[Research progress on the changes of blood-brain barrier in sepsis-associated encephalopathy].

Q3 Medicine
Xiaoyu Zheng, Qian Xiang, Xiaoxu Dong, Yang Shen, Wei Fang, Hongna Yang
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引用次数: 0

Abstract

Sepsis-associated encephalopathy (SAE) is the most common neurological complication of sepsis, with an incidence of up to 70% in sepsis, and contributes to the increased mortality and disability in sepsis. To date, the exact pathogenesis of SAE is not clear. Most of current researches indicated that blood-brain barrier (BBB) dysfunction, active neuroinflammation, glial cell over activation as well as cerebral microcirculation dysfunction contributed to the pathophysiology of SAE. BBB, as a complex cellular structure between the central nervous system and the peripheral system, strictly controls the entrance and discharge of substances and plays an important role in maintaining the balance between biochemical system and immune system of central system. During the progress of sepsis, inflammatory cytokines and reactive oxygen species resulting from peripheral system directly or indirectly resulted in the damage to the integrity and structure of BBB, which helped above species easily enter into the central system. Above these damages caused glial cell activation (microglia and astrocyte), the imbalance of neurotransmitters, mitochondrial dysfunction and neural apoptosis, which also reversely contributed to the damage to the integrity and permeability of BBB via decreasing the expression of tight junctional protein between cells. Therefore, this review focuses on the structural and functional changes of BBB in SAE, and how these changes lead to the development of SAE, in order to seek a BBB-targeted therapy for SAE.

[脓毒症相关脑病血脑屏障变化的研究进展]。
脓毒症相关脑病(SAE)是脓毒症最常见的神经系统并发症,在脓毒症患者中的发病率高达 70%,是导致脓毒症患者死亡率和残疾率增加的原因之一。迄今为止,SAE 的确切发病机制尚不清楚。目前大多数研究表明,血脑屏障(BBB)功能障碍、活跃的神经炎症、神经胶质细胞过度激活以及脑微循环功能障碍是 SAE 的病理生理学原因。BBB 作为中枢神经系统和外周系统之间的复杂细胞结构,严格控制着物质的进入和排出,在维持中枢系统生化系统和免疫系统的平衡方面发挥着重要作用。在败血症进展过程中,外周系统产生的炎性细胞因子和活性氧直接或间接地破坏了 BBB 的完整性和结构,使上述物质很容易进入中枢系统。上述损伤导致神经胶质细胞(小胶质细胞和星形胶质细胞)活化、神经递质失衡、线粒体功能障碍和神经细胞凋亡,这些损伤还通过降低细胞间紧密连接蛋白的表达反向导致 BBB 的完整性和通透性受损。因此,本综述将重点关注SAE中BBB的结构和功能变化,以及这些变化如何导致SAE的发生,从而寻求针对SAE的BBB靶向疗法。
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
Zhonghua wei zhong bing ji jiu yi xue
Zhonghua wei zhong bing ji jiu yi xue Medicine-Critical Care and Intensive Care Medicine
CiteScore
1.00
自引率
0.00%
发文量
42
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