Abstract
The blood-spinal cord barrier (BSCB) has been long thought of as a functional equivalent to the blood-brain barrier (BBB), restricting blood flow into the spinal cord. The spinal cord is supported by various disc tissues that provide agility and has different local immune responses compared to the brain. Though physiologically, structural components of the BSCB and BBB share many similarities, the clinical landscape significantly differs. Thus, it is crucial to understand the composition of BSCB and also to establish the cause-effect relationship with aberrations and spinal cord dysfunctions. Here, we provide a descriptive analysis of the anatomy, current techniques to assess the impairment of BSCB, associated risk factors and impact of spinal disorders such as spinal cord injury (SCI), amyotrophic lateral sclerosis (ALS), peripheral nerve injury (PNI), ischemia reperfusion injury (IRI), degenerative cervical myelopathy (DCM), multiple sclerosis (MS), spinal cavernous malformations (SCM) and cancer on BSCB dysfunction. Along with diagnostic and mechanistic analyses, we also provide an up-to-date account of available therapeutic options for BSCB repair. We emphasize the need to address BSCB as an individual entity and direct future research towards it.
Highlights
Blood vessels are essential for delivering oxygen and nutrients throughout the body.In the vascular tree, the controlled communication that occurs between blood vessels and components of central nervous system (CNS) is unique
We fill the existing gap in the literature pertaining to the role the blood-spinal cord barrier (BSCB) and BSBC in maintaining spinal cord health and how its dysfunction leads to different disorders
Inset shows tight junction proteins (TJs) like endothelial cell-selective adhesion molecule (ESAM), claudins, occludins and Zonula occludens (ZO-1) holding the endothelial cells (ECs) together (E) Inset represents interaction between ECs and pericytes that plays an important role in maintaining the integrity of BSCB by regulating the uptake of circulating macromolecules
Summary
Blood vessels are essential for delivering oxygen and nutrients throughout the body. In the vascular tree, the controlled communication that occurs between blood vessels and components of central nervous system (CNS) is unique. There are three specialised interfaces in the human body that selectively permit entry of nutrients, ions, lipids and small molecules from the blood stream to either the brain (blood-brain barrier; BBB), cerebral spinal fluid (blood-cerebral spinal fluid barrier; BCSFB) or spinal cord (blood-spinal cord barrier; BSCB). Of these the BBB is the most studied and its dysfunction is associated with neurological disorders such as multiple sclerosis (MS), Alzheimer’s disease. We fill the existing gap in the literature pertaining to the role the BSCB and BSBC in maintaining spinal cord health and how its dysfunction leads to different disorders
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