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Mechanisms of Disease: The Blood-Brain Barrier

Neuwelt, Edward A. M.D.

doi: 10.1227/01.NEU.0000097715.11966.8E
Special Article

OBJECTIVE: The blood-brain barrier (BBB) is often perceived as a passive membrane. However, evidence has demonstrated that the BBB plays an active role in normal homeostasis and in certain disease processes.

METHODS: Approximately 300 peer-reviewed publications that discussed normal or abnormal BBB function were reviewed.

RESULTS: The role of the BBB and how it contributes to disorders of the central nervous system vary, depending on the specific disease process.

CONCLUSION: In health and disease and extending to old age, endothelial cells, neurons, and glia constitute a neurovascular unit that regulates the BBB. Advances toward penetrating the BBB must account for both normal and abnormal functions of the neurovascular unit.

Departments of Neurology and Neurosurgery, Oregon Health & Science University, Portland, Oregon

Reprint requests:

Edward A. Neuwelt, M.D., Oregon Health & Science University, 3181 SW Sam Jackson Park Road, L603, Portland, OR 97201.

Email: neuwelte@ohsu.edu

Received, June 16, 2003.

Accepted, September 3, 2003.

Copyright © by the Congress of Neurological Surgeons