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Review
. 2024 Oct;31(7):e12877.
doi: 10.1111/micc.12877. Epub 2024 Sep 2.

Brain Microvascular Pericyte Pathology Linking Alzheimer's Disease to Diabetes

Kareem El-Ghazawi  1 , Ukpong B Eyo  2 , Shayn M Peirce  1
Affiliations
Review

Brain Microvascular Pericyte Pathology Linking Alzheimer's Disease to Diabetes

Kareem El-Ghazawi et al. Microcirculation. 2024 Oct.

Abstract

The brain microvasculature, which delivers oxygen and nutrients and forms a critical barrier protecting the central nervous system via capillaries, is deleteriously affected by both Alzheimer's disease (AD) and type 2 diabetes (T2D). T2D patients have an increased risk of developing AD, suggesting potentially related microvascular pathological mechanisms. Pericytes are an ideal cell type to study for functional links between AD and T2D. These specialized capillary-enwrapping cells regulate capillary density, lumen diameter, and blood flow. Pericytes also maintain endothelial tight junctions to ensure blood-brain barrier integrity, modulation of immune cell extravasation, and clearance of toxins. Changes in these phenomena have been observed in both AD and T2D, implicating "pericyte pathology" as a common feature of AD and T2D. This review examines the mechanisms of AD and T2D from the perspective of the brain microvasculature, highlighting how pericyte pathology contributes to both diseases. Our review identifies voids in understanding how AD and T2D negatively impact the brain microvasculature and suggests future studies to examine the intersections of these diseases.

Keywords: Alzheimer's disease; blood–brain barrier; microcirculation; pericyte; type 2 diabetes.

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Conflict of interest statement

Disclosure/Conflict of Interest

The authors have no disclosures of conflicts of interest to report.

Figures

Figure 1.
Figure 1.
Schematic of the neurovascular unit. Endothelial cells and pericytes comprise the capillaries of the brain microvasculature, and they maintain physical contact with astrocytes, microglia, and neurons. Pericyte-to-endothelial cell ratios are higher in brain capillaries than in peripheral capillaries, which helps to reinforce endothelial tight junctions to maintain the blood-brain barrier.
Figure 2.
Figure 2.
Pericyte pathologies and where they have been observed during AD and T2D. Check marks indicate that this pathology has been documented. Question marks indicate that the pathology has not yet been investigated or identified and may serve as an area of future research.
See this image and copyright information in PMC

References

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