Disruption of blood-brain barrier integrity in postmortem alcoholic brain: preclinical evidence of TLR4 involvement from a binge-like drinking model

Addict Biol. 2017 Jul;22(4):1103-1116. doi: 10.1111/adb.12376. Epub 2016 Mar 7.


Inflammatory cytokines and reactive oxygen species are reported to be involved in blood-brain barrier (BBB) disruption. Because there is evidence that ethanol (EtOH) induces release of free radicals, cytokines and inflammatory mediators we examined BBB integrity and matrix metalloproteinase (MMP) activity in postmortem human alcoholic brain and investigated the role of TLR4 signaling in BBB permeability in TLR4-knockout mice under a binge-like EtOH drinking protocol. Immunohistochemical studies showed reduced immunoreactivity of the basal lamina protein, collagen-IV and of the tight junction protein, claudin-5 in dorsolateral prefrontal cortex of alcoholics. There was also increased MMP-9 activity and expression of phosphorylated ERK1/2 and p-38. Greater number of CD45+ IR cells were observed associated with an enhanced neuroinflammatory response reflected by increased GFAP and Iba-1 immunostaining. To further explore effects of high EtOH consumption on BBB integrity we studied TLR4-knockout mice exposed to the drinking in the dark paradigm. Repetitive EtOH exposure in wild-type mice decreased hippocampal expression of laminin and collagen-IV and increased IgG immunoreactivity, indicating IgG extravasation. Western blot analysis also revealed increased MyD88 and p-ERK1/2 levels. None of these changes was observed in TLR4-knockout mice. Collectively, these findings indicate that chronic EtOH increases degradation of tight junctions and extracellular matrix in postmortem human brain and induces a neuroinflammatory response associated with activation of ERK1/2 and p-38 and greater MMP-9 activity. The EtOH-induced effects on BBB impairment are not evident in the hippocampus of TLR4-knockout mice, suggesting the involvement of TLR4 signaling in the underlying mechanism leading to BBB disruption in mice.

Keywords: MAPK; TLR4; blood-brain barrier; ethanol; human brain; metalloproteinase.

MeSH terms

  • Adult
  • Aged
  • Alcoholism / complications*
  • Alcoholism / genetics
  • Alcoholism / metabolism
  • Animals
  • Autopsy
  • Binge Drinking / complications*
  • Binge Drinking / genetics
  • Binge Drinking / metabolism
  • Blood-Brain Barrier / drug effects*
  • Blood-Brain Barrier / metabolism
  • Blood-Brain Barrier / physiopathology
  • Blotting, Western
  • Brain / drug effects*
  • Brain / metabolism
  • Brain / physiopathology
  • Central Nervous System Depressants / metabolism
  • Central Nervous System Depressants / pharmacology
  • Disease Models, Animal
  • Ethanol / metabolism
  • Ethanol / pharmacology*
  • Female
  • Humans
  • Male
  • Matrix Metalloproteinase 9 / genetics
  • Matrix Metalloproteinase 9 / metabolism
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Middle Aged
  • Tight Junctions / drug effects
  • Tight Junctions / genetics
  • Tight Junctions / metabolism
  • Toll-Like Receptor 4 / genetics
  • Toll-Like Receptor 4 / metabolism*


  • Central Nervous System Depressants
  • Tlr4 protein, mouse
  • Toll-Like Receptor 4
  • Ethanol
  • Matrix Metalloproteinase 9