Review
Anatomy and physiology of the blood–brain barrier

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Abstract

Essential requisite for the preservation of normal brain activity is to maintain a narrow and stable homeostatic control in the neuronal environment of the CNS. Blood flow alterations and altered vessel permeability are considered key determinants in the pathophysiology of brain injuries. We will review the present-day literature on the anatomy, development and physiological mechanisms of the blood–brain barrier, a distinctive and tightly regulated interface between the CNS and the peripheral circulation, playing a crucial role in the maintenance of the strict environment required for normal brain function.

Section snippets

Anatomy of the blood–brain barrier

To maintain normal brain function, the neural environment must be preserved within a narrow homeostatic range; this requires a tight regulation of transportation of cells, molecules and ions between the blood and the brain. Such tight regulation is maintained by a unique anatomical and physiological barrier, formed collectively in the central nervous system (CNS). The existence of a physical interface between the CNS and the peripheral circulation and the vascular capacity was first described

Development of the blood–brain barrier

A key developmental phase of the BBB lies in the early communications of the embryonic endothelium with neural cells [17]. The BBB matures during fetal life and is well formed by birth [18], [19], [20], [21], [22], [23]. Transport mechanisms may continue to develop in mammals born in a relatively immature state (such as the rat and mouse) and become fully functional only in the peri- or post-natal period [24]. The development of the vascular endothelium is now known to be provoked by

Physiology of the blood–brain barrier

Each of the three main CNS interface layers: the BBB, choroid plexus epithelium and the epithelium of the arachnoid mater, functions as a physical, transport, metabolic, and immunologic barrier. The barrier functions are dynamic and respond to regulatory signals from both blood and brain. Tight junctions between adjacent cells restrict diffusion of polar solutes through the intercellular cleft (paracellular pathway). The barriers are permeable to O2 and CO2 and other gaseous molecules such as

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