Cited by 350Neurological Disease Mechanisms and TreatmentsBarrier Structure and Function StudiesNeuroinflammation and Neurodegeneration Mechanisms

The DOI matches its Crossref record; 69 of the 71 references it cites were found in a registry or an index; none of the 39 sources its claims cite is checked for support yet.

Perivascular macrophages mediate the neurovascular and cognitive dysfunction associated with hypertension

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Abstract

Hypertension is a leading risk factor for dementia, but the mechanisms underlying its damaging effects on the brain are poorly understood. Due to a lack of energy reserves, the brain relies on continuous delivery of blood flow to its active regions in accordance with their dynamic metabolic needs. Hypertension disrupts these vital regulatory mechanisms, leading to the neuronal dysfunction and damage underlying cognitive impairment. Elucidating the cellular bases of these impairments is essential for developing new therapies. Perivascular macrophages (PVMs) represent a distinct population of resident brain macrophages that serves key homeostatic roles but also has the potential to generate large amounts of reactive oxygen species (ROS). Here, we report that PVMs are critical in driving the alterations in neurovascular regulation and attendant cognitive impairment in mouse models of hypertension. This effect was mediated by an increase in blood-brain barrier permeability that allowed angiotensin II to enter the perivascular space and activate angiotensin type 1 receptors in PVMs, leading to production of ROS through the superoxide-producing enzyme NOX2. These findings unveil a pathogenic role of PVMs in the neurovascular and cognitive dysfunction associated with hypertension and identify these cells as a putative therapeutic target for diseases associated with cerebrovascular oxidative stress.

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TL;DR

Perivascular macrophages (PVMs) are required for the neurovascular and cognitive dysfunction caused by hypertension in mouse models. Circulating angiotensin II reaches the perivascular space after blood-brain barrier opening, activates PVM AT1 receptors, and drives NOX2-dependent reactive oxygen species production.

Key findings

  • In slow-pressor ANGII hypertension, chronic ANGII infusion increased BBB permeability to sodium fluorescein and FITC-dextran but not Evans blue, and nearly 60% of PVMs were associated with biotinylated ANGII after 14 days; acute ANGII did not produce this BBB effect.
  • Intracerebroventricular clodronate depleted PVMs by 60%–65%, did not alter blood pressure, and restored neurovascular coupling and endothelium-dependent CBF responses in ANGII-treated mice; it also rescued CBF dysfunction in chronically hypertensive BPH/2J mice.
  • Bone marrow chimeras showed that AT1R or NOX2 deletion in PVMs attenuated ANGII-induced vascular oxidative stress and neurovascular dysfunction; by 14 weeks after transplant, 78% ± 2% of CD206+ cells were replaced by donor cells, and At1r−/−→WT chimerism was greater than 95%.
  • PVM depletion improved cognitive deficits in BPH/2J mice: it rescued novel object recognition memory and improved Barnes maze spatial memory, while not affecting normotensive controls.

Methods

  • Male C57BL/6 mice, male BPH/2J mice, and BPN/3J controls were used; hypertension was induced by osmotic minipumps delivering ANGII at 600 ng/kg/min for 2 weeks, and PVMs were depleted with intracerebroventricular liposome-encapsulated clodronate.
  • Bone marrow chimeras were generated by irradiating mice and transplanting At1r−/−, Nox2−/−, or GFP+ marrow; cerebrovascular function was assessed by laser-Doppler CBF responses to whisker stimulation, acetylcholine, and adenosine, with BBB permeability measured using sodium fluorescein, FITC-dextran, and Evans blue.
  • Vascular oxidative stress was assessed by hydroethidine microfluorography; cognition was tested with novel object recognition and Barnes maze; data were analyzed by Student’s t test or ANOVA with Bonferroni/Tukey tests, with P < 0.05 considered significant.

Limitations

  • The paper states that the molecular interactions of PVMs with cells of the neurovascular unit and their role in BBB alteration remain to be defined, and that the mechanisms of ANGII-induced BBB permeability increase remain to be established.
  • The paper states that the rescue by Nox2 deletion in PVMs was not complete, possibly implicating ROS sources other than NOX2 or the 20%–30% of PVMs not replaced by transplant.
  • The paper states that bone marrow chimera experiments could not be performed in BPH/2J mice because of their complex genetic background, and that cognitive function was not assessed in ANGII-treated mice because longer ANGII exposure is needed and is not compatible with the time course of PVM depletion by clodronate.

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Integrity signals

Registry

Crossref · 10.1172/jci86950

Cites

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Claims the paper makes

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  • It may state two separate claims as one. 49
  • The quote only partly states this claim. 3
  • Probably not a substantial claim. 25
69 of 69
  • The paper relies on this without support.

    The factors responsible for the functional alterations of the neurovascular unit in hypertension are poorly understood.

    “The factors responsible for these functional alterations of the NVU are poorly understood, and their exploration is essential to develop preventative or therapeutic approaches to mitigate the impact of hypertension on brain health.”
  • The paper relies on this without support.

    The vascular cell type that produces ROS and initiates the cerebrovascular dysfunction in ANGII hypertension remains unknown.

    “However, the vascular cell type(s) that produces reactive oxygen species (ROS) and initiates the dysfunction remains to be elucidated.”
  • The paper relies on this without support.

    It is unclear whether neurovascular dysfunction is required for the development of cognitive deficits.

    “Furthermore, it is unclear whether the neurovascular dysfunction is required for the development of cognitive deficits.”
  • The paper relies on this without support.

    BPH/2J mice are a more representative model of chronic hypertension in humans than the slow-pressor ANGII model.

    “To overcome these limitations, we also examined the role of PVMs in a model of spontaneous lifelong hypertension more representative of chronic hypertension in humans.”
  • The paper relies on this without support.

    Clodronate liposome treatment selectively depletes perivascular macrophages without affecting other cell types or processes that could rescue neurovascular or cognitive function.

    “To deplete cerebral CD206 + macrophages, clodronate-or PBS-loaded liposomes were prepared as previously described (27).”
  • The paper relies on this without support.

    In bone marrow chimeras, the donor genotype in perivascular macrophages is responsible for the observed effects, rather than other donor-derived immune cells or indirect effects.

    “Using BM chimeras we provided evidence that replacement of WT PVMs with PVMs lacking AT1Rs or NOX2 abrogates the vascular oxidative stress induced by ANGII and counteracts the associated neurovascular dysfunction.”
  • The paper relies on this without support.

    The cerebrovascular and cognitive deficits in BPH/2J mice are representative of hypertension-induced dysfunction rather than unrelated genetic traits.

    “BPH/2J mice are a model of lifelong hypertension on a genetic basis and manifest some of the cardinal features of essential hypertension, i.e., neurohumoral dysfunction, sympathetic activation, cardiac hypertrophy, and kidney atrophy (58,59).”
  • The paper relies on this without support.

    CLOD selectively depletes perivascular macrophages without affecting other brain cells.

    “(A and B) Intracerebroventricular CLOD administration induces depletion of cells expressing the PVM marker CD206 in the somatosensory cortex assessed by histology.”
  • The paper relies on this without support.

    Bone marrow-derived cells that replace CD206+ cells in the brain after transplantation are perivascular macrophages and not other cell types.

    “(B) By 14 weeks after the transplant, approximately 80% of CD206 + cells in the somatosensory cortex are replaced by GFP + bone marrow cells.”
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  1. 10.1006/exnr.2000.7618 · DOI · Paper page
  2. 10.1152/ajpheart.00679.2010 · DOI · Paper page

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Metadata

Authors
Faraco, G., Sugiyama, Y., Lane, D., Garcia-Bonilla, L., Chang, H., Santisteban, M. M., Racchumi, G., Murphy, M., Van Rooijen, N., Anrather, J., & Iadecola, C.
Affiliations
Weill Cornell Medicine (US)
Corresponding author
Iadecola, Costantino
Venue
Journal of Clinical Investigation
Published
2016-11-14
Volume
126
Issue
12
Pages
4674-4689
ISSN
  • 0021-9738 (ISSN-L)
  • 1558-8238
OpenAlex
W2552399604
Cited by
350
References
71
Citations by year
2026: 34 · 2025: 39 · 2024: 47 · 2023: 39 · 2022: 43 · 2021: 31 · 2020: 34 · 2019: 36 · 2018: 26 · 2017: 20 · 2016: 1
FWCI
15.16
Type
journal article
Language
en
Open access
Locations
  • Journal of Clinical Investigation (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion, other-oa)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
  • American Heart Association (15SDG22760007)
  • Fondation Leducq
  • National Institutes of Health
  • College of Veterinary Medicine, Cornell University
  • National Institute of Neurological Disorders and Stroke (R37NS089323, R01NS095441)
Topics
  • Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
  • Life Sciences › Neuroscience › Neurology › Barrier Structure and Function Studies
  • Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
Keywords
perivascular macrophages, hypertension, cognitive impairment, neurovascular regulation, blood-brain barrier permeability, angiotensin II, angiotensin II type 1 receptor, reactive oxygen species, NADPH oxidase 2, oxidative stress, cerebrovascular disease, dementia risk
MeSH terms
NADPH Oxidase 2, Angiotensin II, Animals, Blood-Brain Barrier, Disease Models, Animal, Hypertension, Macrophages, Male, Membrane Glycoproteins, Reactive Oxygen Species, Oxidative Stress, NADPH Oxidases, Receptor, Angiotensin, Type 1, Mice, Cognitive Dysfunction

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