In the past decade, evidence has emerged that there is a variety of bidirectional cell-cell and/or cellextracellular
matrix interactions within the neurovascular unit (NVU), which is composed of neuronal, glial, and vascular
cells along with extracellular matrix. Many central nervous system diseases, which lead to NVU dysfunction, have
common features such as glial activation/transformation and vascular/blood-brain-barrier alteration. These phenomena
show dual opposite roles, harmful at acute phase and beneficial at chronic phase. This diverse heterogeneity may induce
biphasic clinical courses, i.e. degenerative and regenerative processes in the context of dynamically coordinated cellcell/
cell-matrix interactions in the NVU. A deeper understanding of the seemingly contradictory actions in cellular levels
is essential for NVU protection or regeneration to suppress the deleterious inflammatory reactions and promote adaptive
remodeling after central nervous system injury. This mini-review will present an overview of recent progress in the
biphasic roles of the NVU and discuss the clinical relevance of NVU responses associated with central nervous system
diseases, such as stroke and other chronic neurodegenerative diseases.
Keywords: Neurovascular unit, stroke, central nervous system injury, neuroprotection, remodeling, astrocyte, cerebral
endothelial cell, microglia.
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