Chaudhuri J D
Department of Anatomy, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia.
Med Sci Monit. 2000 Nov-Dec;6(6):1213-22.
The blood brain barrier (BBB) is a highly dynamic structure and consists of endothelial cells, which are characterized by the presence of tight junctions and relative lack of endocytic vesicles. The tight junctions are reinforced by the foot processes of the astrocytes. The BBB functions through these specialised structures, to maintain the environment of the brain in a steady state by regulating the influx and efflux of substances. The protective effect of the BBB is however, lost during bacterial and viral infections. The primary mechanism operative are an increase in the permeability of the BBB and/or direct invasion of the brain by microorganisms. Since the BBB is relatively impermeable to chemotherapeutic agents the treatment of CNS infections is difficult. This paper aims to examine the various mechanisms by which infection spreads to the brain, and suggest measures for successful drug delivery into the brain during infections.
血脑屏障(BBB)是一种高度动态的结构,由内皮细胞组成,其特征是存在紧密连接且相对缺乏内吞小泡。紧密连接由星形胶质细胞的足突加强。血脑屏障通过这些特殊结构发挥作用,通过调节物质的流入和流出,使大脑环境保持稳定状态。然而,在细菌和病毒感染期间,血脑屏障的保护作用会丧失。主要作用机制是血脑屏障通透性增加和/或微生物直接侵入大脑。由于血脑屏障对化疗药物相对不渗透,中枢神经系统感染的治疗很困难。本文旨在研究感染扩散至大脑的各种机制,并提出在感染期间成功将药物递送至大脑的措施。