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Review
27 September 2021
The “Neuro-Glial-Vascular” Unit: The Role of Glia in Neurovascular Unit Formation and Dysfunction
Elisabeth C. Kugler
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Ryan B. MacDonald
Glia-endothelial interactions. (A) Pathways across the BBB and BRB allow for the transport of various types of molecules. (B) Glial signaling impacts ECs [i.e., glial-derived neurotrophic factor (GDNF), transforming growth factor β (TGF-β), Ang1, fibroblast growth factor 2 (FGF2), and vascular endothelial growth factor (VEGF)] and in turn BBB stability (dotted arrow). (C) BBB stability is highly dependent on EC inter-cellular junction integrity including adherens junctions, gap junctions, junctional adhesion molecules, and tight junctions adapted from Abbott et al. (2006); Malik and Di Benedetto (2018).

The neurovascular unit (NVU) is a complex multi-cellular structure consisting of endothelial cells (ECs), neurons, glia, smooth muscle cells (SMCs), and pericytes. Each component is closely linked to each other, establishing a structural and functional unit, regulating central nervous system (CNS) blood flow and energy metabolism as well as forming the blood-brain barrier (BBB) and inner blood-retina barrier (BRB). As the name suggests, the “neuro” and “vascular” components of the NVU are well recognized and neurovascular coupling is the key function of the NVU. However, the NVU consists of multiple cell types and its functionality goes beyond the resulting neurovascular coupling, with cross-component links of signaling, metabolism, and homeostasis. Within the NVU, glia cells have gained increased attention and it is increasingly clear that they fulfill various multi-level functions in the NVU. Glial dysfunctions were shown to precede neuronal and vascular pathologies suggesting central roles for glia in NVU functionality and pathogenesis of disease. In this review, we take a “glio-centric” view on NVU development and function in the retina and brain, how these change in disease, and how advancing experimental techniques will help us address unanswered questions.

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Review
12 July 2021

Neurovascular coupling is a crucial mechanism that matches the high energy demand of the brain with a supply of energy substrates from the blood. Signaling within the neurovascular unit is responsible for activity-dependent changes in cerebral blood flow. The strength and reliability of neurovascular coupling form the basis of non-invasive human neuroimaging techniques, including blood oxygen level dependent (BOLD) functional magnetic resonance imaging. Interestingly, BOLD signals are negative in infants, indicating a mismatch between metabolism and blood flow upon neural activation; this response is the opposite of that observed in healthy adults where activity evokes a large oversupply of blood flow. Negative neurovascular coupling has also been observed in rodents at early postnatal stages, further implying that this is a process that matures during development. This rationale is consistent with the morphological maturation of the neurovascular unit, which occurs over a similar time frame. While neurons differentiate before birth, astrocytes differentiate postnatally in rodents and the maturation of their complex morphology during the first few weeks of life links them with synapses and the vasculature. The vascular network is also incomplete in neonates and matures in parallel with astrocytes. Here, we review the timeline of the structural maturation of the neurovascular unit with special emphasis on astrocytes and the vascular tree and what it implies for functional maturation of neurovascular coupling. We also discuss similarities between immature astrocytes during development and reactive astrocytes in disease, which are relevant to neurovascular coupling. Finally, we close by pointing out current gaps in knowledge that must be addressed to fully elucidate the mechanisms underlying neurovascular coupling maturation, with the expectation that this may also clarify astrocyte-dependent mechanisms of cerebrovascular impairment in neurodegenerative conditions in which reduced or negative neurovascular coupling is noted, such as stroke and Alzheimer’s disease.

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74 citations
Mature human astrocytes contact developing zebrafish brain vessels. (A–E) Immunocytochemistry of GFP-expressing human astrocytes (green), with DAPI counterstained nuclei (blue) (A), the common marker GFAP (B), and mature markers ALDH1L1 (C), Kir4.1 (D), and GLT-1 (E) (red). Scale bar = 30 μm. (F) 48 h post-implantation, human astrocytes (green) reach out to the surrounding brain vasculature (red) of a 6 dpf Tg(kdrl:mCherry) zebrafish larvae. (G) Green channel highlighting the astrocyte’s morphology. (H) A zoomed in view from the white dotted box in panel (F) showing the astrocyte reaching out to a vessel. n = 5 animals. Scale bar = 10 μm. (I,J) Quantification of human glia-zebrafish vessel interactions. While there was a decrease in human glia present in the brain from 24 to 48 h post-intracranial injection (I), the amount of glial-vessel contacts did not subsequently decrease (J). n = 4 animals in (I) and n = 3–7 animals in (J). A paired, two-tailed t-test was performed (*p < 0.05) in (I) and an unpaired, two-tailed t-test was performed in (J).
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