[Implication of the blood-brain barrier in neurological diseases: part II]

The main characteristic of the blood-brain-barrier (BBB) is its extremely low permeability, due to tight intercellular endothelial junctions and a variety of transporters, which provides the brain with a unique protection against the potential toxicity of several xenobiotics, but also constitutes a major limitation to drug delivery to the central nervous system. Several dysfunctions of the BBB have been recently implicated in the pathophysiology of neurological diseases: inflammatory, vascular, tumoral, infectious and neurodegenerative diseases. Based on a better knowledge of the BBB biology, new therapeutic strategies are emerging, which by-pass the BBB or take advantage of the selective expression of membrane proteins by brain endothelial cells or circulating leucocytes to target new drugs, such as the anti-VLA4 antibody recently approved for multiple sclerosis treatment. This review will focus on the recently described BBB dysfunctions presumably involved in various neurological diseases.