Mechanisms of Blood–Brain Barrier Disintegration in the Pathophysiology of Multiple Sclerosis

Abstract Multiple sclerosis (MS) is a demyelinating and neurodegenerative disease of the human brain, optic nerves, and spinal cord, which commonly leads to irreversible neurological disability. The etiology and cure of MS remain far from our reach. However, we are making slow, but persistent progress in our understanding of the fundamental mechanisms underlying MS pathophysiology. A prominent step in the pathophysiology of MS is anatomic and physiologic failure of the blood–brain barrier (BBB), which in turn leads to transendothelial migration of activated immune cells and other mediators of neuroinflammation from the periphery to the central nervous system environment. The latest findings on the pathophysiologic mechanisms of the BBB disruption in the context of MS are discussed.