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
Abstract
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.
About the Author
D. V. Blinov
The Russian National Research Medical University named after N.I. Pirogov of the Ministry of Health of the Russian Federation, Moscow
Russian Federation
Russian Federation
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For citations:
Blinov D.V. 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. Epilepsy and paroxysmal conditions. 2014;6(1):70-84. (In Russ.)
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