Evidence mapPaperPMID 42353291Full record

ReviewInternational journal of molecular sciences2026

Molecular and Cellular Signaling Pathways of the Effects of Hypoxia and Hypercapnia on the Mechanisms of Neuroinflammation.

Pavel A Chekulaev, Georgy M Zembatov, Eugenia D Namiot, Tatiana M Alekseeva, Ivan K Ternovykh, Zaripat S Manasova, Vladimir P Kulikov, Natalia S Andriutsa, Pavel P Tregub

Abstract readReview
In one paragraph

Review in International journal of molecular sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Pavel A ChekulaevBrain Science Institute, Russian Center of Neurology and Neurosciences, 125367 Moscow, Russia.
Georgy M ZembatovBrain Science Institute, Russian Center of Neurology and Neurosciences, 125367 Moscow, Russia.
Eugenia D NamiotBrain Science Institute, Russian Center of Neurology and Neurosciences, 125367 Moscow, Russia.
Tatiana M AlekseevaV.A. Almazov National Medical Research Center, 197341 St. Petersburg, Russia.
Ivan K TernovykhV.A. Almazov National Medical Research Center, 197341 St. Petersburg, Russia.
Zaripat S ManasovaDepartment of Pathophysiology, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia.
Vladimir P KulikovDepartment of Ultrasound and Functional Diagnostics, Altay State Medical University, 656040 Barnaul, Russia.ORCID 0000-0003-4869-5465
Natalia S AndriutsaDepartment of Pathophysiology, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia.ORCID 0000-0001-5425-7707
Pavel P TregubBrain Science Institute, Russian Center of Neurology and Neurosciences, 125367 Moscow, Russia.ORCID 0000-0002-3650-6121

Funding

Russian Science Foundation 25-25-00101
6 · The paper itself

Abstract

Recovery after an ischemic stroke depends not only on neuronal survival but also on inflammatory mechanisms that determine secondary injury and reparative plasticity. This review summarizes the evidence on hypoxic conditioning, permissive hypercapnia, and their combined application as modulators of neuroinflammation and neurorehabilitation. This review does not aim to describe the fundamental mechanisms of neuroinflammation, but rather to examine how hypoxia, hypercapnia, and their interaction provide potential targets for its modulation. Prolonged or severe hypoxia exacerbates neuroinflammation through NF-κB activation, NLRP3 inflammasome signaling, pro-inflammatory cytokine production, and microglial activation. In contrast, controlled intermittent hypoxia in pre-/postconditioning protocols suppresses inflammatory processes, promotes reparative microglial phenotypes, activates PI3K/Akt-dependent survival pathways, and modulates the fractalkine/CX3CR1 axis. Permissive hypercapnia also has context-dependent immunomodulatory properties: moderate exposure may reduce NF-κB-driven inflammation, oxidative damage, apoptosis, and blood-brain barrier disruption, whereas prolonged hypercapnia, especially with hypoxemia, may enhance inflammasome activation and microglial reactivity. Therefore, combined intermittent hypercapnic hypoxia may act as a therapeutic stimulus integrating anti-inflammatory, cytoprotective, barrier-stabilizing, and neuroplastic mechanisms. Clinical evidence regarding ischemic stroke and cerebral palsy is encouraging but limited. Future studies should determine optimal gas exposure protocols, precisely define the mechanisms underlying the anti-inflammatory effects, and establish whether pharmacological potentiation using modulators of the NLRP3, PI3K/Akt, BDNF/TrkB, and JNK signaling pathways is feasible.

Indexed as

HypercapniaHypoxiaNeuroinflammatory DiseasesSignal TransductionAnimalsHumansInflammationMicrogliahypercapniahypercapnic hypoxiahypoxiamicroglianeuroinflammation

Identifiers

PMID42353291
PMCPMC13300615

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.