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Dysfunction of the Blood-brain Barrier in Cerebral Microbleeds: from Bedside to Bench
Hai-Ling Wang1, Chun-Lin Zhang1, Yan-Mei Qiu1
1Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Abstract:
Cerebral microbleeds (CMBs) are a disorder of cerebral microvessels that are characterized as small (<10 mm), hypointense, round or ovoid lesions seen on T2*-weighted gradient echo MRI. There is a high prevalence of CMBs in community-dwelling healthy older people. An increasing number of studies have demonstrated the significance of CMBs in stroke, dementia, Parkinson's disease, gait disturbances and late-life depression. Blood-brain barrier (BBB) dysfunction is considered to be the event that initializes CMBs development. However, the pathogenesis of CMBs has not yet been clearly elucidated. In this review, we introduce the pathogenesis of CMBs, hypertensive vasculopathy and cerebral amyloid angiopathy, and review recent research that has advanced our understanding of the mechanisms underlying BBB dysfunction and CMBs presence. CMBs-associated risk factors can exacerbate BBB breakdown through the vulnerability of BBB anatomical and functional changes. Finally, we discuss potential pharmacological approaches to target the BBB as therapy for CMBs.
Insights
Cerebral microbleeds (CMBs) are common in older adults and linked to neurological disorders. This review explores CMBs pathogenesis, focusing on blood-brain barrier dysfunction and potential therapies.
Area of Science:
- Neurology
- Neuroimaging
- Vascular Biology
Background:
- Cerebral microbleeds (CMBs) are small lesions common in aging populations.
- CMBs are associated with stroke, dementia, and Parkinson's disease.
- Blood-brain barrier (BBB) dysfunction is implicated in CMBs initiation, but pathogenesis remains unclear.
Purpose of the Study:
- To review the pathogenesis of cerebral microbleeds.
- To explore mechanisms of BBB dysfunction in CMBs.
- To discuss potential therapeutic strategies targeting the BBB for CMBs.
Main Methods:
- Literature review of pathogenesis of CMBs.
- Examination of hypertensive vasculopathy and cerebral amyloid angiopathy.
- Analysis of recent research on BBB dysfunction and CMBs.
Main Results:
- CMBs are prevalent in healthy older individuals.
- BBB dysfunction is a key factor in CMB development.
- Risk factors can worsen BBB breakdown, contributing to CMBs.
Conclusions:
- Understanding CMB pathogenesis is crucial for neurological disease management.
- Targeting BBB dysfunction offers potential therapeutic avenues for CMBs.
- Further research is needed to elucidate CMB mechanisms and develop effective treatments.
