8 - Role of the Blood-Brain Barrier in Communication between the Central Nervous System and the Peripheral Tissues

Abstract

This chapter explores the principles underlying the role of the blood–brain barrier (BBB) in communication between the central nervous system (CNS) and the peripheral tissues. The BBB has an important role in the physiological regulation of peripheral tissues and the CNS function. Alterations in communication are a mechanism by which the BBB may be involved in disease, either as a target of disease processes or as the initiator. The BBB is also important therapeutically, either as a conduit for the delivery of drugs to treat CNS diseases or as the object of treatment when it is itself a target or cause of disease. The passage of peptides and regulatory proteins across the BBB is a key factor in the communication between peripheral tissues and the CNS. Saturable and nonsaturable mechanisms participate in this process and disturbances can lead to disease states. An understanding of mechanisms underlying passage is essential to the rationale drug development of substances that can penetrate the BBB. In addition to being a therapeutic conduit, the BBB can be affected by diseases, can mediate disease processes, or can be the cause of disease.