Brain Behav. 2026 Feb;16(2):e71237. doi: 10.1002/brb3.71237.
ABSTRACT
PURPOSE OF REVIEW: To review how the immune microenvironment and oxidative stress modulate the initiation, maturation, and hemorrhagic conversion of cerebral cavernous malformations (CCM) and to appraise the therapeutic potential of immune-directed interventions.
FINDING: This project conducts systematic research on the pathogenesis of cerebral cavernous malformation (CCM), focusing on the complex interactions between genetic mutations (KRIT1, CCM2, PDCD10) and the immune microenvironment, oxidative stress, inflammatory responses, and vascular dysfunction. The study confirms that CCM development relies not only on genetic mutations but also on the synergistic effects of a "second hit" mechanism and microenvironmental stressors. Immune cell infiltration (e.g., B cells, T cells, neutrophils) and oxidative stress responses play pivotal roles in lesion progression; Blood-brain barrier disruption and immune thrombosis further exacerbate the pathological process. These findings provide theoretical foundations for understanding CCM's multifactorial pathogenic network and establish scientific bases for personalized therapeutic strategies targeting the immune microenvironment and oxidative stress.
CONCLUSION: Genetic mutations trigger the formation of initial CCM lesions, while environmental and immune factors promote disease progression, increasing the risk of abnormal cerebral vascular formation or rupture.
PMID:41618979 | DOI:10.1002/brb3.71237