The nerve: A fragile balance between physiology and pathophysiology
Jean-Pierre Estebe1, Arthur Atchabahian
1From the Department of Anaesthesiology, Intensive Care, and Pain Medicine, University of Rennes, CHU of Rennes, Cedex 9, France (J-PE); Department of Anesthesiology, Perioperative Care, and Pain Medicine, NYU School of Medicine, New York, New York, USA (AA).
European Journal of Anaesthesiology
|February 2, 2017
Summary
Nerves are complex living tissues, not simple conduits. Understanding the blood-nerve barrier is crucial for treating nerve disorders and improving drug delivery to nerves.
Area of Science:
- Neuroscience
- Physiology
- Pharmacology
Background:
- Nerves are often mistakenly viewed as simple electrical cables.
- This oversimplification hinders understanding of postoperative nerve anomalies and disorders.
- Nerves possess complex physiological regulation, akin to the blood-brain barrier.
Purpose of the Study:
- To review the structure and function of the blood-nerve barrier (BNB).
- To highlight mechanisms of BNB breakdown and associated disorders.
- To emphasize the BNB's role as a significant pharmacologic barrier.
Main Methods:
- Literature review of nerve physiology and the blood-nerve barrier.
- Analysis of molecular diffusion across the perineurium.
- Examination of inflammatory cascades and ischemic events in neural tissue.
Main Results:
- The blood-nerve barrier regulates molecular exchange, limiting diffusion.
- Compromised vascular blood supply leads to rapid nerve ischemia.
- Inflammation can cause secondary nerve damage even after initial injury.
Conclusions:
- The blood-nerve barrier is a critical factor in nerve function and drug delivery.
- Understanding BNB dynamics is essential for managing nerve disorders.
- The barrier's complexity influences therapeutic strategies and outcomes in neuropathy.
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