Inflammation and cerebral small vessel disease_West China Medical Journal

Authors：

HAN Fei ,  NI Jun

Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, P. R. China;

Corresponding author：

NI Jun, Email: pumchnijun@163.com

Keywords：

Cerebral small vessel disease; inflammation; review

DOI：

10.7507/1002-0179.202503228

Video：

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Cerebral small vessel disease (CSVD) encompasses a group of progressive disorders involving the small vessels of the brain with complex etiologies. Inflammation plays a pivotal role in both the onset and progression of CSVD. In age-related CSVD, chronic inflammation can exacerbate brain tissue damage by impairing endothelial function and disrupting the blood-brain barrier. In contrast, in inflammatory CSVD subtypes driven primarily by immune dysregulation, inflammation itself constitutes the core pathogenic mechanism. These subtypes present with diverse clinical manifestations, posing significant challenges for diagnosis and treatment. A deeper understanding of the inflammatory mechanisms involved in CSVD and the unresolved issues in this field may provide new avenues for personalized interventions and improved prognosis.

1.	Pantoni L. Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges. Lancet Neurol, 2010, 9(7): 689-701.
2.	Wardlaw JM, Smith C, Dichgans M. Mechanisms of sporadic cerebral small vessel disease: insights from neuroimaging. Lancet Neurol, 2013, 12(5): 483-497.
3.	Bailey EL, Smith C, Sudlow CL, et al. Pathology of lacunar ischemic stroke in humans--a systematic review. Brain Pathol, 2012, 22(5): 583-591.
4.	Wardlaw JM, Makin SJ, Valdés Hernández MC, et al. Blood-brain barrier failure as a core mechanism in cerebral small vessel disease and dementia: evidence from a cohort study. Alzheimers Dement, 2017, 13(6): 634-643.
5.	Hong H, Tozer DJ, Chen Y, et al. Perivascular space dysfunction in cerebral small vessel disease is related to neuroinflammation. Brain, 2025, 148(5): 1540-1550.
6.	van Dijk EJ, Prins ND, Vermeer SE, et al. C-reactive protein and cerebral small-vessel disease: the Rotterdam Scan Study. Circulation, 2005, 112(6): 900-905.
7.	Zhang DD, Cao Y, Mu JY, et al. Inflammatory biomarkers and cerebral small vessel disease: a community-based cohort study. Stroke Vasc Neurol, 2022, 7(4): 302-309.
8.	Walker KA, Windham BG, Power MC, et al. The association of mid-to late-life systemic inflammation with white matter structure in older adults: the Atherosclerosis Risk in Communities Study. Neurobiol Aging, 2018, 68: 26-33.
9.	Jalal FY, Yang Y, Thompson JF, et al. Hypoxia-induced neuroinflammatory white-matter injury reduced by minocycline in SHR/SP. J Cereb Blood Flow Metab, 2015, 35(7): 1145-1153.
10.	Brown RB, Tozer DJ, Loubière L, et al. MINocyclinE to Reduce inflammation and blood-brain barrier leakage in small Vessel diseAse (MINERVA): a phase II, randomized, double-blind, placebo-controlled experimental medicine trial. Alzheimers Dement, 2024, 20(6): 3852-3863.
11.	Wu JJ, Yao M, Ni J. Cerebral amyloid angiopathy-related inflammation: current status and future implications. Chin Med J (Engl), 2021, 134(6): 646-654.
12.	An J, Marwaha A, Laxer RM. Autoinflammatory diseases: a review. J Rheumatol, 2024, 51(9): 848-861.
13.	Navon Elkan P, Pierce SB, Segel R, et al. Mutant adenosine deaminase 2 in a polyarteritis nodosa vasculopathy. N Engl J Med, 2014, 370(10): 921-931.
14.	Lee PY, Davidson BA, Abraham RS, et al. Evaluation and management of deficiency of adenosine deaminase 2: an international consensus statement. JAMA Netw Open, 2023, 6(5): e2315894.

1. Pantoni L. Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges. Lancet Neurol, 2010, 9(7): 689-701.
2. Wardlaw JM, Smith C, Dichgans M. Mechanisms of sporadic cerebral small vessel disease: insights from neuroimaging. Lancet Neurol, 2013, 12(5): 483-497.
3. Bailey EL, Smith C, Sudlow CL, et al. Pathology of lacunar ischemic stroke in humans--a systematic review. Brain Pathol, 2012, 22(5): 583-591.
4. Wardlaw JM, Makin SJ, Valdés Hernández MC, et al. Blood-brain barrier failure as a core mechanism in cerebral small vessel disease and dementia: evidence from a cohort study. Alzheimers Dement, 2017, 13(6): 634-643.
5. Hong H, Tozer DJ, Chen Y, et al. Perivascular space dysfunction in cerebral small vessel disease is related to neuroinflammation. Brain, 2025, 148(5): 1540-1550.
6. van Dijk EJ, Prins ND, Vermeer SE, et al. C-reactive protein and cerebral small-vessel disease: the Rotterdam Scan Study. Circulation, 2005, 112(6): 900-905.
7. Zhang DD, Cao Y, Mu JY, et al. Inflammatory biomarkers and cerebral small vessel disease: a community-based cohort study. Stroke Vasc Neurol, 2022, 7(4): 302-309.
8. Walker KA, Windham BG, Power MC, et al. The association of mid-to late-life systemic inflammation with white matter structure in older adults: the Atherosclerosis Risk in Communities Study. Neurobiol Aging, 2018, 68: 26-33.
9. Jalal FY, Yang Y, Thompson JF, et al. Hypoxia-induced neuroinflammatory white-matter injury reduced by minocycline in SHR/SP. J Cereb Blood Flow Metab, 2015, 35(7): 1145-1153.
10. Brown RB, Tozer DJ, Loubière L, et al. MINocyclinE to Reduce inflammation and blood-brain barrier leakage in small Vessel diseAse (MINERVA): a phase II, randomized, double-blind, placebo-controlled experimental medicine trial. Alzheimers Dement, 2024, 20(6): 3852-3863.
11. Wu JJ, Yao M, Ni J. Cerebral amyloid angiopathy-related inflammation: current status and future implications. Chin Med J (Engl), 2021, 134(6): 646-654.
12. An J, Marwaha A, Laxer RM. Autoinflammatory diseases: a review. J Rheumatol, 2024, 51(9): 848-861.
13. Navon Elkan P, Pierce SB, Segel R, et al. Mutant adenosine deaminase 2 in a polyarteritis nodosa vasculopathy. N Engl J Med, 2014, 370(10): 921-931.
14. Lee PY, Davidson BA, Abraham RS, et al. Evaluation and management of deficiency of adenosine deaminase 2: an international consensus statement. JAMA Netw Open, 2023, 6(5): e2315894.

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