Claudin-5 is a tight junction (TJ) protein in the blood-brain barrier (BBB) that has recently attracted increased attention. Numerous studies have demonstrated that claudin-5 regulates the integrity and permeability of the BBB. Increased claudin-5 expression plays a neuroprotective role in neurological diseases, particularly in cerebral ischemic stroke. Moreover, claudin-5 might be a potential marker for early hemorrhagic transformation detection in ischemic stroke. In light of the distinctive effects of claudin-5 on the nervous system, we present the elaborate network of roles that claudin-5 plays in ischemic stroke. In this review, we first introduce basic knowledge regarding the BBB and the claudin family, the characterization and regulation of claudin-5, and association between claudin-5 and other TJ proteins. Subsequently, we describe BBB dysfunction and neuron-specific drivers of pathogenesis of ischemic stroke, including inflammatory disequilibrium and oxidative stress. Furthermore, we summarize promising ischemic stroke treatments that target the BBB via claudin-5, including modified rt-PA therapy, pharmacotherapy, hormone treatment, receptor-targeted therapy, gene therapy, and physical therapy. This review highlights recent advances and provides a comprehensive summary of claudin-5 in the regulation of the BBB and may be helpful for drug design and clinical therapy for treatment of ischemic stroke.

Claudin-5是血脑屏障（BBB）中的紧密连接（TJ）蛋白，最近引起了越来越多的关注。大量研究表明，claudin-5可调节BBB的完整性和通透性。claudin-5表达的增加在神经系统疾病（尤其是脑缺血性中风）中具有神经保护作用。此外，claudin-5可能是缺血性中风早期出血转化检测的潜在标志物。鉴于claudin-5对神经系统的独特作用，我们介绍了claudin-5在缺血性中风中扮演的复杂角色。在这篇综述中，我们首先介绍有关BBB和claudin家族的基本知识，claudin-5的表征和调控以及claudin-5与其他TJ蛋白之间的关联。随后，我们描述血脑屏障功能障碍和缺血性中风的发病机制的神经元特定驱动程序，包括炎症性不平衡和氧化应激。此外，我们总结了通过claudin-5靶向BBB的有前途的缺血性卒中治疗，包括改良的rt-PA治疗，药物治疗，激素治疗，受体靶向治疗，基因治疗和物理治疗。这篇综述着重介绍了最近的进展，并提供了claudin-5在BBB调节中的全面综述，可能有助于药物设计和临床治疗缺血性中风的治疗。药物治疗，激素治疗，受体靶向治疗，基因治疗和物理治疗。这篇综述着重介绍了最近的进展，并提供了claudin-5在BBB调节中的全面综述，可能有助于药物设计和临床治疗缺血性中风的治疗。药物治疗，激素治疗，受体靶向治疗，基因治疗和物理治疗。这篇综述着重介绍了最近的进展，并提供了claudin-5在BBB调节中的全面综述，可能有助于药物设计和临床治疗缺血性中风的治疗。