Abstract
Astrocytes, as key support cells in the central nervous system, maintain homeostasis in the brain through mechanisms such as ionic homeostasis regulation, metabolic support, synaptic modulation, and neuroinflammatory regulation. Recent studies have shown that astrocyte dysfunction is closely related to the pathologic processes of various neurological diseases, such as Alzheimer's disease, Parkinson's disease, multiple sclerosis, and stroke. In this review, we comprehensively summarize the dual roles of astrocytes in neurological diseases: on one hand, their aberrant activation can exacerbate disease progression by mediating neuroinflammation, synaptic dysfunction, and blood-brain barrier disruption; on the other hand, their metabolic disorders, such as lipid droplet accumulation, mitochondrial dysfunction, and oxidative stress imbalance, further drive neurodegeneration. In terms of therapeutic strategies, interventions targeting astrocytes, such as modulation of activation phenotype, metabolic reprogramming, gene therapy, and innovative therapies based on exosomes and nanotechnology, show great promise. In the future, we may integrate multi-omics technologies and deepen clinical translational research to systematically analyze the spatial heterogeneity of astrocytes and their dynamic regulatory networks at different stages of the disease, in order to elucidate the precise mechanisms of their roles in the pathological process, and thus provide multidimensional theoretical support for the design of targeted therapeutic strategies.