The mitochondrial network as a key link in the survival of the neurovascular unit

This review analyzes the fundamental mechanisms of neurovascular unit (NVU) degradation and restoration under conditions of acute cerebral blood flow deficiency and subsequent reperfusion. The physiological basis of cellular disorganization is examined, with lipid peroxidation acting as the leading factor in neuronal membrane destruction. Particular attention is paid to the role of the mitochondrial network as a central regulator of NVU cell survival. The paper describes in detail current understanding of the structural and functional integrity of the NVU and the molecular mechanisms of its damage. Central to this is the analysis of the PGC-1α regulatory axis as a key factor in mitochondrial biogenesis and antioxidant defense. The authors systematize data on mitochondrial dynamics (fusion), selective autophagy (mitophagy), and the role of the mitochondrial proliferator-activated pore (mPTP) in determining cell fate in the post-perfusion period. The final section of the review discusses promising strategies for pharmacological correction: from the reduction of oxidative stress and neuroinflammation to the induction of organelle biogenesis. The therapeutic potential of mitochondrial modulation as an effective method for restoring the neurovascular unit after ischemic injury is substantiated.

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