Rishi Desai, MD, MPH

Blood brain barrier

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NOTES NOTES  BLOOD BRAIN BARRIER & CSF  BLOOD BRAIN BARRIER (BBB) osms.it/blood-brain_barrier ▪ Selective barrier separating blood, interstitial liquid in central nervous system (CNS) ▪ Molecular transport keeps harmful substances out, allows metabolic waste products to diffuse from brain → plasma ▪ Formed by ▫ Tight junctions between endothelial cells of brain capillaries ▫ Astrocyte projection (“feet”) supporting, maintaining structure ▫ Basal (basement) membrane ▪ Passive transport: no energy needed (e.g. passive diffusion of lipid-soluble molecules) ▪ Active transport: energy needed (e.g. facilitated diffusion of glucose, amino acids) ▪ Primary function: CNS homeostasis ▫ Providing selective nutrient passage ▫ Controlling ﬂuid movement ▫ Protecting from toxins, microbes  Figure 52.1 Components of the blood brain barrier.  BBB PERMEABILITY  ▪ May change due to inﬂammation, irradiation, tumors ▪ Permeant molecules (lipid-soluble molecules) ▫ Steroid hormones; oxygen; carbon dioxide; water; glucose, essential amino acids; certain electrolytes ▪ Impermeant molecules ▫ Non-essential amino acids; waste products; microbes, toxins; proteins; certain electrolytes (e.g. potassium); water-soluble drugs  BBB IN CIRCUMVENTRICULAR ORGANS  ▪ Absent in circumventricular organs → connection between CNS, blood ▪ Includes sensory, secretory organs  Sensory organs ▪ Sense plasma molecules, coordinate response to them ▫ Area postrema/vomiting center (senses harmful substances in blood → vomiting reﬂex) ▫ Subfornical organ ▫ Vascular organ of lamina terminalis Secretory organs ▪ Receive stimuli, secrete substances directly in plasma ▫ Posterior pituitary gland ▫ Median eminence of hypothalamus ▫ Pineal gland  OSMOSIS.ORG 455   

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