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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.

Author Information

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.


Received, June 16, 2003.

Accepted, September 3, 2003.

Copyright © by the Congress of Neurological Surgeons