Abstract
Cerebral edema formation stems from disruption of blood brain barrier (BBB) integrity and occurs after injury to the CNS. Due to the restrictive skull, relatively small increases in brain volume can translate into impaired tissue perfusion and brain herniation. In excess, cerebral edema can be gravely harmful. Astrocytes are key participants in cerebral edema by virtue of their relationship with the cerebral vasculature, their unique compliment of solute and water transport proteins, and their general role in brain volume homeostasis. Following the discovery of aquaporins, passive conduits of water flow, aquaporin 4 (AQP4) was identified as the predominant astrocyte water channel. Normally, AQP4 is highly enriched at perivascular endfeet, the outermost layer of the BBB, whereas after injury, AQP4 expression disseminates to the entire astrocytic plasmalemma, a phenomenon termed dysregulation. Arguably, the most important role of AQP4 is to rapidly neutralize osmotic gradients generated by ionic transporters. In pathological conditions, AQP4 is believed to be intimately involved in the formation and clearance of cerebral edema. In this review, we discuss aquaporin function and localization in the BBB during health and injury, and we examine post-injury ionic events that modulate AQP4-dependent edema formation.
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Acknowledgments
We would like to thank the anonymous reviewers who made invaluable suggestions to improve our manuscript. This work was supported by grants to JMS from the Department of Veterans Affairs (Baltimore) (BX001629), the National Institute of Neurological Disorders and Stroke (NINDS) (NS060801; NS061808), the National Heart, Lung and Blood Institute (HL082517), and the Department of the Army (W81XWH 1010898); and to VG from NINDS (NS061934; NS072501).
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All studies of human tissues were approved by the appropriate ethics committee and have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
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All authors declare that they have no conflict of interest.
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Special Issue: In honor of Michael Norenberg.
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Stokum, J.A., Kurland, D.B., Gerzanich, V. et al. Mechanisms of Astrocyte-Mediated Cerebral Edema. Neurochem Res 40, 317–328 (2015). https://doi.org/10.1007/s11064-014-1374-3
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DOI: https://doi.org/10.1007/s11064-014-1374-3