Neuroinflammation and hypoxia promote astrocyte phenotypic transformation and propel neurovascular dysfunction in brain arteriovenous malformation

Abstract Brain arteriovenous malformation (BAVM) is a complex cerebrovascular disease characterized by an abnormal high-flow vascular network, which increases the risk of hemorrhage, particularly in young individuals. Endothelial dysfunction has traditionally been considered the primary cause, while...

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Main Authors: Tianqi Tu, Zhenghong Peng, Lihan Zhang, Jieru Yang, Kecheng Guo, Xiaogang Tang, Jiasen Ye, Fan Zhang, An Huang, Jiaxing Yu, Changren Huang, Hongqi Zhang, Donghai Wang, Jianhua Peng, Yong Jiang
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Journal of Neuroinflammation
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Online Access:https://doi.org/10.1186/s12974-025-03442-2
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author Tianqi Tu
Zhenghong Peng
Lihan Zhang
Jieru Yang
Kecheng Guo
Xiaogang Tang
Jiasen Ye
Fan Zhang
An Huang
Jiaxing Yu
Changren Huang
Hongqi Zhang
Donghai Wang
Jianhua Peng
Yong Jiang
author_facet Tianqi Tu
Zhenghong Peng
Lihan Zhang
Jieru Yang
Kecheng Guo
Xiaogang Tang
Jiasen Ye
Fan Zhang
An Huang
Jiaxing Yu
Changren Huang
Hongqi Zhang
Donghai Wang
Jianhua Peng
Yong Jiang
author_sort Tianqi Tu
collection DOAJ
description Abstract Brain arteriovenous malformation (BAVM) is a complex cerebrovascular disease characterized by an abnormal high-flow vascular network, which increases the risk of hemorrhage, particularly in young individuals. Endothelial dysfunction has traditionally been considered the primary cause, while the contributions of the microenvironment and glial cells have not been fully explored. Astrocytes, as a key component of the central nervous system, play a crucial role in regulating neurovascular function, maintaining the integrity of the blood–brain barrier, and ensuring neural homeostasis. However, under the pathological conditions of BAVM, the phenotypic changes in astrocytes and their role in disease progression remain poorly understood. In our study, we emphasized the critical role of neuroinflammation and hypoxia in the progression of BAVM within its pathological microenvironment. Specifically, reactive astrocytes undergo phenotypic changes under these pathological conditions, significantly promoting vascular instability. Moreover, nitric oxide (NO) produced by BAVM endothelial cells activates signaling pathways that stabilize HIF-1α in astrocytes, initiating a “hypoxic” gene program under normoxic conditions. Furthermore, we discovered that COX-2, a direct target gene of HIF-1α, is upregulated in the BAVM microenvironment. These changes promoted endothelial dysfunction and vascular fragility, creating a vicious cycle that exacerbates hemorrhage risk. The application of COX-2 inhibitors significantly reduced neuroinflammation, stabilized blood vessels, and decreased hemorrhage risk. Our findings highlighted the crucial interaction between the BAVM microenvironment and astrocytes in driving disease progression, suggesting that COX-2 could be a potential therapeutic target for stabilizing BAVM vessels and reducing hemorrhagic events.
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institution Kabale University
issn 1742-2094
language English
publishDate 2025-04-01
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series Journal of Neuroinflammation
spelling doaj-art-bb976d4e6e0345b9966b88d24826b87a2025-08-20T03:52:20ZengBMCJournal of Neuroinflammation1742-20942025-04-0122112210.1186/s12974-025-03442-2Neuroinflammation and hypoxia promote astrocyte phenotypic transformation and propel neurovascular dysfunction in brain arteriovenous malformationTianqi Tu0Zhenghong Peng1Lihan Zhang2Jieru Yang3Kecheng Guo4Xiaogang Tang5Jiasen Ye6Fan Zhang7An Huang8Jiaxing Yu9Changren Huang10Hongqi Zhang11Donghai Wang12Jianhua Peng13Yong Jiang14Department of Neurosurgery, The Affiliated Hospital Southwest Medical UniversityLaboratory of Neurological Diseases and Brain Function, the Affiliated Hospital, Southwest Medical UniversityDepartment of Neurosurgery, The Affiliated Hospital Southwest Medical UniversityDepartment of Neurosurgery, The Affiliated Hospital Southwest Medical UniversityDepartment of Neurosurgery, The Affiliated Hospital Southwest Medical UniversityDepartment of Neurosurgery, The Affiliated Hospital Southwest Medical UniversityDepartment of Neurosurgery, The Affiliated Hospital Southwest Medical UniversityDepartment of Neurosurgery, The Affiliated Hospital Southwest Medical UniversitySichuan Clinical Research Center for Neurosurgery, The Affiliated Hospital, Southwest Medical UniversityDepartment of Neurosurgery, Xuanwu Hospital, China International Neuroscience Institute, Capital Medical UniversityDepartment of Neurosurgery, The Affiliated Hospital Southwest Medical UniversityDepartment of Neurosurgery, Xuanwu Hospital, China International Neuroscience Institute, Capital Medical UniversityMedical Integration and Practice Center, Shandong UniversityDepartment of Neurosurgery, The Affiliated Hospital Southwest Medical UniversityDepartment of Neurosurgery, The Affiliated Hospital Southwest Medical UniversityAbstract Brain arteriovenous malformation (BAVM) is a complex cerebrovascular disease characterized by an abnormal high-flow vascular network, which increases the risk of hemorrhage, particularly in young individuals. Endothelial dysfunction has traditionally been considered the primary cause, while the contributions of the microenvironment and glial cells have not been fully explored. Astrocytes, as a key component of the central nervous system, play a crucial role in regulating neurovascular function, maintaining the integrity of the blood–brain barrier, and ensuring neural homeostasis. However, under the pathological conditions of BAVM, the phenotypic changes in astrocytes and their role in disease progression remain poorly understood. In our study, we emphasized the critical role of neuroinflammation and hypoxia in the progression of BAVM within its pathological microenvironment. Specifically, reactive astrocytes undergo phenotypic changes under these pathological conditions, significantly promoting vascular instability. Moreover, nitric oxide (NO) produced by BAVM endothelial cells activates signaling pathways that stabilize HIF-1α in astrocytes, initiating a “hypoxic” gene program under normoxic conditions. Furthermore, we discovered that COX-2, a direct target gene of HIF-1α, is upregulated in the BAVM microenvironment. These changes promoted endothelial dysfunction and vascular fragility, creating a vicious cycle that exacerbates hemorrhage risk. The application of COX-2 inhibitors significantly reduced neuroinflammation, stabilized blood vessels, and decreased hemorrhage risk. Our findings highlighted the crucial interaction between the BAVM microenvironment and astrocytes in driving disease progression, suggesting that COX-2 could be a potential therapeutic target for stabilizing BAVM vessels and reducing hemorrhagic events.https://doi.org/10.1186/s12974-025-03442-2Brain arteriovenous malformationAstrocytesNeuroinflammationHypoxiaCyclooxygenase-2
spellingShingle Tianqi Tu
Zhenghong Peng
Lihan Zhang
Jieru Yang
Kecheng Guo
Xiaogang Tang
Jiasen Ye
Fan Zhang
An Huang
Jiaxing Yu
Changren Huang
Hongqi Zhang
Donghai Wang
Jianhua Peng
Yong Jiang
Neuroinflammation and hypoxia promote astrocyte phenotypic transformation and propel neurovascular dysfunction in brain arteriovenous malformation
Journal of Neuroinflammation
Brain arteriovenous malformation
Astrocytes
Neuroinflammation
Hypoxia
Cyclooxygenase-2
title Neuroinflammation and hypoxia promote astrocyte phenotypic transformation and propel neurovascular dysfunction in brain arteriovenous malformation
title_full Neuroinflammation and hypoxia promote astrocyte phenotypic transformation and propel neurovascular dysfunction in brain arteriovenous malformation
title_fullStr Neuroinflammation and hypoxia promote astrocyte phenotypic transformation and propel neurovascular dysfunction in brain arteriovenous malformation
title_full_unstemmed Neuroinflammation and hypoxia promote astrocyte phenotypic transformation and propel neurovascular dysfunction in brain arteriovenous malformation
title_short Neuroinflammation and hypoxia promote astrocyte phenotypic transformation and propel neurovascular dysfunction in brain arteriovenous malformation
title_sort neuroinflammation and hypoxia promote astrocyte phenotypic transformation and propel neurovascular dysfunction in brain arteriovenous malformation
topic Brain arteriovenous malformation
Astrocytes
Neuroinflammation
Hypoxia
Cyclooxygenase-2
url https://doi.org/10.1186/s12974-025-03442-2
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