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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">epilepsia</journal-id><journal-title-group><journal-title xml:lang="en">Epilepsy and paroxysmal conditions</journal-title><trans-title-group xml:lang="ru"><trans-title>Эпилепсия и пароксизмальные состояния</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2077-8333</issn><issn pub-type="epub">2311-4088</issn><publisher><publisher-name>IRBIS LLC</publisher-name></publisher></journal-meta><article-meta><article-id custom-type="elpub" pub-id-type="custom">epilepsia-34</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>LITERATURE SURVEY</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОР ЛИТЕРАТУРЫ</subject></subj-group></article-categories><title-group><article-title>СURRENT CONCEPTS OF THE ROLE OF ALTERED BLOOD-BRAIN BARRIER RESISTANCE IN THE PATHOGENESIS OF CNS DISORDERS. PART II: FUNCTIONS AND MECHANISMS OF THE BLOOD-BRAIN BARRIER DAMAGE</article-title><trans-title-group xml:lang="ru"><trans-title>СОВРЕМЕННЫЕ ПРЕДСТАВЛЕНИЯ О РОЛИ НАРУШЕНИЯ РЕЗИСТЕНТНОСТИ ГЕМАТОЭНЦЕФАЛИЧЕСКОГО БАРЬЕРА В ПАТОГЕНЕЗЕ ЗАБОЛЕВАНИЙ ЦНС. ЧАСТЬ 2: ФУНКЦИИ И МЕХАНИЗМЫ ПОВРЕЖДЕНИЯ ГЕМАТОЭНЦЕФАЛИЧЕСКОГО БАРЬЕРА</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Блинов</surname><given-names>Д. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Blinov</surname><given-names>D. V.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Российский национальный исследовательский медицинский университет имени Н. И. Пирогова, Москва</institution><country>Россия</country></aff><aff xml:lang="en"><institution>The Russian National Research Medical University named after N.I. Pirogov of the Ministry of Health of the Russian Federation, Moscow</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2014</year></pub-date><pub-date pub-type="epub"><day>01</day><month>06</month><year>2016</year></pub-date><volume>6</volume><issue>1</issue><fpage>70</fpage><lpage>84</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Blinov D.V., 2016</copyright-statement><copyright-year>2016</copyright-year><copyright-holder xml:lang="ru">Блинов Д.В.</copyright-holder><copyright-holder xml:lang="en">Blinov D.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.epilepsia.su/jour/article/view/34">https://www.epilepsia.su/jour/article/view/34</self-uri><abstract><p>Abstract: altered permeability of the blood-brain  barrier (BBB) plays a key role in the pathogenesis of epilepsy as well as vascular, demyelinating, neurodegenerative central neural system (CNS) diseases, head injury, hypoxic-ischemic CNS damage in obstetric practice, and other common disorders.  The understanding  of functions, transport  mechanisms and mechanisms of damage  of the BBB in pathologic  settings  would allow determining  promising  ways to improve the efficacy of current diagnostics  and treatment  options.  The review article describes  brain-to-blood  and blood-to-brain  transport  and presents four main mechanisms of transcellular  transport  of bioactive substances via the BBB: simple diffusion, carrier-mediated diffusion, carrier-mediated  transport  (liquid endocytosis,  receptor-mediated  endocytosis,  absorption-mediated  transport) and efflux transport.  Our knowledge of mechanisms of BBB damage  are limited to three main types (dehiscence  of 'tight junctions' between endothelial cells, toxic damage of the membrane structures of astrocytes  and endotelial cells, and physical destruction  of the BBB). Detailed descriptions  are provided of specific features of the BBB damage associated with various pathologies – hypoxic-ischemic CNS damage, inflammation, pain, toxic exposure, tumor growth, etc. This allows to rationalize the need for objective assessment of the BBB and neural tissue condition by detecting neurospecific proteins in blood serum to choose adequate approach to treatment and rehabilitation.</p></abstract><trans-abstract xml:lang="ru"><p>При эпилепсии, а также при сосудистых, демиелинизирующих, нейродегенеративных заболеваниях центральной нервной системы (ЦНС), при черепно­мозговой травме (ЧМТ), при гипоксически-ишемическом поражении ЦНС в акушерской практике и ряде других распространенных заболеваний ключевую роль в патогенезе играет нарушение проницаемости гематоэнцефалического барьера (ГЭБ). Понимание функций, транспортных механизмов и механизмов повреждения ГЭБ в условиях патологии даст возможность определить перспективные пути улучшения эффективности своевременной диагностики и терапии. В обзорной статье описан транспорт в направлении «мозг – кровь» и «кровь – мозг», представлены четыре основных механизма трансцеллюлярного транспорта биологически активных веществ через ГЭБ: простая диффузия (simple diffusion), облегченная диффузия, опосредованная переносчиком (carrier-mediated diffusion), опосредованный переносчиком транспорт (carrier-mediated transport), (жидкостный эндоцитоз, рецепторно-опосредованный эндоцитоз, адсорбтивно­опосредованный транспорт) и эффлюксный транспорт. Представления об основных механизмах повреждения ГЭБ сведены к трем основным видам (расхождение «плотных контактов» между эндотелиоцитами, токсическое повреждение мембранных структур астроцитов и эндотелиоцитов, физическое разрушение структур ГЭБ). Детально описаны особенности повреждения ГЭБ при различных патологических состояниях – гипоксически-ишемическом поражении ЦНС, воспалении, болевом, токсическом воздействии, опухолевом росте и др. Это дает возможность обосновать необходимость объективной оценки состояния ГЭБ и нервной ткани путем определения нейроспецифических белков в сыворотке крови для выбора адекватной тактики лечения и реабилитации.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>ЦНС</kwd><kwd>ГЭБ</kwd><kwd>резистентность</kwd><kwd>трансцеллюлярный транспорт</kwd><kwd>плотные контакты</kwd></kwd-group><kwd-group xml:lang="en"><kwd>CNS</kwd><kwd>BBB</kwd><kwd>resistance</kwd><kwd>transcellular transport</kwd><kwd>tight junctions</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Андрианов В.В., Гайнутдинов Х.Л., Гайнутдинова Т.Х., Мухамедшина Д.И., Штарк М.Б., Эпштейн О.И. 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