Emerging biomarkers and frontier therapies: unveiling the role of endothelial dysfunction in cerebral small vessel disease.
Level 5 - mechanism / opinion, no new human data
Narrative review without systematic review methodology or primary clinical data.
PubMed 40718100 · doi:10.3389/fneur.2025.1615883
What was done
The authors conducted a narrative literature review by searching databases including PubMed and Web of Science through 2025. The paper synthesizes current evidence on the mechanistic role of endothelial dysfunction in cerebral small vessel disease (cSVD), evaluates emerging circulating and neuroimaging biomarkers, and reviews preclinical and clinical trial progress on endothelial-targeted therapeutic strategies.
What was found
The abstract reports that cSVD accounts for approximately 25% of ischemic strokes. Beyond this background figure, no quantitative findings, effect sizes, diagnostic accuracy metrics, or primary trial outcomes are reported in the abstract. The narrative synthesis details how chronic endothelial injury impairs blood-brain barrier integrity, autoregulation, and nitric oxide-mediated vasodilation, leading to white matter hyperintensities, lacunar infarcts, and microbleeds.
Why it matters
The paper summarizes the translational landscape linking endothelial dysfunction to cSVD, outlining potential early diagnostic biomarkers and frontier therapeutic pathways for vascular protection.
Limits
As a narrative review, it lacks a systematic review protocol, formal quality appraisal, and meta-analytic pooling. No primary human data or specific study numbers are provided in the abstract, and many discussed therapeutic strategies remain in preclinical stages.
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