title: The blood-brain barrier-gatekeeper to neuronal homeostasis: clinical implications in the setting of stroke.
abstract: The blood-brain barrier is part of the neurovascular unit and serves as a functional and anatomical barrier between the blood and the extracellular space. It controls the flow of solutes in and out of the brain thereby providing an optimal environment for neuronal functioning. Paracellular transport between endothelial cells is restricted by tight junctions and transendothelial transport is reduced and more selective compared to capillaries of other organs. Further, the blood-brain barrier is involved in controlling blood flow and it is the site for signaling damage of the nervous system to the peripheral immune system. As an important player in brain homeostasis, blood-brain barrier dysfunction has been implicated in the pathophysiology of many brain diseases including stroke, traumatic brain injury, brain tumors, epilepsy and neurodegenerative disorders. In this article - highlighting recent advances in basic science - we review the features of the blood-brain barrier and their significance for neuronal homeostasis to discuss clinical implications for neurological complications following cerebral ischemia.
authors.affiliation: Institute for Neurophysiology, Charité - University Medicine Berlin, Germany.
authors.forename: Karl
authors.initials: K
authors.lastname: Schoknecht
authors.affiliation: Departments of Physiology & Cell Biology, Cognitive & Brain Sciences, The Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Yaron
authors.initials: Y
authors.lastname: David
authors.affiliation: Institute for Neurophysiology, Charité - University Medicine Berlin, Germany. Electronic address: uwe.heinemann@charite.de.
authors.forename: Uwe
authors.initials: U
authors.lastname: Heinemann
mesh_terms: D000818:Animals; D001812:Blood-Brain Barrier / Q000502:physiology*; D001921:Brain / Q000276:immunology*; D001927:Brain Diseases / Q000378:metabolism / Q000503:physiopathology*; D006706:Homeostasis; D006801:Humans; D020521:Stroke / Q000503:physiopathology
keywords: Blood–brain barrier; Cerebral inflammation; Cerebral ischemia; Neurological complications; Neurovascular coupling