Blood-brain barrier disruption in multiple sclerosis

The blood-brain barrier is specialized to function as a barrier to protect the central nervous system by restricting entry of unwanted molecules and immune cells into the brain and inversely, to prevent central nervous system-born agents from reaching the systemic circulation. The blood-brain barrier endothelium, together with cells involved in its regulation forms the neurovascular unit. Blood-brain barrier dysfunction is an important hallmark of early multiple sclerosis pathophysiology, leading to a consequent loss of the imperative brain homeostasis and subsequent neuronal dysfunction and damage. The neuroinfl ammatory changes at the blood-brain barrier are numerous and include the loss of barrier function, altered communication with surrounding cells, and activation of both infl ammation promoting and dampening mechanisms. A better understanding of blood-brain barrier alterations in neuroinfl ammation might lead to new ways to promote blood-brain barrier function in neurological diseases like multiple sclerosis.