Abstract
The blood–brain barrier (BBB) plays a vital role in maintaining the specialized microenvironment of the neural tissue. It separates the peripheral circulatory system from the brain parenchyma while facilitating communication. Alterations in the distinct physiological properties of the BBB lead to BBB breakdown associated with normal aging and various neurodegenerative diseases. In this review, we first briefly discuss the aging process, then review the phenotypes and mechanisms of BBB breakdown associated with normal aging that further cause neurodegeneration and cognitive impairments. We also summarize dementia such as Alzheimer's disease (AD) and vascular dementia (VaD) and subsequently discuss the phenotypes and mechanisms of BBB disruption in dementia correlated with cognition decline. Overlaps between AD and VaD are also discussed. Techniques that could identify biomarkers associated with BBB breakdown are briefly summarized. Finally, we concluded that BBB breakdown could be used as an emerging biomarker to assist to diagnose cognitive impairment associated with normal aging and dementia.
Highlights
The central nervous system (CNS) comprises the brain and spinal cord that control all the essential functions of the body
In Alzheimer’s disease (AD) with disruption of blood–brain barrier (BBB), Aβ and neurofibrillary tangles (NFT) of p-tau accumulate in the blood vessel, causing further inflammation in the neurovascular unit (NVU) that, in turn, induces the release inflammatory factors to degenerate neurons associated with a decline in cognition
Another factor that degrades the integrity of BBB associated with AD is APOE4
Summary
The central nervous system (CNS) comprises the brain and spinal cord that control all the essential functions of the body. In the aged human brain, the level of soluble PDGFRβ in cerebrospinal fluid (CSF) increases, showing damage to the pericyte associated with BBB disruption (Montagne et al, 2015; Sagare et al, 2015; Nation et al, 2019).
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