Document Detail

The adaptation of the cerebral circulation to pregnancy: mechanisms and consequences.
MedLine Citation:
PMID:  23321787     Owner:  NLM     Status:  MEDLINE    
The adaptation of the cerebral circulation to pregnancy is unique from other vascular beds. Most notably, the growth and vasodilatory response to high levels of circulating growth factors and cytokines that promote substantial hemodynamic changes in other vascular beds is limited in the cerebral circulation. This is accomplished through several mechanisms, including downregulation of key receptors and transcription factors, and production of circulating factors that counteract the vasodilatory effects of vascular endothelial growth factor (VEGF) and placental growth factor. Pregnancy both prevents and reverses hypertensive inward remodeling of cerebral arteries, possibly through downregulation of the angiotensin type 1 receptor. The blood-brain barrier (BBB) importantly adapts to pregnancy by preventing the passage of seizure provoking serum into the brain and limiting the permeability effects of VEGF that is more highly expressed in cerebral vasculature during pregnancy. While the adaptation of the cerebral circulation to pregnancy provides for relatively normal cerebral blood flow and BBB properties in the face of substantial cardiovascular changes and high levels of circulating factors, under pathologic conditions, these adaptations appear to promote greater brain injury, including edema formation during acute hypertension, and greater sensitivity to bacterial endotoxin.
Marilyn J Cipolla
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review     Date:  2013-01-16
Journal Detail:
Title:  Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism     Volume:  33     ISSN:  1559-7016     ISO Abbreviation:  J. Cereb. Blood Flow Metab.     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-04-01     Completed Date:  2013-05-23     Revised Date:  2014-04-10    
Medline Journal Info:
Nlm Unique ID:  8112566     Medline TA:  J Cereb Blood Flow Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  465-78     Citation Subset:  IM    
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MeSH Terms
Adaptation, Physiological*
Blood-Brain Barrier / physiology*
Capillary Permeability / physiology
Cerebral Arteries / physiology
Cerebrovascular Circulation / physiology*
Pregnancy / physiology*
Pregnancy Proteins / metabolism
Vascular Endothelial Growth Factor A / metabolism
Grant Support
P01 095488//PHS HHS; R01 NS045940/NS/NINDS NIH HHS; R01 NS045940/NS/NINDS NIH HHS; R01 NS045940-05S1/NS/NINDS NIH HHS; R01 NS045940-6S1/NS/NINDS NIH HHS
Reg. No./Substance:
0/Pregnancy Proteins; 0/VEGFA protein, human; 0/Vascular Endothelial Growth Factor A; 144589-93-5/placenta growth factor

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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