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A contemporary concept of the blood-aqueous barrier
Open accessAbstract
This review traces the evolution of the concept of the blood-aqueous barrier (BAB) during the past 20 years. The Classical model simply stipulated that the tight junctions of the iris vasculature and ciliary epithelium excluded plasma proteins from the aqueous humor (AH). It failed to reconcile the presence of AH protein levels equal to 1% of that found in plasma. Moreover, models of barrier kinetics assumed that the processes of AH secretion and plasma protein entry were directly linked. Thus, elevations of AH protein levels could only be explained by a pathological breakdown of the BAB. Over the last 20 years it has been shown that the plasma proteins in normal AH by-pass the posterior chamber entirely. Instead, these proteins diffuse from the capillaries of ciliary body stroma, into the iris stroma and then into the anterior chamber. This creates a reservoir of plasma-proteins in the iris stroma that is not derived from the iris vessels. This reservoir is prevented from diffusing posteriorly by tight junctions in the posterior iris epithelium. The one-way valve created by the pupil resting on the anterior lens capsule, combined with the continuous, forward flow of AH through the pupil, prevents protein reflux into the posterior chamber. Importantly, in the new paradigm, secretion of AH and the entry of plasma proteins into AH, are semi-independent events. This opens the possibility that AH protein levels could increase in the absence of breakdown of the BAB. Clinical consequences of this new paradigm of the BAB are discussed.
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Metadata
- Authors
- Freddo, T. F.
- Affiliations
- Boston University (US)
- Corresponding author
- Freddo, Thomas F.
- Venue
- Progress in Retinal and Eye Research
- Publisher
- Elsevier BV
- Published
- 2013-01
- Volume
- 32
- Pages
- 181-195
- ISSN
- 1350-9462 (ISSN-L)
- PMC
- PMC3544162
- OpenAlex
- W2033105460
- Cited by
- 143
- References
- 102
- Citations by year
- 2026: 19 · 2025: 17 · 2024: 13 · 2023: 24 · 2022: 10 · 2021: 6 · 2020: 9 · 2019: 8 · 2018: 4 · 2017: 7 · 2016: 9 · 2015: 11 · 2014: 3 · 2013: 3
- FWCI
- 0.84
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- Locations
- Progress in Retinal and Eye Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5r01ey004567-17)
- National Eye Institute (R01-EY04567, R01EY009699, R01EY013825, R01 EY-09699, R01 EY-13825)
- Topics
- Health Sciences › Medicine › Ophthalmology › Glaucoma and retinal disorders
- Life Sciences › Neuroscience › Neurology › Barrier Structure and Function Studies
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Keywords
- blood-aqueous barrier, aqueous humor protein, iris stroma, tight junctions, iris vasculature, ciliary epithelium, aqueous humor secretion
- MeSH terms
- Animals, Anterior Chamber, Aqueous Humor, Capillary Permeability, Humans, Blood-Aqueous Barrier
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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