Cited by 897Traumatic Brain Injury and Neurovascular DisturbancesBarrier Structure and Function StudiesTraumatic Brain Injury Research

Blood–brain barrier breakdown as a therapeutic target in traumatic brain injury

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Shlosberg, Dan, Benifla, Mony, Kaufer, Daniela, Friedman, Alon·2010·Nature Reviews Neurology

Abstract

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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Crossref · 10.1038/nrneurol.2010.74

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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).”

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  1. [90]Floyd CL Lyeth BG Weber JT Maas AIR Progress in Brain Research Neurotrauma: New Insights into Pathology and Treatment 61 79 Elsevier Amsterdam 2007

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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
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
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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