok

  3. Department of Neurology, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA

    MingMing Ning

  4. Department of Pediatrics, Massachusetts General Hospital Harbard Medical School, Boston, Massachusetts, USA

    Michael J. Whalen

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Dave, K.R., Thompson, J.W., Neumann, J.T., Perez-Pinzon, M.A., Lin, H.W. (2014). Neurovascular Mechanisms of Ischemia Tolerance Against Brain Injury. In: Lo, E., Lok, J., Ning, M., Whalen, M. (eds) Vascular Mechanisms in CNS Trauma. Springer Series in Translational Stroke Research, vol 5. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8690-9_10

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