The blood–spinal cord barrier: Morphology and Clinical Implications

Abstract

The blood-spinal cord barrier (BSCB) is the functional equivalent of the blood-brain barrier (BBB) in the sense of providing a specialized microenvironment for the cellular constituents of the spinal cord. Even if intuitively the BSCB could be considered as the morphological extension of the BBB into the spinal cord, evidence suggests that this is not so. The BSCB shares the same principal building blocks with the BBB; nevertheless, it seems that morphological and functional differences may exist between them. Dysfunction of the BSCB plays a fundamental role in the etiology or progression of several pathological conditions of the spinal cord, such as spinal cord injury, amyotrophic lateral sclerosis, and radiation-induced myelopathy. This review summarizes current knowledge of the morphology of the BSCB, the methodology of studying the BSCB, and the potential role of BSCB dysfunction in selected disorders of the spinal cord, and finally summarizes therapeutic approaches to the BSCB.

Regulation of Caveolin-1 and Junction Proteins by bFGF Contributes to the Integrity of Blood–Spinal Cord Barrier and Functional Recovery

“…Similarly to the blood-brain barrier (BBB), BSCB plays a protective and regulatory role in spinal cord parenchyma. Endothelial cells, basement membranes, pericytes, and astrocytic end-feet processes constitute a specialized system for this functional barrier [5]. Early microvascular reactions and BSCB disruption are instrumental in the pathophysiology of SCI and repair [6,7].…”

BBB-targeting, protein-based nanomedicines for drug and nucleic acid delivery to the CNS

“…However, the potential toxic effects, especially under 168 pathological conditions, are notable. Though the permeability of the BBB may 169 be spontaneously enhanced at certain time-windows post-injury, as for 170 example after Traumatic Brain or Spinal Cord Injury (Bartanusz et al 2011), 171 that will allow the desired drugs entering the CNS, the pharmacological 172 disruption of the BBB under pathological conditions may in contrast worsen 173 the disease progression. For instance, the pharmacological disruption of the 174 BBB enhanced the clinical severity in an EAE model (Alvarez et al 2011), 175…”

“…In this context, the dysfunction of the BBB and BSCB 177 has been well documented in the etiology or progression of several CNS 178 pathologies (Bartanusz et al 2011), making the enhancement of BBB barrier 179 permeability not indicated for the delivery of drugs into the damaged CNS. Parkinson's disease (Wade and Katzman 1975).…”

Nanofiber mat spinal cord dressing-released glutamate impairs blood-spinal cord barrier

“…The blood-brain barrier (BBB) and blood-spinal cord barrier (BSCB) are composite structures the role of which is selective separation of the cerebral and spinal parenchyma from the contents of the blood vessel; these barriers play both a protective and regulatory role for the respective central nervous system (CNS) parenchyma [3]. The blood-brain barrier and BSCB are prone to damage from insults of varying origin, including local inflammatory processes, ischemia, hypoxia, mechanical trauma, and more.…”

“…These differences may be responsible for diverse susceptibility of BBB and BSCB to some pathological conditions [3]. Many authors suggest that disruption of BSCB or alteration of its permeability may be of key importance for the consequences of acute injury of the spinal cord [47] and for the development of some CNS pathologies, such as multiple sclerosis [37], amyotrophic lateral sclerosis [15,29], spinal cord ischemia [16,18,27], and neuropathic pain [4].…”