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Review
. 2013 Oct;33(10):1500-13.
doi: 10.1038/jcbfm.2013.135. Epub 2013 Aug 7.

Blood-brain barrier dysfunction as a cause and consequence of Alzheimer's disease

Michelle A Erickson  1 , William A Banks
Affiliations
Review

Blood-brain barrier dysfunction as a cause and consequence of Alzheimer's disease

Michelle A Erickson et al. J Cereb Blood Flow Metab. 2013 Oct.

Abstract

The blood-brain barrier (BBB) plays critical roles in the maintenance of central nervous system (CNS) homeostasis. Dysfunction of the BBB occurs in a number of CNS diseases, including Alzheimer's disease (AD). A prevailing hypothesis in the AD field is the amyloid cascade hypothesis that states that amyloid-β (Aβ) deposition in the CNS initiates a cascade of molecular events that cause neurodegeneration, leading to AD onset and progression. In this review, the participation of the BBB in the amyloid cascade and in other mechanisms of AD neurodegeneration will be discussed. We will specifically focus on three aspects of BBB dysfunction: disruption, perturbation of transporters, and secretion of neurotoxic substances by the BBB. We will also discuss the interaction of the BBB with components of the neurovascular unit in relation to AD and the potential contribution of AD risk factors to aspects of BBB dysfunction. From the results discussed herein, we conclude that BBB dysfunction contributes to AD through a number of mechanisms that could be initiated in the presence or absence of Aβ pathology.

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Figures

Figure 1
Figure 1
Clearance pathways of amyloid-β (Aβ) from the brain. BBB, blood–brain barrier; CNS, central nervous system; BCSFB, blood–cerebrospinal fluid barrier; CSF, cerebrospinal fluid; ISF, interstitial fluid; RAGE, receptor for advanced glycation endproducts; VSMC, vascular smooth muscle cell.
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