加齢・血管機能障害・血液脳関門：高齢者における脳卒中の病態生理学的考察
Aging represents a principal risk factor for stroke, accompanied by progressive deterioration of vascular integrity and blood-brain barrier (BBB) function. This review consolidates current knowledge on cellular and molecular alterations within the neurovascular unit, including endothelial senescence, oxidative stress accumulation, and tight junction protein degradation, all of which contribute to BBB dysfunction. Key molecular drivers such as the NLRP3 inflammasome, matrix metalloproteinases, and non-coding RNAs (miRNAs, circRNAs) are discussed in the context of BBB disruption during aging and stroke. Advanced imaging modalities including dynamic contrast-enhanced MRI and PET enable real-time permeability assessment. Biomarkers such as claudin-5, PDGFRβ, and albumin reflect BBB and vascular integrity. Among emerging interventional strategies reviewed, hydrogen-rich water is noted for its potential to counteract oxidative stress-mediated BBB damage, alongside sirtuin modulators, iPSC-derived extracellular vesicles, NLRP3 inhibitors, and neuropeptides such as cortistatin. The review synthesizes pathophysiological mechanisms and potential molecular targets aimed at improving vascular health and neuroprotection in aging-related stroke.
Hydrogen-rich water is proposed to mitigate oxidative stress-induced damage to the blood-brain barrier, potentially preserving BBB integrity in the context of aging and stroke pathophysiology.
Hydrogen-rich water is a low-risk delivery route, but the achievable systemic hydrogen dose is bounded. For clinical applications, inhalation is the most efficient route; inhalation, however, carries explosion risk, and concentration matters (empirical LFL of 10% applies to inhalation environments; high-concentration devices are documented in the Consumer Affairs Agency accident database and are not recommended).
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https://h2-papers.org/en/papers/40044939