Vascular cognitive impairment: pathophysiological mechanisms, insights into structural basis, and perspectives in specific treatments

Vladimir A Parfenov,1 Olga D Ostroumova,2,3 Tatiana M Ostroumova,1 Alexey I Kochetkov,2 Victoria V Fateeva,4 Kristina K Khacheva,4 Gulnara R Khakimova,5 Oleg I Epstein61Department of Neurology, Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Med...

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Autores principales: Parfenov VA, Ostroumova OD, Ostroumova TM, Kochetkov AI, Fateeva VV, Khacheva KK, Khakimova GR, Epstein OI
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Publicado: Dove Medical Press 2019
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spelling oai:doaj.org-article:9aaced5f9c3f4c4a8b07e6549d00734a2021-12-02T08:14:21ZVascular cognitive impairment: pathophysiological mechanisms, insights into structural basis, and perspectives in specific treatments1178-2021https://doaj.org/article/9aaced5f9c3f4c4a8b07e6549d00734a2019-05-01T00:00:00Zhttps://www.dovepress.com/vascular-cognitive-impairment-pathophysiological-mechanisms-insights-i-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Vladimir A Parfenov,1 Olga D Ostroumova,2,3 Tatiana M Ostroumova,1 Alexey I Kochetkov,2 Victoria V Fateeva,4 Kristina K Khacheva,4 Gulnara R Khakimova,5 Oleg I Epstein61Department of Neurology, Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation; 2Laboratory of Clinical Pharmacology and therapy, Federal State Budgetary Educational Institution of Higher Education “N.I. Pirogov Russian National Research Medical University” of the Ministry of Health of the Russian Federation, Russian Clinical and Research Center of Gerontology, Moscow, Russia; 3Department of Clinical Pharmacology, Internal Medicine and Propaedeutics I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; 4Medical Information Department, OOO NPF Materia Medica Holding, Moscow, Russian Federation; 5Research and Analytical Division of Scientific Research and Development Department, Moscow, Russian Federation; 6Laboratory of Physiologicaly Active Substances, Department of Molecular and Cellular Pathophysiology, Research Institute of General Pathology and Pathophysiology, Moscow, Russian FederationAbstract: Vascular cognitive impairment (VCI) and vascular dementia are the most common forms of cognitive disorder associated with cerebrovascular disease and related to increased morbidity and mortality among the older population. Growing evidence suggests the contribution of blood-pressure variability, cardiac arrhythmia, hyperactivation of the renin–angiotensin–aldosterone system, endothelial dysfunction, vascular remodeling and stiffness, different angiopathies, neural tissue homeostasis, and systemic metabolic disorders to the pathophysiology of VCI. In this review, we focus on factors contributing to cerebrovascular disease, neurovascular unit alterations, and novel approaches to cognitive improvement in patients with cognitive decline. One of the important factors associated with the neuronal causes of VCI is the S100B protein, which can affect the expression of cytokines in the brain, support homeostasis, and regulate processes of differentiation, repair, and apoptosis of the nervous tissue. Since the pathological basis of VCI is complex and diverse, treatment affecting the mechanisms of cognitive disorders should be developed. The prospective role of a novel complex drug consisting of released–active antibodies to S100 and to endothelial NO synthase in VCI treatment is highlighted.Keywords: vascular cognitive impairment, cerebrovascular disease, neurovascular unit, endothelial dysfunction, S100 proteinParfenov VAOstroumova ODOstroumova TMKochetkov AIFateeva VVKhacheva KKKhakimova GREpstein OIDove Medical PressarticleVascular cognitive impairmentcerebrovascular diseaseneurovascular unitendothelial dysfunctionS100 proteinNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 15, Pp 1381-1402 (2019)
institution DOAJ
collection DOAJ
language EN
topic Vascular cognitive impairment
cerebrovascular disease
neurovascular unit
endothelial dysfunction
S100 protein
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
spellingShingle Vascular cognitive impairment
cerebrovascular disease
neurovascular unit
endothelial dysfunction
S100 protein
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
Parfenov VA
Ostroumova OD
Ostroumova TM
Kochetkov AI
Fateeva VV
Khacheva KK
Khakimova GR
Epstein OI
Vascular cognitive impairment: pathophysiological mechanisms, insights into structural basis, and perspectives in specific treatments
description Vladimir A Parfenov,1 Olga D Ostroumova,2,3 Tatiana M Ostroumova,1 Alexey I Kochetkov,2 Victoria V Fateeva,4 Kristina K Khacheva,4 Gulnara R Khakimova,5 Oleg I Epstein61Department of Neurology, Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation; 2Laboratory of Clinical Pharmacology and therapy, Federal State Budgetary Educational Institution of Higher Education “N.I. Pirogov Russian National Research Medical University” of the Ministry of Health of the Russian Federation, Russian Clinical and Research Center of Gerontology, Moscow, Russia; 3Department of Clinical Pharmacology, Internal Medicine and Propaedeutics I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; 4Medical Information Department, OOO NPF Materia Medica Holding, Moscow, Russian Federation; 5Research and Analytical Division of Scientific Research and Development Department, Moscow, Russian Federation; 6Laboratory of Physiologicaly Active Substances, Department of Molecular and Cellular Pathophysiology, Research Institute of General Pathology and Pathophysiology, Moscow, Russian FederationAbstract: Vascular cognitive impairment (VCI) and vascular dementia are the most common forms of cognitive disorder associated with cerebrovascular disease and related to increased morbidity and mortality among the older population. Growing evidence suggests the contribution of blood-pressure variability, cardiac arrhythmia, hyperactivation of the renin–angiotensin–aldosterone system, endothelial dysfunction, vascular remodeling and stiffness, different angiopathies, neural tissue homeostasis, and systemic metabolic disorders to the pathophysiology of VCI. In this review, we focus on factors contributing to cerebrovascular disease, neurovascular unit alterations, and novel approaches to cognitive improvement in patients with cognitive decline. One of the important factors associated with the neuronal causes of VCI is the S100B protein, which can affect the expression of cytokines in the brain, support homeostasis, and regulate processes of differentiation, repair, and apoptosis of the nervous tissue. Since the pathological basis of VCI is complex and diverse, treatment affecting the mechanisms of cognitive disorders should be developed. The prospective role of a novel complex drug consisting of released–active antibodies to S100 and to endothelial NO synthase in VCI treatment is highlighted.Keywords: vascular cognitive impairment, cerebrovascular disease, neurovascular unit, endothelial dysfunction, S100 protein
format article
author Parfenov VA
Ostroumova OD
Ostroumova TM
Kochetkov AI
Fateeva VV
Khacheva KK
Khakimova GR
Epstein OI
author_facet Parfenov VA
Ostroumova OD
Ostroumova TM
Kochetkov AI
Fateeva VV
Khacheva KK
Khakimova GR
Epstein OI
author_sort Parfenov VA
title Vascular cognitive impairment: pathophysiological mechanisms, insights into structural basis, and perspectives in specific treatments
title_short Vascular cognitive impairment: pathophysiological mechanisms, insights into structural basis, and perspectives in specific treatments
title_full Vascular cognitive impairment: pathophysiological mechanisms, insights into structural basis, and perspectives in specific treatments
title_fullStr Vascular cognitive impairment: pathophysiological mechanisms, insights into structural basis, and perspectives in specific treatments
title_full_unstemmed Vascular cognitive impairment: pathophysiological mechanisms, insights into structural basis, and perspectives in specific treatments
title_sort vascular cognitive impairment: pathophysiological mechanisms, insights into structural basis, and perspectives in specific treatments
publisher Dove Medical Press
publishDate 2019
url https://doaj.org/article/9aaced5f9c3f4c4a8b07e6549d00734a
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