Microbial translocation of the blood-brain barrier.
A major contributing factor to high mortality and morbidity associated with CNS infection is the incomplete understanding of the pathogenesis of this disease. Relatively small numbers of pathogens account for most cases of CNS infections in humans, but it is unclear how such pathogens cross the blood-brain barrier (BBB) and cause infections. The development of the in vitro BBB model using human brain microvascular endothelial cells has facilitated our understanding of the microbial translocation of the BBB, a key step for the acquisition of CNS infections. Recent studies have revealed that microbial translocation of the BBB involves host cell actin cytoskeletal rearrangements, most likely as the result of specific microbial-host interactions. A better understanding of microbial-host interactions that are involved in microbial translocation of the BBB should help in developing new strategies to prevent CNS infections. This review summarises our current understanding of the pathogenic mechanisms involved in translocation of the BBB by meningitis-causing bacteria, fungi and parasites.
Division of Pediatric Infectious Diseases, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Park 256, Baltimore, MD 21287, USA. kwangkim@jhmi.edu
Kwang Sik
KS
Kim
D000818:Animals; D018988:Bacterial Translocation; D001812:Blood-Brain Barrier / Q000382:microbiology*; D020806:Central Nervous System Bacterial Infections / Q000382:microbiology; D020314:Central Nervous System Fungal Infections / Q000382:microbiology; D002494:Central Nervous System Infections / Q000382:microbiology*; D020807:Central Nervous System Parasitic Infections / Q000469:parasitology; D042783:Endothelial Cells / Q000382:microbiology; D004730:Endothelium, Vascular / Q000382:microbiology; D006801:Humans; D051381:Rats