The blood-brain barrier (BBB) is a dynamic but solid shield in the cerebral microvascular system. It plays a pivotal role in maintaining central nervous system (CNS) homeostasis by regulating the exchange of materials between the circulation and the brain and protects the neural tissue from neurotoxic components as well as pathogens. Here, we discuss the development of the BBB in physiological conditions and then focus on the role of the BBB in cerebrovascular disease, including acute ischemic stroke and intracerebral hemorrhage, and neurodegenerative disorders, such as Alzheimer’s disease (AD), Parkinson’s disease (PD), and multiple sclerosis (MS). Finally, we summarize recent advancements in the development of therapies targeting the BBB and outline future directions and outstanding questions in the field. We propose that BBB dysfunction not only results from, but is causal in the pathogenesis of neurological disorders; the BBB is more a contributor to the disruption of CNS homeostasis than a victim in neurological disorders.

中文翻译：

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血脑屏障：比神经系统疾病的受害者更能破坏中枢神经系统的稳态

血脑屏障（BBB）是脑微血管系统中动态但坚固的屏障。它通过调节循环系统和大脑之间的物质交换，在维持中枢神经系统 (CNS) 稳态方面发挥着关键作用，并保护神经组织免受神经毒性成分和病原体的侵害。在这里，我们讨论血脑屏障在生理条件下的发展，然后重点讨论血脑屏障在脑血管疾病（包括急性缺血性中风和脑出血）以及神经退行性疾病（例如阿尔茨海默病（AD）、帕金森病（PD））中的作用和多发性硬化症（MS）。最后，我们总结了针对 BBB 的疗法开发的最新进展，并概述了该领域的未来方向和突出问题。我们认为 BBB 功能障碍不仅是神经系统疾病的发病机制的结果，而且是神经系统疾病发病机制的因果关系。血脑屏障更多的是破坏中枢神经系统稳态的因素，而不是神经系统疾病的受害者。