Immunologic privilege in the central nervous system and the blood-brain barrier.
The brain is in many ways an immunologically and pharmacologically privileged site. The blood-brain barrier (BBB) of the cerebrovascular endothelium and its participation in the complex structure of the neurovascular unit (NVU) restrict access of immune cells and immune mediators to the central nervous system (CNS). In pathologic conditions, very well-organized immunologic responses can develop within the CNS, raising important questions about the real nature and the intrinsic and extrinsic regulation of this immune privilege. We assess the interactions of immune cells and immune mediators with the BBB and NVU in neurologic disease, cerebrovascular disease, and intracerebral tumors. The goals of this review are to outline key scientific advances and the status of the science central to both the neuroinflammation and CNS barriers fields, and highlight the opportunities and priorities in advancing brain barriers research in the context of the larger immunology and neuroscience disciplines. This review article was developed from reports presented at the 2011 Annual Blood-Brain Barrier Consortium Meeting.
Department of Neurology, Oregon Health and Science University, Portland, OR, USA.
Leslie L
LL
Muldoon
Jorge I
JI
Alvarez
David J
DJ
Begley
Ruben J
RJ
Boado
Gregory J
GJ
Del Zoppo
Nancy D
ND
Doolittle
Britta
B
Engelhardt
John M
JM
Hallenbeck
Russell R
RR
Lonser
John R
JR
Ohlfest
Alexandre
A
Prat
Maurizio
M
Scarpa
Richard J
RJ
Smeyne
Lester R
LR
Drewes
Edward A
EA
Neuwelt
D000818:Animals; D001812:Blood-Brain Barrier / Q000276:immunology*; D002493:Central Nervous System Diseases / Q000276:immunology*; D004730:Endothelium, Vascular / Q000276:immunology; D006801:Humans; D020078:Neurogenic Inflammation / Q000276:immunology*; D059906:Neuroimaging; D015213:Neuroimmunomodulation