神经系统疾病的血-脑脊液-脑途径：进入大脑的间接途径,Neuropathology and Applied Neurobiology

当前位置： X-MOL 学术 › Neuropathol. Appl. Neurobiol. › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

神经系统疾病的血-脑脊液-脑途径：进入大脑的间接途径
Neuropathology and Applied Neurobiology ( IF 4.0 ) Pub Date : 2021-12-21 , DOI: 10.1111/nan.12789
Oliver Cousins ₁ , Angela Hodges ₂ , Julia Schubert ₁ , Mattia Veronese ₁ , Federico Turkheimer ₁ , Jaleel Miyan ₃ , Britta Engelhardt ₄ , Federico Roncaroli _{3,

5}

Affiliation

大脑受到内皮血脑屏障 (BBB) 的保护，该屏障限制微生物、肿瘤细胞、免疫细胞和自身抗体进入实质。然而，疾病在破坏的 BBB 中传播的经典模型并不能解释在各种神经系统疾病中看到的病灶的局灶性分布，以及为什么病灶经常与脑脊液 (CSF) 空间相邻。我们已经批判性地回顾了血-脑脊液-脑通路作为疾病进入脑实质的可能作用。该途径的第一步是将病原体或免疫成分从血液转移到脉络丛的 CSF 中，即血液 - CSF 屏障 (BCSFB) 所在的位置。脑脊液的流动导致疾病在整个脑脊液空间传播。然后，从脑脊液进入脑实质可以穿过心室表面的室管膜层或穿过蛛网膜下腔和 Virchow-Robin 空间的软脑胶质屏障。我们回顾了血-脑脊液-脑通路的解剖学和生理学以及控制这一过程的脑屏障。然后，我们总结了在包括视神经脊髓炎、多发性硬化、神经结节病、神经精神狼疮、隐球菌感染以及实体瘤和血液肿瘤在内的神经系统疾病的横截面中支持这种大脑进入途径的证据。本总结强调了共享血-脑脊液-脑通路作为致病机制的条件。这些包括病变与 CSF 的特征性接近，脑屏障破坏的证据和脑脊液内显着病理学的识别。更好地理解通过 CSF 和跨组织的病理转移所有脑屏障都将为中枢神经系统原发性和继发性疾病的更有效和更有针对性的治疗提供信息。

"点击查看英文标题和摘要"

The blood–CSF–brain route of neurological disease: The indirect pathway into the brain

The brain is protected by the endothelial blood–brain barrier (BBB) that limits the access of micro-organisms, tumour cells, immune cells and autoantibodies to the parenchyma. However, the classic model of disease spread across a disrupted BBB does not explain the focal distribution of lesions seen in a variety of neurological diseases and why lesions are frequently adjacent to the cerebrospinal fluid (CSF) spaces. We have critically reviewed the possible role of a blood–CSF–brain route as a disease entry pathway into the brain parenchyma. The initial step of this pathway is the transfer of pathogens or immune components from the blood into the CSF at the choroid plexuses, where the blood–CSF barrier (BCSFB) is located. The flow of CSF results in disease dissemination throughout the CSF spaces. Access to the brain parenchyma from the CSF can then occur across the ependymal layer at the ventricular surface or across the pial–glial barrier of the subarachnoid space and the Virchow–Robin spaces. We have reviewed the anatomy and physiology of the blood–CSF–brain pathway and the brain barriers controlling this process. We then summarised the evidence supporting this brain entry route in a cross-section of neurological diseases including neuromyelitis optica, multiple sclerosis, neurosarcoidosis, neuropsychiatric lupus, cryptococcal infection and both solid and haematological tumours. This summary highlights the conditions that share the blood–CSF–brain pathway as a pathogenetic mechanism. These include the characteristic proximity of lesions to CSF, evidence of disruption of the brain barriers and the identification of significant pathology within the CSF. An improved understanding of pathological transfer through the CSF and across all brain barriers will inform on more effective and targeted treatments of primary and secondary diseases of the central nervous system.

更新日期：2021-12-21

点击分享查看原文

点击收藏

阅读更多本刊新发论文本刊介绍/投稿指南