Development, maintenance and disruption of the blood-brain barrier

Nat Med. 2013 Dec;19(12):1584-96. doi: 10.1038/nm.3407. Epub 2013 Dec 5.


The interface between the blood circulation and the neural tissue features unique characteristics that are encompassed by the term 'blood-brain barrier' (BBB). The main functions of this barrier, namely maintenance of brain homeostasis, regulation of influx and efflux transport, and protection from harm, are determined by its specialized multicellular structure. Every constituent cell type makes an indispensable contribution to the BBB's integrity. But if one member of the BBB fails, and as a result the barrier breaks down, there can be dramatic consequences and neuroinflammation and neurodegeneration can occur. In this Review, we highlight recently gained mechanistic insights into the development and maintenance of the BBB. We then discuss how BBB disruption can cause or contribute to neurological disease. Finally, we examine how this knowledge can be used to explore new possibilities for BBB repair.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Blood Vessels / embryology
  • Blood-Brain Barrier / embryology*
  • Blood-Brain Barrier / injuries*
  • Blood-Brain Barrier / physiology*
  • Brain / blood supply
  • Brain / embryology
  • Humans
  • Neovascularization, Physiologic / physiology
  • Nervous System Diseases / etiology*
  • Nervous System Diseases / therapy
  • Vascular Endothelial Growth Factor A / physiology
  • Wnt Signaling Pathway / physiology


  • Vascular Endothelial Growth Factor A