The vascular-immune-neural network: a new pathophysiological paradigm and the dawn of cytoprotection in stroke

Summary: At present, no drugs related to brain protection have received strong recommendations from the guidelines in the treatment of stroke. Given the increasing understanding of the interactions between the immune system and the central nervous system and the promising efficacy of our latest immu...

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Main Authors: Yiliang Fang, Zhiyi Zhu, John H. Zhang, Fu-Dong Shi, Qingwu Yang
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:EBioMedicine
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352396425002877
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author Yiliang Fang
Zhiyi Zhu
John H. Zhang
Fu-Dong Shi
Qingwu Yang
author_facet Yiliang Fang
Zhiyi Zhu
John H. Zhang
Fu-Dong Shi
Qingwu Yang
author_sort Yiliang Fang
collection DOAJ
description Summary: At present, no drugs related to brain protection have received strong recommendations from the guidelines in the treatment of stroke. Given the increasing understanding of the interactions between the immune system and the central nervous system and the promising efficacy of our latest immune therapy, it is necessary to reconsider the critical role of immunity in the pathophysiology of stroke. In this review, we propose a new pathophysiological paradigm, namely, the vascular-immune-neural network (VIN), emphasizing the dynamic and continuous interactions between the immune system and the vascular neural network. We update current pathways of brain–immune communication during AIS and dissect the panorama of the immune response to stroke, both in the global brain and the whole body, highlighting the importance and features of the VIN paradigm in stroke. Additionally, we summarize recent advances in immune-related therapies to shed light on the use of cytoprotective treatments throughout the stroke process.
format Article
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institution DOAJ
issn 2352-3964
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publishDate 2025-08-01
publisher Elsevier
record_format Article
series EBioMedicine
spelling doaj-art-091c0984b96648dd8927fda722af75e42025-08-20T03:04:50ZengElsevierEBioMedicine2352-39642025-08-0111810584310.1016/j.ebiom.2025.105843The vascular-immune-neural network: a new pathophysiological paradigm and the dawn of cytoprotection in strokeYiliang Fang0Zhiyi Zhu1John H. Zhang2Fu-Dong Shi3Qingwu Yang4Department of Neurology, Second Affiliated Hospital of Army Medical University (Xinqiao Hospital), No. 183 Xinqiao Main St, Shapingba District, Chongqing 400037, ChinaDepartment of Neurology, Second Affiliated Hospital of Army Medical University (Xinqiao Hospital), No. 183 Xinqiao Main St, Shapingba District, Chongqing 400037, ChinaDepartment of Neurosurgery, Loma Linda University, Loma Linda, CA 92350, USA; Corresponding author.Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin 300052, China; Corresponding author. Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.Department of Neurology, Second Affiliated Hospital of Army Medical University (Xinqiao Hospital), No. 183 Xinqiao Main St, Shapingba District, Chongqing 400037, China; Chongqing Institute for Brain and Intelligence, Guangyang Bay Laboratory, Chongqing 400064, China; Corresponding author. Department of Neurology, Second Affiliated Hospital of Army Medical University (Xinqiao Hospital), No. 183 Xinqiao Main St, Shapingba District, Chongqing 400037, China.Summary: At present, no drugs related to brain protection have received strong recommendations from the guidelines in the treatment of stroke. Given the increasing understanding of the interactions between the immune system and the central nervous system and the promising efficacy of our latest immune therapy, it is necessary to reconsider the critical role of immunity in the pathophysiology of stroke. In this review, we propose a new pathophysiological paradigm, namely, the vascular-immune-neural network (VIN), emphasizing the dynamic and continuous interactions between the immune system and the vascular neural network. We update current pathways of brain–immune communication during AIS and dissect the panorama of the immune response to stroke, both in the global brain and the whole body, highlighting the importance and features of the VIN paradigm in stroke. Additionally, we summarize recent advances in immune-related therapies to shed light on the use of cytoprotective treatments throughout the stroke process.http://www.sciencedirect.com/science/article/pii/S2352396425002877Acute ischaemic stroke (AIS)Vascular-immune-neural network (VIN)Immune responseCytoprotective therapy
spellingShingle Yiliang Fang
Zhiyi Zhu
John H. Zhang
Fu-Dong Shi
Qingwu Yang
The vascular-immune-neural network: a new pathophysiological paradigm and the dawn of cytoprotection in stroke
EBioMedicine
Acute ischaemic stroke (AIS)
Vascular-immune-neural network (VIN)
Immune response
Cytoprotective therapy
title The vascular-immune-neural network: a new pathophysiological paradigm and the dawn of cytoprotection in stroke
title_full The vascular-immune-neural network: a new pathophysiological paradigm and the dawn of cytoprotection in stroke
title_fullStr The vascular-immune-neural network: a new pathophysiological paradigm and the dawn of cytoprotection in stroke
title_full_unstemmed The vascular-immune-neural network: a new pathophysiological paradigm and the dawn of cytoprotection in stroke
title_short The vascular-immune-neural network: a new pathophysiological paradigm and the dawn of cytoprotection in stroke
title_sort vascular immune neural network a new pathophysiological paradigm and the dawn of cytoprotection in stroke
topic Acute ischaemic stroke (AIS)
Vascular-immune-neural network (VIN)
Immune response
Cytoprotective therapy
url http://www.sciencedirect.com/science/article/pii/S2352396425002877
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