Wang Yihao, Zhang Fangcheng, Xiong Nanxiang, Xu Hao, Chai Songshan, Wang Haofei, Wang Jiajing, Zhao Hongyang, Jiang Xiaobing, Fu Peng, Xiang Wei
Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China.
Department of Neurosurgery, Zhongnan Hospital, Wuhan University, Wuhan, 430071, People's Republic of China.
Cancer Manag Res. 2021 May 27;13:4217-4232. doi: 10.2147/CMAR.S288720. eCollection 2021.
The blood-brain barrier (BBB) is an essential structure of the central nervous system (CNS), and its existence makes the local internal environment of the CNS a relatively independent structure distinct from other internal environments of the human body to ensure normal physiological and high stability of activities of the CNS. Changes in BBB structure and function are fundamental to the pathophysiology of many diseases. The occurrence and development of glioma are often accompanied by a series of changes in the structure and function of the internal environment, the most significant of which is remodelling of the BBB. The remodelling of the BBB usually leads to changes in the permeability of local microvessels, which provide certain favourable conditions for the occurrence and development of glioma. Meanwhile, the newly generated abnormal blood vessels and the remaining intact regions of the BBB also hinder the effects of drug treatments. Changes in permeability and structural function often lead to the creation of abnormally functioning vascular regions, which pose further treatment challenges. At present, therapeutic methods for glioma have not achieved satisfactory effects in clinical practice, and emerging therapeutic methods have not yet been widely used in clinical practice. In this review, we summarize the knowledge of remodelling of the BBB in the glioma environment, the type of changes that occur, and current BBB treatment methods and prospects for the treatment of glioma.
血脑屏障(BBB)是中枢神经系统(CNS)的重要结构,其存在使CNS的局部内部环境成为一个相对独立的结构,有别于人体的其他内部环境,以确保CNS活动的正常生理功能和高度稳定性。BBB结构和功能的变化是许多疾病病理生理学的基础。胶质瘤的发生和发展通常伴随着内部环境结构和功能的一系列变化,其中最显著的是BBB的重塑。BBB的重塑通常会导致局部微血管通透性的改变,这为胶质瘤的发生和发展提供了一定的有利条件。同时,新生成的异常血管和BBB的剩余完整区域也会阻碍药物治疗的效果。通透性和结构功能的变化往往会导致功能异常的血管区域的形成,这带来了进一步的治疗挑战。目前,胶质瘤的治疗方法在临床实践中尚未取得令人满意的效果,新兴的治疗方法也尚未在临床实践中广泛应用。在这篇综述中,我们总结了胶质瘤环境中BBB重塑的相关知识、所发生的变化类型以及当前针对BBB的治疗方法和胶质瘤治疗的前景。