Blood–brain barrier breakdown as a therapeutic target in traumatic brain injury
Open accessAbstract
Traumatic brain injury (TBI) is the leading cause of death in young adults and children. The treatment of TBI in the acute phase has improved substantially; however, the prevention and management of long-term complications remain a challenge. Blood-brain barrier (BBB) breakdown has often been documented in patients with TBI, but the role of such vascular pathology in neurological dysfunction has only recently been explored. Animal studies have demonstrated that BBB breakdown is involved in the initiation of transcriptional changes in the neurovascular network that ultimately lead to delayed neuronal dysfunction and degeneration. Brain imaging data have confirmed the high incidence of BBB breakdown in patients with TBI and suggest that such pathology could be used as a biomarker in the clinic and in drug trials. Here, we review the neurological consequences of TBI, focusing on the long-term complications of such injuries. We present the clinical evidence for involvement of BBB breakdown in TBI and examine the primary and secondary mechanisms that underlie such pathology. We go on to consider the consequences of BBB injury, before analyzing potential mechanisms linking vascular pathology to neuronal dysfunction and degeneration, and exploring possible targets for treatment. Finally, we highlight areas for future basic research and clinical studies into TBI.
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TBI can disrupt vascular integrity in the meninges and brain parenchyma, resulting in leakage of materials from the blood supply into CNS.
“TBI can disrupt vascular integrity in the meninges and brain parenchyma, resulting in leakage of materials from the blood supply into CNS (Fig. 4) (125-127).”
From The anatomy and immunology of vasculature in the central nervous system (2019) · cites this paper as [125]
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Li, H., Sun, J., Wang, F., Ding, G., Chen, W., Fang, R., Yao, Y., Pang, M., Lu, Z.-Q., & Liu, J. (2016) · Brain Research · doi:10.1016/j.brainres.2016.03.031 · Cited by 152 · see citing works
Cytoprotective protein C pathways and implications for stroke and neurological disorders
Zlokovic, B. V., & Griffin, J. H. (2011) · Trends in Neurosciences · doi:10.1016/j.tins.2011.01.005 · Cited by 128 · see citing works
Matrix Metalloproteinases as New Targets in Alzheimer’s Disease: Opportunities and Challenges
Zipfel, P., Rochais, C., Baranger, K., Rivera, S., & Dallemagne, P. (2020) · Journal of Medicinal Chemistry · doi:10.1021/acs.jmedchem.0c00352 · Cited by 94 · see citing works
Benou, A., Veksler, R., Friedman, A., & Riklin Raviv, T. (2017) · Medical Image Analysis · doi:10.1016/j.media.2017.07.006 · Cited by 91 · see citing works
Self-citationExtracellular Vesicle Proteins and MicroRNAs as Biomarkers for Traumatic Brain Injury
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Role of P2X7 Receptors in Immune Responses During Neurodegeneration
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Extracellular vesicles: pathogenetic, diagnostic and therapeutic value in traumatic brain injury
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Head Injury and Amyotrophic Lateral Sclerosis: A Meta-Analysis
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- Authors
- Shlosberg, D., Benifla, M., Kaufer, D., & Friedman, A.
- Affiliations
- Ben-Gurion University of the Negev (IL)
- University of California, Berkeley (US)
- Corresponding author
- Friedman, Alon
- Venue
- Nature Reviews Neurology
- Published
- 2010-06-15
- Volume
- 6
- Issue
- 7
- Pages
- 393-403
- ISSN
- 1759-4758 (ISSN-L)
- 1759-4766
- PMC
- PMC3625732
- OpenAlex
- W2000965529
- Cited by
- 897
- References
- 175
- Citations by year
- 2026: 38 · 2025: 55 · 2024: 45 · 2023: 56 · 2022: 61 · 2021: 89 · 2020: 84 · 2019: 66 · 2018: 62 · 2017: 53 · 2016: 48 · 2015: 49 · 2014: 52 · 2013: 63 · 2012: 38
- FWCI
- 5.54
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Reviews Neurology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Public Health Service (1R01N5066005)
- National Institute of Neurological Disorders and Stroke (R01NS066005)
- Topics
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Life Sciences › Neuroscience › Neurology › Barrier Structure and Function Studies
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Keywords
- traumatic brain injury, blood-brain barrier disruption, late complications, neurovascular unit, neurodegeneration, biomarkers, secondary injury mechanisms, vascular pathology
- MeSH terms
- Alzheimer Disease, Animals, Blood-Brain Barrier, Brain, Brain Injuries, Epilepsy, Humans, Inflammation, Nerve Degeneration, Seizures
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