摘要
The vascular blood-brain barrier is a highly regulated interface between the blood and brain.Its primary function is to protect central neurons while signaling the presence of systemic inflammation and infection to the brain to enable a protective sickness behavior response.With increasing degrees and duration of systemic inflammation,the vascular blood-brain barrier becomes more permeable to solutes,undergoes an increase in lymphocyte trafficking,and is infiltrated by innate immune cells;endothelial cell damage may occasionally occur.Perturbation of neuronal function results in the clinical features of encephalopathy.Here,the molecular and cellular anatomy of the vascular blood-brain barrier is reviewed,first in a healthy context and second in a systemic inflammatory context.Distinct from the molecular and cellular mediators of the blood-brain barrier’s response to inflammation,several moderators influence the direction and magnitude at genetic,system,cellular and molecular levels.These include sex,genetic background,age,pre-existing brain pathology,systemic comorbidity,and gut dysbiosis.Further progress is required to define and measure mediators and moderators of the blood-brain barrier’s response to systemic inflammation in order to explain the heterogeneity observed in animal and human studies.
