Microglia serve as the brain’s “first responders” and are present throughout the brain and spinal cord. The new study, which was published today in the Proceedings of the National Academy of Science, reveals that the brain’s immune system, specifically cells called microglia, play a central role in the process of repairing damage to the BBB. This most frequently occurs during a stroke, which triggers inflammation that can cause the BBB to break down. It is, therefore, imperative that the openings in the BBB are resealed, and quickly. When the BBB is breached the brain becomes vulnerable to infection and injury. Movement in and out of the brain is tightly controlled through a complex system of gateways and controls that are collectively referred to as the blood-brain barrier (BBB). It possesses a dedicated system of defenses against infection and recently Nedergaard and her colleagues demonstrated that the brain also maintains its own unique process of removing waste. The brain is essentially an independent and separate ecosystem. “When this barrier is breached it must be rapidly repaired in order to maintain the health of the brain and aid in recovery after an injury – a process that could be impaired by drugs that are intended to prevent this damage in the first place.” “This study shows that the resident immune cells of the central nervous system play a critical and previously unappreciated role in maintaining the integrity of the blood-brain barrier,” said Maiken Nedergaard, M.D., D.M.Sc., co-director of the Center for Translational Neuromedicine at the University of Rochester Medical Center (URMC) and lead author of the study. These findings have significant clinical implications because certain cardiovascular drugs could possibly impede the brain’s ability to repair itself after a stroke or other injury. Siponimod, Ponesimod and Ozanimod target the same receptors as Gilenya (fingolimod).New research shows that the cells responsible for protecting the brain from infection and inflammation are also responsible for repairing the system of defenses that separates the brain from the rest of the body. Gilenya (fingolimod) targets receptors on the BBB to strengthen the barrier, and also traps immune cells in the lymph glands so they don't cross into the central nervous system. These include Tysabri (natalizumab), which binds to immune cells so they can't get through the barrier. Several of the disease modifying drugs currently available or in development act on the blood-brain barrier itself, or aim to stop immune cells from passing through the BBB. Possible links between gut health and the strength of the BBB have been explored through work on the microbiome. The BBB can be damaged or disrupted by many things including stress, inflammation, or chemical processes thought to be triggered by disease, drugs, air pollution or smoking. These cells then attack the myelin around your nerves, which leads to nerve damage and MS symptoms. If the BBB is damaged or weakened in some way, immune cells are able to cross. A breakdown in the blood-brain barrier (BBB) is thought to be an early stage in this process. It is thought that there are a series of events that lead to multiple sclerosis. The blood-brain barrier (BBB) is maintained by glial cells, including astrocytes. In the brain and spinal cord, the endothelial cells are tightly joined together, and substances can only cross the barrier through controlled transport channels or under special circumstances. ![]() Throughout most of your body, the tiny blood vessels (capillaries) are lined by endothelial cells, but substances can seep in and out of them between the gaps in the cell layer. Brain and nerve cells in the CNS need to be able to get oxygen and glucose from the blood but not to become infected by disease or to be influenced by hormones produced elsewhere in the body. The brain and spinal cord have very specific requirements to enable them to function efficiently. This barrier prevents large molecules, immune cells, and disease-causing organisms such as bacteria and viruses from passing from the blood stream into the central nervous system (CNS). ![]() The blood-brain barrier is a tightly packed layer of cells that line the blood vessels in the brain and spinal cord. Pharmaceutical and other industry supporters.
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