Setiadi Anthony, Korim Willian S, Elsaafien Khalid, Yao Song T
Florey Institute of Neuroscience and Mental Health, University of Melbourne, Victoria, Australia.
Florey Department of Neuroscience and Mental Health, University of Melbourne, Victoria, Australia.
Exp Physiol. 2018 Mar 1;103(3):337-342. doi: 10.1113/EP086434. Epub 2017 Nov 2.
What is the topic of this review? This review highlights the importance of the blood-brain barrier in the context of diseases involving autonomic dysfunction, such as hypertension and heart failure. What advances does it highlight? It highlights the potential role of pro-inflammatory cytokines, leucocytes and angiotensin II in disrupting the blood-brain barrier in cardiovascular diseases. Advances are highlighted in our understanding of neurovascular unit cells, astrocytes and microglia, with a specific emphasis on their pathogenic roles within the brain. The blood-brain barrier (BBB) is a crucial barrier that provides both metabolic and physical protection to an immune-privileged CNS. The BBB has been shown to be disrupted in hypertension. This review addresses the importance of the BBB in maintaining homeostasis in the context of diseases related to autonomic dysfunction, such as hypertension. We highlight the potentially important roles of the immune system and neurovascular unit in the maintenance of the BBB, whereby dysregulation may lead to autonomic dysfunction in diseases such as heart failure and hypertension. Circulating leucocytes and factors such as angiotensin II and pro-inflammatory cytokines are thought ultimately to downregulate endothelial tight junction proteins that are a crucial component of the BBB. The specific mechanisms underlying BBB disruption and their role in contributing to autonomic dysfunction are not yet fully understood but are a growing area of interest. A greater understanding of these systems and advances in our knowledge of the molecular mechanisms causing BBB disruption will allow for the development of future therapeutic interventions in the treatment of autonomic imbalance associated with diseases such as heart failure and hypertension.
本综述的主题是什么？本综述强调了血脑屏障在涉及自主神经功能障碍的疾病（如高血压和心力衰竭）背景下的重要性。它突出了哪些进展？它突出了促炎细胞因子、白细胞和血管紧张素II在破坏心血管疾病血脑屏障方面的潜在作用。我们对神经血管单元细胞、星形胶质细胞和小胶质细胞的理解有了进展，特别强调了它们在脑内的致病作用。血脑屏障（BBB）是一道关键屏障，为免疫特权的中枢神经系统提供代谢和物理保护。血脑屏障在高血压中已被证明遭到破坏。本综述探讨了血脑屏障在与自主神经功能障碍相关的疾病（如高血压）背景下维持体内平衡的重要性。我们强调了免疫系统和神经血管单元在维持血脑屏障方面的潜在重要作用，失调可能导致心力衰竭和高血压等疾病中的自主神经功能障碍。循环白细胞以及血管紧张素II和促炎细胞因子等因素最终被认为会下调作为血脑屏障关键组成部分的内皮紧密连接蛋白。血脑屏障破坏的具体机制及其在导致自主神经功能障碍中的作用尚未完全了解，但却是一个日益受关注的领域。对这些系统的更深入理解以及我们对导致血脑屏障破坏的分子机制的认识进展，将有助于开发未来治疗与心力衰竭和高血压等疾病相关的自主神经失衡的治疗干预措施。
