The blood-brain barrier

Abstract

There has been extraordinary research in the blood-brain barrier over the past decade. Once considered a static anatomical barrier to the traffic of molecules in and out of the central nervous system when fully developed in adults, and otherwise irrelevant to neuroscience and disease, the blood-brain barrier is now known not only to be fully functional in development, but vital in cerebrovascular angiogenesis. The cellular components and other molecular constituents of the blood-brain barrier, contained in a neurovascular unit, protect the central nervous system from injury and disease by limiting the passage of toxins, pathogens, and inflammatory effectors of the immune system. Blood-brain barrier breakdown has been recognized as an important factor in a variety of primary neurological diseases however such disturbances while common to primary and vasculitis of the central nervous system, has yet to be critically analyzed. The chapter provides a comprehensive review of the blood-brain barrier in health and disease, with special consideration to the pathogenesis of central nervous system vasculitis. This chapter reviews the history, neurodevelopment, ultrastructure, function, and clinicopathologic correlation and relevance to central nervous system vasculitis.