Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, A Coruña, Spain.
NeuroAging Laboratory Group (NEURAL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, A Coruña, Spain.
Int J Mol Sci. 2022 Aug 22;23(16):9486. doi: 10.3390/ijms23169486.
Blood-brain barrier (BBB) integrity is essential to maintaining brain health. Aging-related alterations could lead to chronic progressive leakiness of the BBB, which is directly correlated with cerebrovascular diseases. Indeed, the BBB breakdown during acute ischemic stroke is critical. It remains unclear, however, whether BBB dysfunction is one of the first events that leads to brain disease or a down-stream consequence. This review will focus on the BBB dysfunction associated with cerebrovascular disease. An added difficulty is its association with the deleterious or reparative effect, which depends on the stroke phase. We will first outline the BBB structure and function. Then, we will focus on the spatiotemporal chronic, slow, and progressive BBB alteration related to ischemic stroke. Finally, we will propose a new perspective on preventive therapeutic strategies associated with brain aging based on targeting specific components of the BBB. Understanding BBB age-evolutions will be beneficial for new drug development and the identification of the best performance window times. This could have a direct impact on clinical translation and personalised medicine.
血脑屏障 (BBB) 的完整性对于维持大脑健康至关重要。与衰老相关的改变可能导致 BBB 的慢性进行性渗漏，这与脑血管疾病直接相关。事实上，急性缺血性中风期间的 BBB 破裂是至关重要的。然而，尚不清楚 BBB 功能障碍是导致脑部疾病的最初事件之一，还是下游后果。本综述将重点关注与脑血管疾病相关的 BBB 功能障碍。一个额外的困难是它与有害或修复作用的关联，这取决于中风阶段。我们将首先概述 BBB 的结构和功能。然后，我们将重点关注与缺血性中风相关的时空慢性、缓慢和进行性 BBB 改变。最后，我们将基于针对 BBB 的特定成分，提出与大脑衰老相关的预防性治疗策略的新观点。了解 BBB 的年龄演变将有助于新药物的开发和最佳性能窗口时间的确定。这可能会对临床转化和个性化医疗产生直接影响。
