Targeting the Blood-Brain Barrier to Prevent Sepsis-Associated Cognitive Impairment
| العنوان: | Targeting the Blood-Brain Barrier to Prevent Sepsis-Associated Cognitive Impairment |
|---|---|
| المؤلفون: | Candice M. Brown, Jessica Griffith, Divine C. Nwafor, Paul R. Lockman, Werner J. Geldenhuys, Allison L. Brichacek, Brandon Lucke-Wold, Afroz S. Mohammad, Stanley A. Benkovic |
| المصدر: | Journal of Central Nervous System Disease, Vol 11 (2019) Journal of Central Nervous System Disease |
| بيانات النشر: | SAGE Publications, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | 0301 basic medicine, medicine.medical_specialty, Review, Disease, Blood–brain barrier, lcsh:RC346-429, neuroinflammation, Sepsis, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Medicine, tissue non-specific alkaline phosphatase, Cognitive impairment, lcsh:Neurology. Diseases of the nervous system, Neuroinflammation, sepsis-associated encephalopathy, business.industry, blood-brain barrier, Sepsis-Associated Encephalopathy, medicine.disease, 3. Good health, 030104 developmental biology, medicine.anatomical_structure, drug delivery, business, 030217 neurology & neurosurgery |
| الوصف: | Sepsis is a systemic inflammatory disease resulting from an infection. This disorder affects 750 000 people annually in the United States and has a 62% rehospitalization rate. Septic symptoms range from typical flu-like symptoms (eg, headache, fever) to a multifactorial syndrome known as sepsis-associated encephalopathy (SAE). Patients with SAE exhibit an acute altered mental status and often have higher mortality and morbidity. In addition, many sepsis survivors are also burdened with long-term cognitive impairment. The mechanisms through which sepsis initiates SAE and promotes long-term cognitive impairment in septic survivors are poorly understood. Due to its unique role as an interface between the brain and the periphery, numerous studies support a regulatory role for the blood-brain barrier (BBB) in the progression of acute and chronic brain dysfunction. In this review, we discuss the current body of literature which supports the BBB as a nexus which integrates signals from the brain and the periphery in sepsis. We highlight key insights on the mechanisms that contribute to the BBB’s role in sepsis which include neuroinflammation, increased barrier permeability, immune cell infiltration, mitochondrial dysfunction, and a potential barrier role for tissue non-specific alkaline phosphatase (TNAP). Finally, we address current drug treatments (eg, antimicrobials and intravenous immunoglobulins) for sepsis and their potential outcomes on brain function. A comprehensive understanding of these mechanisms may enable clinicians to target specific aspects of BBB function as a therapeutic tool to limit long-term cognitive impairment in sepsis survivors. |
| تدمد: | 1179-5735 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4483c9d8c151142408df36eaba44e550Test https://doi.org/10.1177/1179573519840652Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....4483c9d8c151142408df36eaba44e550 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 11795735 |
|---|