Blood-brain barrier disruption: a culprit of cognitive decline?

IF 5.9 1区医学 Q1 NEUROSCIENCES

Fluids and Barriers of the CNS Pub Date : 2024-08-07 DOI:10.1186/s12987-024-00563-3

Ji Che, Yinying Sun, Yixu Deng, Jun Zhang

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引用次数: 0

Abstract

Cognitive decline covers a broad spectrum of disorders, not only resulting from brain diseases but also from systemic diseases, which seriously influence the quality of life and life expectancy of patients. As a highly selective anatomical and functional interface between the brain and systemic circulation, the blood-brain barrier (BBB) plays a pivotal role in maintaining brain homeostasis and normal function. The pathogenesis underlying cognitive decline may vary, nevertheless, accumulating evidences support the role of BBB disruption as the most prevalent contributing factor. This may mainly be attributed to inflammation, metabolic dysfunction, cell senescence, oxidative/nitrosative stress and excitotoxicity. However, direct evidence showing that BBB disruption causes cognitive decline is scarce, and interestingly, manipulation of the BBB opening alone may exert beneficial or detrimental neurological effects. A broad overview of the present literature shows a close relationship between BBB disruption and cognitive decline, the risk factors of BBB disruption, as well as the cellular and molecular mechanisms underlying BBB disruption. Additionally, we discussed the possible causes leading to cognitive decline by BBB disruption and potential therapeutic strategies to prevent BBB disruption or enhance BBB repair. This review aims to foster more investigations on early diagnosis, effective therapeutics, and rapid restoration against BBB disruption, which would yield better cognitive outcomes in patients with dysregulated BBB function, although their causative relationship has not yet been completely established.

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血脑屏障破坏：认知能力下降的罪魁祸首？

认知功能衰退涉及的疾病范围很广，不仅包括脑部疾病，还包括全身性疾病，严重影响患者的生活质量和预期寿命。血脑屏障（BBB）是大脑和全身循环之间的一个高度选择性的解剖和功能界面，在维持大脑平衡和正常功能方面发挥着关键作用。认知能力下降的发病机理可能各不相同，但越来越多的证据表明，血脑屏障破坏是最常见的致病因素。这可能主要归因于炎症、代谢功能障碍、细胞衰老、氧化/亚硝基应激和兴奋毒性。然而，表明生物BB破坏导致认知能力下降的直接证据并不多见，有趣的是，仅操纵生物BB的开放就可能对神经系统产生有益或有害的影响。综观目前的文献，我们发现 BBB 干扰与认知能力下降、BBB 干扰的风险因素以及 BBB 干扰的细胞和分子机制之间存在密切关系。此外，我们还讨论了BBB破坏导致认知能力下降的可能原因，以及预防BBB破坏或加强BBB修复的潜在治疗策略。本综述旨在促进更多关于早期诊断、有效治疗和快速修复 BBB 破坏的研究，这将为 BBB 功能失调的患者带来更好的认知结果，尽管它们之间的因果关系尚未完全确定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Fluids and Barriers of the CNS Neuroscience-Developmental Neuroscience

CiteScore

10.70

自引率

8.20%

发文量

审稿时长

14 weeks

期刊介绍： "Fluids and Barriers of the CNS" is a scholarly open access journal that specializes in the intricate world of the central nervous system's fluids and barriers, which are pivotal for the health and well-being of the human body. This journal is a peer-reviewed platform that welcomes research manuscripts exploring the full spectrum of CNS fluids and barriers, with a particular focus on their roles in both health and disease. At the heart of this journal's interest is the cerebrospinal fluid (CSF), a vital fluid that circulates within the brain and spinal cord, playing a multifaceted role in the normal functioning of the brain and in various neurological conditions. The journal delves into the composition, circulation, and absorption of CSF, as well as its relationship with the parenchymal interstitial fluid and the neurovascular unit at the blood-brain barrier (BBB).