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<p>Endothelial-mesenchymal transition (EndMT) is a critical process in cerebrovascular diseases, contributing to vascular instability, fibrosis, and inflammation. This review summarizes the molecular mechanisms driving EndMT—including TGF-β, Wnt, Notch pathways, inflammation, oxidative stress, and hemodynamics—and its role in specific conditions such as cerebral cavernous malformations, brain arteriovenous malformations, and moyamoya disease. We also evaluate promising pharmacological strategies, including statins, antihypertensives, antidiabetic drugs, and anti-inflammatory agents, that show efficacy in preclinical models. However, clinical translation remains challenging due to issues of specificity, drug delivery across the blood-brain barrier, and disease heterogeneity. Future directions emphasize biomarker-driven approaches and endothelial-specific therapies to bridge mechanistic insights into clinical applications.</p>

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Endothelial-Mesenchymal transition in cerebrovascular diseases: molecular mechanisms and promising pharmacological strategies

  • 期刊论文

  • 发表日期：

    2026年1月6日

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  • Jinlin Xiao,
  • Canyang Yu,
  • Dianda Chen,
  • Feng Lin,
  • Shuhua Zhang,
  • Daya Luo,
  • Erming Zeng

摘要

Endothelial-mesenchymal transition (EndMT) is a critical process in cerebrovascular diseases, contributing to vascular instability, fibrosis, and inflammation. This review summarizes the molecular mechanisms driving EndMT—including TGF-β, Wnt, Notch pathways, inflammation, oxidative stress, and hemodynamics—and its role in specific conditions such as cerebral cavernous malformations, brain arteriovenous malformations, and moyamoya disease. We also evaluate promising pharmacological strategies, including statins, antihypertensives, antidiabetic drugs, and anti-inflammatory agents, that show efficacy in preclinical models. However, clinical translation remains challenging due to issues of specificity, drug delivery across the blood-brain barrier, and disease heterogeneity. Future directions emphasize biomarker-driven approaches and endothelial-specific therapies to bridge mechanistic insights into clinical applications.