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Although ICAS develops intracranially, cerebral artery innervation originates in the peripheral nervous system. The scarcity of human intracranial specimens has hindered investigations into the potential role of Schwann cells (SCs) in neurovascular homeostasis. Using multimodal analysis of plaque\u2010bearing and non\u2010plaque\u2010bearing intracranial artery samples from the same postmortem individuals (n = 16 donors), SCs associated with myelinated neural structures are identified. Quantitative ultrastructural evaluation reveals a 4.3\u2010fold increase in SC\u2010derived myelin sheaths within plaque\u2010bearing vessels (\n                    <jats:italic>P<\/jats:italic>\n                    &lt;0.001). Single\u2010cell RNA sequencing (scRNA\u2010seq) of SCs demonstrates significant upregulation of genes involved in axonogenesis, axon ensheathment, axon guidance, synaptic transmission, and synaptic integration. Cell\u2013cell communication analysis shows enhanced interactions between SCs and vascular smooth muscle cells (VSMCs) in plaque\u2010bearing vessels. Synaptic\u2010like structures are observed in the walls of intracranial arteries, along with a 2.9\u2010fold increase in VSMC\u2010innervating myelinated fibers (\n                    <jats:italic>P<\/jats:italic>\n                    &lt;0.001). Ligand\u2013receptor analysis indicates SPP1\u2013ITGB1 signaling as a potential mediator of SCs\u2010VSMCs crosstalk. This study provides evidence for the involvement of SCs in ICAS pathobiology and proposes novel neurovascular targets for precision therapies in cerebrovascular disease.\n                  <\/jats:p>","DOI":"10.1002\/advs.202503033","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T02:23:57Z","timestamp":1750991037000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Identification of Schwann Cells in Human Intracranial Arteries: Potential Regulatory Role in Atherosclerotic Plaque Progression"],"prefix":"10.1002","volume":"12","author":[{"given":"Zijue","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Neurology State Key Laboratory of Complex, Severe, and Rare Diseases Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing 100730 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Chinese Academy of Medical Sciences Peking Union Medical Collage  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Ma","sequence":"additional","affiliation":[{"name":"National Human Brain Bank for Development and Function Department of Human Anatomy Histology and Embryology Institute of Basic Medical Sciences Chinese Academy of Medical Sciences Peking Union Medical Collage  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyue","family":"Wang","sequence":"additional","affiliation":[{"name":"Center for bioinformatics National Infrastructures for Translational Medicine Institute of Clinical Medicine and Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Neurology State Key Laboratory of Complex, 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