Xiao Minjia, Xiao Zhi Jie, Yang Binbin, Lan Ziwei, Fang Fang
Department of Neurology, Second Xiangya Hospital, Central South University, Changsha, China.
Department of Critical Care Medicine, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Front Neurosci. 2020 Aug 6;14:764. doi: 10.3389/fnins.2020.00764. eCollection 2020.
The blood-brain barrier (BBB) is a dynamic but solid shield in the cerebral microvascular system. It plays a pivotal role in maintaining central nervous system (CNS) homeostasis by regulating the exchange of materials between the circulation and the brain and protects the neural tissue from neurotoxic components as well as pathogens. Here, we discuss the development of the BBB in physiological conditions and then focus on the role of the BBB in cerebrovascular disease, including acute ischemic stroke and intracerebral hemorrhage, and neurodegenerative disorders, such as Alzheimer's disease (AD), Parkinson's disease (PD), and multiple sclerosis (MS). Finally, we summarize recent advancements in the development of therapies targeting the BBB and outline future directions and outstanding questions in the field. We propose that BBB dysfunction not only results from, but is causal in the pathogenesis of neurological disorders; the BBB is more a contributor to the disruption of CNS homeostasis than a victim in neurological disorders.
血脑屏障（BBB）是脑微血管系统中一个动态但坚固的屏障。它通过调节循环系统与大脑之间的物质交换，在维持中枢神经系统（CNS）内环境稳定方面发挥着关键作用，并保护神经组织免受神经毒性成分以及病原体的侵害。在此，我们将讨论生理条件下血脑屏障的发育，然后重点关注血脑屏障在脑血管疾病（包括急性缺血性中风和脑出血）以及神经退行性疾病（如阿尔茨海默病（AD）、帕金森病（PD）和多发性硬化症（MS））中的作用。最后，我们总结了针对血脑屏障治疗方法开发的最新进展，并概述了该领域未来的方向和悬而未决的问题。我们认为，血脑屏障功能障碍不仅是神经疾病发病机制的结果，而且在其中起因果作用；在神经疾病中，血脑屏障更多地是中枢神经系统内环境稳定破坏的促成因素，而非受害者。
