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Garun odoleztatzea
1




Garun odoleztatzea
                        Enrike G. Argandoña
    Neurozientzia kliniko eta esperimentaleko laborategia (LaNCE)
                    Euskal Herriko Unibertsitatea
                     http://www.ehu.es/LaNCE
                        Iruñea. Uztaila 2006
Garun odoleztatzea




                     2
Garun odoleztatzea


 Arteria-sistema aferentea



                        2
Garun odoleztatzea


 Arteria-sistema aferentea
 Bena-sistema eferentea

                          2
3




    Garun odoleztatzea
3




    Garun odoleztatzea

     Garun bolumenaren %1
3




    Garun odoleztatzea

     Garun bolumenaren %1
     Bihotz gastuaren %20
3




    Garun odoleztatzea

     Garun bolumenaren %1
     Bihotz gastuaren %20
     Energiaren %65
4


    Garun odoleztatzea
    Babes mekanismoak
4


       Garun odoleztatzea
       Babes mekanismoak


    Zirkulazio sistemikoaren kontrola
4


       Garun odoleztatzea
       Babes mekanismoak


    Zirkulazio sistemikoaren kontrola
    Garun-odol basoen autorregulazioa
4


       Garun odoleztatzea
       Babes mekanismoak


    Zirkulazio sistemikoaren kontrola
    Garun-odol basoen autorregulazioa
    Fluxuaren banaketa
5




    Garun odoleztatzea
5




    Garun odoleztatzea
8
8
8
8
Garun barneko odol hodiak




                            9
Garun barneko odol hodiak


 Arteriolak (50-100 µm)




                            9
Garun barneko odol hodiak


 Arteriolak (50-100 µm)
 Arteriola terminalak (10-100µm)




                                   9
Garun barneko odol hodiak


 Arteriolak (50-100 µm)
 Arteriola terminalak (10-100µm)
 Benulak (± 30 µm)


                                   9
Garun barneko odol hodiak


 Arteriolak (50-100 µm)
 Arteriola terminalak (10-100µm)
 Benulak (± 30 µm)
 Kapilareak (<30 µm)

                                   9
10




     Garun odoleztatzea
10




     Garun odoleztatzea

       Sare kapilarea
10




     Garun odoleztatzea

       Sare kapilarea
       Barrera hematoentzefalikoa
10




     Garun odoleztatzea

       Sare kapilarea
       Barrera hematoentzefalikoa
        Egitura-mekanismoak
10




     Garun odoleztatzea

       Sare kapilarea
       Barrera hematoentzefalikoa
        Egitura-mekanismoak
        Mekanismo metabolikoak
Garun-barrerak
Garun-barrerak
12



     Barrera hematoentzefalikoa
12



     Barrera hematoentzefalikoa
12



     Barrera hematoentzefalikoa
13



     Barrera hematoentzefalikoa
13



     Barrera hematoentzefalikoa
Garraio motak
Garraio motak
a                           b               c                                 d                         e
Paracellular aqueous        Transcellular   Transport proteins                Receptor-mediated         Adsorptive
pathway                     lipophilic                                        transcytosis              transcytosis
                            pathway
    Water-soluble           Lipid-soluble   Glucose,       Vinca alkaloids,   Insulin,                  Albumin, other
    agents                  agents          amino acids,   Cyclosporin A,     transferrin               plasma proteins
                                            nucleosides    AZT
                                                                                                             +++
                                                                                                            + +
                                                                                                             +++
Blood                                                                                                       –––– +
                                                                                                                 –+ + –
                                                                                                                  + +
                                                                                                                 –+ + –
                                                                                                                   +
             Tight
             junction
                                                                                                                –+ + + –
                                                                                                                 + +
                                                                                                                –+ + + –


                                                                                                               – –
              Endothelium                                                                                      – –
                                                                                                                +++
Brain                                                                                                           + +
                                                                                                                +++




                            Astrocyte                                                       Astrocyte




Figure 3 | Pathways across the blood–brain barrier. A schematic diagram of the endothelial cells that form the blood–
brain barrier (BBB) and their associations with the perivascular endfeet of astrocytes. The main routes for molecular
15



      Barrera hematoentzefalikoa
 Zelulak
15



                    Barrera hematoentzefalikoa
                                        REVIEWS



                                                               Basal lamina
                                                                                                                                                Neuron
                                                                               Interneuron


                                                               Tight
                                                               junction        Astrocyte
Tight junction                      Pericyte                Capillary
           Zelulak




A belt-like region of adhesion                                                                                    Astrocyte
                                                       Endothelial
between adjacent cells. Tight
                                                              cell
junctions regulate paracellular
flux, and contribute to the                                                                                         b                             LIF
maintenance of cell polarity by
stopping molecules from                                                           a                                              Tight
diffusing within the plane of the                                                                                                                     TGFβ
                                                                                                                              junction
membrane.
                                                                                              Tight                                        ?            bFGF
                                                                                                         GLUT1
Abluminal membrane                                                                         junction
                                                                                                                     Capillary
The endothelial cell membrane                                                                                                                              ANG1
that faces away from the vessel
                                                                                   Capillary                        Endothelial
lumen, towards the brain.                      Microglia                                                   LAT1
                                                                                                                           cell
Meninges
                                                                                  Endothelial   Pgp                                                   GDNF
                                                                                         cell
The complex arrangement of
                                                                                                        EAAT1–3                                         Astrocyte
three protective membranes
surrounding the brain, with a                                                                                                            Basal
thick outer connective tissue                                                                                                            lamina
layer (dura) overlying the                                                                                              ET1       TIE2         P2Y2        5-HT
barrier layer (arachnoid), and
finally the thin layer covering     Figure 2 | Cellular constituents of the blood–brain barrier. The barrier is formed by capillary endothelial cells,
the glia limitans (pia). The sub-   surrounded by basal lamina and astrocytic perivascular endfeet. Astrocytes provide the cellular link to the neurons.
arachnoid layer has a sponge-
Zelularteko seinaleak BHEn
at the BBB is observed in starvation and hypoxia53,54.
                   Zelularteko seinaleak BHEn
Blood                                     Ligand           Tight
                                                           junction
                                            Receptor

                                               ↑Ca2+              ↑Ca2+
Endothelial cell
                                                                           Pericyte
   Smooth muscle



 Basal                                                                Microglia
 lamina

                    Neuron            Astrocyte                           Neuron



Figure 5 | Complex cell–cell signalling at the blood–brain barrier. A portion of a
brain capillary wall, showing the main cell types present with the potential to signal to
each other. Pericytes are enclosed within the endothelial basal lamina and form the
17




Garun endotelioa
17




Garun endotelioa

                   Mitokondria ugari
17




Garun endotelioa

                   Mitokondria ugari
                   Pinozitosiaren gabezia
17




Garun endotelioa

                   Mitokondria ugari
                   Pinozitosiaren gabezia
                   Fenestrazioen gabezia
17




Garun endotelioa

                   Mitokondria ugari
                   Pinozitosiaren gabezia
                   Fenestrazioen gabezia
18




Astroglia
18




Astroglia

            BHEren indukzioa
18




Astroglia

            BHEren indukzioa
            BHEren
            mantenimendua
18




Astroglia

            BHEren indukzioa
            BHEren
            mantenimendua
            Tonu baskularraren
            kontrola
18




Astroglia

            BHEren indukzioa
            BHEren
            mantenimendua
            Tonu baskularraren
            kontrola
            BHEren egitura?
18




Astroglia

            BHEren indukzioa
            BHEren
            mantenimendua
            Tonu baskularraren
            kontrola
            BHEren egitura?
19



     Perizitoak
19



     Perizitoak
19



     Perizitoak


                  Nortasun iluna
                  Pluripotentzialak
                  Parte hartzea
                  angiogenesian eta
                  BHEren ontzean
Lotura sendoak (TJ)
Lotura sendoak (TJ)
Apical membrane

     Cingulin, JACOP, PAR3/6,
     CASK, 7H6, Itch, MUPP1,                              Claudin 3, 5, 12
     MAGI-1–3, ZONAB                ZO-2                  Occludin
     AF6, RGS5                                                                Tight
                                                                              junction
                                                          JAMs,
                          ZO-3                            ESAM
                                           ZO-1
                                                        Basolateral
                                                        membrane

                                                        PECAM
               α-, β-, γ-Catenin,
               Desmoplakin,                                                  Adherens
               p120ctn, ZO-1                                                 junction
     Actin/vinculin-based                               VE-cadherin
     cytoskeleton



                                                       Basal lamina
Figure 4 | Molecular composition of endothelial tight junctions. Simplified and
Lotura sendoak (TJ)
Lotura sendoak (TJ)
Barrera hematoentzefalikoa
Barrera hematoentzefalikoa
Barrera hematoentzefalikoa
Barrera hematoentzefalikoa
24



     Aktina
24



     Aktina
25


     Iragazkortasun mikrobaskularraren
     erregulazioa
25


     Iragazkortasun mikrobaskularraren
     erregulazioa
BHE gaixotasunetan
Box 3 | Pathological states involving BBB breakdown or disorder                            permeability (little or no aquaporin)88–90, it is likely that
                                                                                                                the excess metabolic water joins the ISF being secreted
                     Several pathologies of the CNS involve disturbance of blood–brain barrier (BBB)            into the pericapillary space by the endothelium5. ISF out-
                     function, and, in many of these, astrocyte–endothelial cooperation is also abnormal.       flow involves perivascular spaces around large vessels,
                     Stroke                                                                                     and clearance routes either through the CSF or following
                     • Astrocytes secrete transforming growth factor-β (TGFβ), which downregulates brain        alternative pathways to neck lymphatics.



BHE gaixotasunetan
                       capillary endothelial expression of fibrinolytic enzyme tissue plasminogen activator         Neurotransmitter recycling can also lead to local
                       (tPA) and anticoagulant thrombomodulin (TM)150.                                          changes in ions and water. Glutamate is the major
                     • Proteolysis of the vascular basement membrane/matrix151.                                 excitatory transmitter of the brain, and astrocyte proc-
                     • Induction of aquaporin 4 (AQP4) mRNA and protein at BBB disruption152.                   esses surrounding synapses can take up glutamate
                     • Decrease in BBB permeability after treatment with arginine vasopressin V1 receptor       through transport proteins (particularly EAAT1 and 2);
                       antagonist in a stroke model153.                                                         the transport is Na+-dependent and accompanied by
                                                                                                                net uptake of ions and water, again contributing to
                     Trauma                                                                                     water clearance at the BBB85. Glutamate is converted
                     • Bradykinin, a mediator of inflammation, is produced and stimulates production and        to glutamine within the astrocyte and recycled to the
                       release of interleukin-6 (IL-6) from astrocytes, which leads to opening of the BBB102.   neurons. The slight astrocytic cell swelling that accom-
                     Infectious or inflammatory processes                                                       panies neuronal activity, resulting from activation by
                     Examples include bacterial infections, meningitis, encephalitis and sepsis.                glutamate or ion uptake, leads to several cellular mech-
                     • The bacterial protein lipopolysaccharide affects the permeability of BBB tight           anisms that contribute to the recovery of ionic balance
                       junctions. This is mediated by the production of free radicals, IL-6 and IL-1β154.       and cell volume, some of which involve elevated intra-
                     • Interferon-β prevents BBB disruption155.                                                 cellular Ca2+ concentration66,91,92. Hence, there are many
                                                                                                                links between the signalling and regulatory processes
                     Multiple sclerosis                                                                         that occur in the neurovascular unit.
                     • Breakdown of the BBB97.
                     • Downregulation of laminin in the basement membrane156.                                   BBB changes in pathology
                     • Selective loss of claudin 1/3 in experimental autoimmune encephalomyelitis94.            In a number of pathologies, the function of the BBB is
                                                                                                                altered (BOX 3), and several disorders appear to involve
                     HIV
                                                                                                                disturbances of endothelial–glial interaction. Thus,
                     • BBB tight junction disruption157,158.                                                    the capillaries of many glial tumours are more leaky
                     Alzheimer’s disease                                                                        than those of normal brain tissue, either as a result
                     • Increased glucose transport, upregulation of glucose transporter GLUT1, altered          of a lack of inductive factors, or owing to the release
                       agrin levels, upregulation of AQP4 expression95,159.                                     of permeability factors such as vascular endothelial
                     • Accumulation of amyloid-β, a key neuropathological feature of Alzheimer’s disease,
                                                                                                                growth factor (VEGF). Moreover, the tight junction
                       by decreased levels of P-glycoprotein transporter expression160.                         protein claudin 1/3 is downregulated in some brain
                                                                                                                tumours93,94.
                     • Altered cellular relations at the BBB, and changes in the basal lamina and amyloid-β
                       clearance100.                                                                                In BBB disruption, agrin is lost from the abluminal
                                                                                                                surface of the brain endothelial cells adjacent to astro-
                     Parkinson’s disease                                                                        cytic endfeet11; this may contribute to BBB damage in
                     • Dysfunction of the BBB by reduced efficacy of P-glycoprotein101.                         Alzheimer’s disease95, and to the redistribution of astro-
                     Epilepsy
                                                                                                                cytic AQP4 in glioblastomas96. Astrocytic AQP4 expres-
                                                                                                                sion is upregulated in brain oedema triggered by BBB
                     • Transient BBB opening in epileptogenic foci, and upregulated expression of
                                                                                                                breakdown. Such upregulation could be adaptive in
                       P-glycoprotein and other drug efflux transporters in astrocytes and endothelium98,99.
                                                                                                                helping to clear the accumulating fluid, but the associ-
                     Brain tumours                                                                              ated cell swelling would tend to exacerbate the problem
                     • Breakdown of the BBB161,162.                                                             under extreme conditions. Indeed, AQP4–/– mice show
                     • Downregulation of tight junction protein claudin 1/3; redistribution of astrocyte        protection against ischaemic brain oedema48. Some
                       AQP4 and Kir4.1 (inwardly rectifying K+ channel)20,93,96.                                chronic neuropathologies such as multiple sclerosis may
                                                                                                                involve an early phase of BBB disturbance (involving
                     Pain
                                                                                                                the downregulation of claudin 1/3 (REF. 11)) that precedes
                     • Inflammatory pain alters BBB tight junction protein expression and BBB                   neuronal damage, which suggests that vascular damage
                       permeability108.
                                                                                                                can lead to secondary neuronal disorder97.
BHE gaixotasunetan
1                                                                                  junctions, bradykini

BHE gaixotasunetan                           NF-κB

                                               ET-1
                                                             B2
                                                                              Bradykinin

                                                                                                          3
                                                                                                                                 leading to the releas
                                                                                                                                 amplify the effect by
                                                                                                                                 Tumour necrosis fa
                                                              TNFα
                                                                                                       Microglial cell           permeability by dir
                                                                                                                                 and indirect effects
                                     lL-6                                                                 2                      production and IL
                                            TNFα                    •O2–
                                                     lL-1β                     LPS                                               complex immunore
                                                                                                                   Substance P   can exacerbate CNS
                                                                                            [Ca2+]i↑               5-HT          multiple sclerosis b
                                                                                                                   Histamine     activation of already
                                                                                ATP
                                                                                                                                 some mechanisms e
                                                                              PGs
                                                                   B2                                                            Indeed, the ability of
                                                                                                                                 contribute to the lin
                                                     tPA
                                                                                                                                 disease106.
                                                                        tPA                                                         It has recently be
                      Capillary                                                                                                  cytes and microglia
                                                  Tight                                                   4                      pain107. As astrocyt
                                               junction                             TGFβ↓
                                                                                                                                 connectivity and fo
                                                                                                                                 gested that glia ma
                                                                                                                                 pain sensation. In in
                                     Endothelial                                                                                 from central and pe
                                     cell                                                                                        sue cells and blood
                                                   Agrin?                                                                        such as substance P
                                                                                        K+                                       (CGRP), serotonin,
                                                                  AQP4                  Glu                                      BBB from both the
                                                                                                                                 For example, the re
                            Basal lamina              Astrocyte                     5                                            concentration or alt
                                                                                                                                 tion protein occludi
                     Figure 6 | Astroglial–endothelial signalling under pathological conditions.                                 TNFα, histamine an
                     Examples of astroglial–endothelial signalling in infection or inflammation, stroke or                       matory pain can also
28




     Kapilare-sarea
28




     Kapilare-sarea
Odol hodien garapena




                       29
Odol hodien garapena

Kraniokanpokoa




                        29
Odol hodien garapena

Kraniokanpokoa
Kraniobarnekoa




                        29
Odol hodien garapena

Kraniokanpokoa
Kraniobarnekoa
 Enbor perpendikularrak



                          29
Odol hodien garapena

Kraniokanpokoa
Kraniobarnekoa
 Enbor perpendikularrak
 Zuhaitzea


                          29
Odol hodien garapena
Odol hodien garapena
Odol hodien garapena
0 dpn




        34
7 dpn




        35
14 dpn




         36
21 dpn




         37
60 dpn




   38
40


VEGF
Vascular Endothelial Growth Factor
40


VEGF
Vascular Endothelial Growth Factor
40


VEGF
Vascular Endothelial Growth Factor
41




VEGF-ren ekintzak
41




VEGF-ren ekintzak
41




VEGF-ren ekintzak
I. Indukzioa:
    . Proliferazio endoteliala

  . Migrazio endoteliala

  . Apoptosiaren inhibizioa

II. Ondorio neurotrofikoak eta
neurobabesleak

III. Odol hodien iragazkortasuna
VEGF-ren hartzaileak
VEGF-ren hartzaileak
VEGF angiogenesian




                     43
VEGF angiogenesian




                     43
VEGF angiogenesian
VEGF angiogenesian

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Garun odoleztatzea

  • 1. 1
  • 3. 1 Garun odoleztatzea Enrike G. Argandoña Neurozientzia kliniko eta esperimentaleko laborategia (LaNCE) Euskal Herriko Unibertsitatea http://www.ehu.es/LaNCE Iruñea. Uztaila 2006
  • 6. Garun odoleztatzea Arteria-sistema aferentea Bena-sistema eferentea 2
  • 7. 3 Garun odoleztatzea
  • 8. 3 Garun odoleztatzea Garun bolumenaren %1
  • 9. 3 Garun odoleztatzea Garun bolumenaren %1 Bihotz gastuaren %20
  • 10. 3 Garun odoleztatzea Garun bolumenaren %1 Bihotz gastuaren %20 Energiaren %65
  • 11. 4 Garun odoleztatzea Babes mekanismoak
  • 12. 4 Garun odoleztatzea Babes mekanismoak Zirkulazio sistemikoaren kontrola
  • 13. 4 Garun odoleztatzea Babes mekanismoak Zirkulazio sistemikoaren kontrola Garun-odol basoen autorregulazioa
  • 14. 4 Garun odoleztatzea Babes mekanismoak Zirkulazio sistemikoaren kontrola Garun-odol basoen autorregulazioa Fluxuaren banaketa
  • 15. 5 Garun odoleztatzea
  • 16. 5 Garun odoleztatzea
  • 17.
  • 18.
  • 19.
  • 20.
  • 21. 8
  • 22. 8
  • 23. 8
  • 24. 8
  • 25. Garun barneko odol hodiak 9
  • 26. Garun barneko odol hodiak Arteriolak (50-100 µm) 9
  • 27. Garun barneko odol hodiak Arteriolak (50-100 µm) Arteriola terminalak (10-100µm) 9
  • 28. Garun barneko odol hodiak Arteriolak (50-100 µm) Arteriola terminalak (10-100µm) Benulak (± 30 µm) 9
  • 29. Garun barneko odol hodiak Arteriolak (50-100 µm) Arteriola terminalak (10-100µm) Benulak (± 30 µm) Kapilareak (<30 µm) 9
  • 30. 10 Garun odoleztatzea
  • 31. 10 Garun odoleztatzea Sare kapilarea
  • 32. 10 Garun odoleztatzea Sare kapilarea Barrera hematoentzefalikoa
  • 33. 10 Garun odoleztatzea Sare kapilarea Barrera hematoentzefalikoa Egitura-mekanismoak
  • 34. 10 Garun odoleztatzea Sare kapilarea Barrera hematoentzefalikoa Egitura-mekanismoak Mekanismo metabolikoak
  • 37. 12 Barrera hematoentzefalikoa
  • 38. 12 Barrera hematoentzefalikoa
  • 39. 12 Barrera hematoentzefalikoa
  • 40. 13 Barrera hematoentzefalikoa
  • 41. 13 Barrera hematoentzefalikoa
  • 43. Garraio motak a b c d e Paracellular aqueous Transcellular Transport proteins Receptor-mediated Adsorptive pathway lipophilic transcytosis transcytosis pathway Water-soluble Lipid-soluble Glucose, Vinca alkaloids, Insulin, Albumin, other agents agents amino acids, Cyclosporin A, transferrin plasma proteins nucleosides AZT +++ + + +++ Blood –––– + –+ + – + + –+ + – + Tight junction –+ + + – + + –+ + + – – – Endothelium – – +++ Brain + + +++ Astrocyte Astrocyte Figure 3 | Pathways across the blood–brain barrier. A schematic diagram of the endothelial cells that form the blood– brain barrier (BBB) and their associations with the perivascular endfeet of astrocytes. The main routes for molecular
  • 44. 15 Barrera hematoentzefalikoa Zelulak
  • 45. 15 Barrera hematoentzefalikoa REVIEWS Basal lamina Neuron Interneuron Tight junction Astrocyte Tight junction Pericyte Capillary Zelulak A belt-like region of adhesion Astrocyte Endothelial between adjacent cells. Tight cell junctions regulate paracellular flux, and contribute to the b LIF maintenance of cell polarity by stopping molecules from a Tight diffusing within the plane of the TGFβ junction membrane. Tight ? bFGF GLUT1 Abluminal membrane junction Capillary The endothelial cell membrane ANG1 that faces away from the vessel Capillary Endothelial lumen, towards the brain. Microglia LAT1 cell Meninges Endothelial Pgp GDNF cell The complex arrangement of EAAT1–3 Astrocyte three protective membranes surrounding the brain, with a Basal thick outer connective tissue lamina layer (dura) overlying the ET1 TIE2 P2Y2 5-HT barrier layer (arachnoid), and finally the thin layer covering Figure 2 | Cellular constituents of the blood–brain barrier. The barrier is formed by capillary endothelial cells, the glia limitans (pia). The sub- surrounded by basal lamina and astrocytic perivascular endfeet. Astrocytes provide the cellular link to the neurons. arachnoid layer has a sponge-
  • 47. at the BBB is observed in starvation and hypoxia53,54. Zelularteko seinaleak BHEn Blood Ligand Tight junction Receptor ↑Ca2+ ↑Ca2+ Endothelial cell Pericyte Smooth muscle Basal Microglia lamina Neuron Astrocyte Neuron Figure 5 | Complex cell–cell signalling at the blood–brain barrier. A portion of a brain capillary wall, showing the main cell types present with the potential to signal to each other. Pericytes are enclosed within the endothelial basal lamina and form the
  • 49. 17 Garun endotelioa Mitokondria ugari
  • 50. 17 Garun endotelioa Mitokondria ugari Pinozitosiaren gabezia
  • 51. 17 Garun endotelioa Mitokondria ugari Pinozitosiaren gabezia Fenestrazioen gabezia
  • 52. 17 Garun endotelioa Mitokondria ugari Pinozitosiaren gabezia Fenestrazioen gabezia
  • 54. 18 Astroglia BHEren indukzioa
  • 55. 18 Astroglia BHEren indukzioa BHEren mantenimendua
  • 56. 18 Astroglia BHEren indukzioa BHEren mantenimendua Tonu baskularraren kontrola
  • 57. 18 Astroglia BHEren indukzioa BHEren mantenimendua Tonu baskularraren kontrola BHEren egitura?
  • 58. 18 Astroglia BHEren indukzioa BHEren mantenimendua Tonu baskularraren kontrola BHEren egitura?
  • 59. 19 Perizitoak
  • 60. 19 Perizitoak
  • 61. 19 Perizitoak Nortasun iluna Pluripotentzialak Parte hartzea angiogenesian eta BHEren ontzean
  • 64.
  • 65. Apical membrane Cingulin, JACOP, PAR3/6, CASK, 7H6, Itch, MUPP1, Claudin 3, 5, 12 MAGI-1–3, ZONAB ZO-2 Occludin AF6, RGS5 Tight junction JAMs, ZO-3 ESAM ZO-1 Basolateral membrane PECAM α-, β-, γ-Catenin, Desmoplakin, Adherens p120ctn, ZO-1 junction Actin/vinculin-based VE-cadherin cytoskeleton Basal lamina Figure 4 | Molecular composition of endothelial tight junctions. Simplified and
  • 72. 24 Aktina
  • 73. 24 Aktina
  • 74. 25 Iragazkortasun mikrobaskularraren erregulazioa
  • 75. 25 Iragazkortasun mikrobaskularraren erregulazioa
  • 77. Box 3 | Pathological states involving BBB breakdown or disorder permeability (little or no aquaporin)88–90, it is likely that the excess metabolic water joins the ISF being secreted Several pathologies of the CNS involve disturbance of blood–brain barrier (BBB) into the pericapillary space by the endothelium5. ISF out- function, and, in many of these, astrocyte–endothelial cooperation is also abnormal. flow involves perivascular spaces around large vessels, Stroke and clearance routes either through the CSF or following • Astrocytes secrete transforming growth factor-β (TGFβ), which downregulates brain alternative pathways to neck lymphatics. BHE gaixotasunetan capillary endothelial expression of fibrinolytic enzyme tissue plasminogen activator Neurotransmitter recycling can also lead to local (tPA) and anticoagulant thrombomodulin (TM)150. changes in ions and water. Glutamate is the major • Proteolysis of the vascular basement membrane/matrix151. excitatory transmitter of the brain, and astrocyte proc- • Induction of aquaporin 4 (AQP4) mRNA and protein at BBB disruption152. esses surrounding synapses can take up glutamate • Decrease in BBB permeability after treatment with arginine vasopressin V1 receptor through transport proteins (particularly EAAT1 and 2); antagonist in a stroke model153. the transport is Na+-dependent and accompanied by net uptake of ions and water, again contributing to Trauma water clearance at the BBB85. Glutamate is converted • Bradykinin, a mediator of inflammation, is produced and stimulates production and to glutamine within the astrocyte and recycled to the release of interleukin-6 (IL-6) from astrocytes, which leads to opening of the BBB102. neurons. The slight astrocytic cell swelling that accom- Infectious or inflammatory processes panies neuronal activity, resulting from activation by Examples include bacterial infections, meningitis, encephalitis and sepsis. glutamate or ion uptake, leads to several cellular mech- • The bacterial protein lipopolysaccharide affects the permeability of BBB tight anisms that contribute to the recovery of ionic balance junctions. This is mediated by the production of free radicals, IL-6 and IL-1β154. and cell volume, some of which involve elevated intra- • Interferon-β prevents BBB disruption155. cellular Ca2+ concentration66,91,92. Hence, there are many links between the signalling and regulatory processes Multiple sclerosis that occur in the neurovascular unit. • Breakdown of the BBB97. • Downregulation of laminin in the basement membrane156. BBB changes in pathology • Selective loss of claudin 1/3 in experimental autoimmune encephalomyelitis94. In a number of pathologies, the function of the BBB is altered (BOX 3), and several disorders appear to involve HIV disturbances of endothelial–glial interaction. Thus, • BBB tight junction disruption157,158. the capillaries of many glial tumours are more leaky Alzheimer’s disease than those of normal brain tissue, either as a result • Increased glucose transport, upregulation of glucose transporter GLUT1, altered of a lack of inductive factors, or owing to the release agrin levels, upregulation of AQP4 expression95,159. of permeability factors such as vascular endothelial • Accumulation of amyloid-β, a key neuropathological feature of Alzheimer’s disease, growth factor (VEGF). Moreover, the tight junction by decreased levels of P-glycoprotein transporter expression160. protein claudin 1/3 is downregulated in some brain tumours93,94. • Altered cellular relations at the BBB, and changes in the basal lamina and amyloid-β clearance100. In BBB disruption, agrin is lost from the abluminal surface of the brain endothelial cells adjacent to astro- Parkinson’s disease cytic endfeet11; this may contribute to BBB damage in • Dysfunction of the BBB by reduced efficacy of P-glycoprotein101. Alzheimer’s disease95, and to the redistribution of astro- Epilepsy cytic AQP4 in glioblastomas96. Astrocytic AQP4 expres- sion is upregulated in brain oedema triggered by BBB • Transient BBB opening in epileptogenic foci, and upregulated expression of breakdown. Such upregulation could be adaptive in P-glycoprotein and other drug efflux transporters in astrocytes and endothelium98,99. helping to clear the accumulating fluid, but the associ- Brain tumours ated cell swelling would tend to exacerbate the problem • Breakdown of the BBB161,162. under extreme conditions. Indeed, AQP4–/– mice show • Downregulation of tight junction protein claudin 1/3; redistribution of astrocyte protection against ischaemic brain oedema48. Some AQP4 and Kir4.1 (inwardly rectifying K+ channel)20,93,96. chronic neuropathologies such as multiple sclerosis may involve an early phase of BBB disturbance (involving Pain the downregulation of claudin 1/3 (REF. 11)) that precedes • Inflammatory pain alters BBB tight junction protein expression and BBB neuronal damage, which suggests that vascular damage permeability108. can lead to secondary neuronal disorder97.
  • 79. 1 junctions, bradykini BHE gaixotasunetan NF-κB ET-1 B2 Bradykinin 3 leading to the releas amplify the effect by Tumour necrosis fa TNFα Microglial cell permeability by dir and indirect effects lL-6 2 production and IL TNFα •O2– lL-1β LPS complex immunore Substance P can exacerbate CNS [Ca2+]i↑ 5-HT multiple sclerosis b Histamine activation of already ATP some mechanisms e PGs B2 Indeed, the ability of contribute to the lin tPA disease106. tPA It has recently be Capillary cytes and microglia Tight 4 pain107. As astrocyt junction TGFβ↓ connectivity and fo gested that glia ma pain sensation. In in Endothelial from central and pe cell sue cells and blood Agrin? such as substance P K+ (CGRP), serotonin, AQP4 Glu BBB from both the For example, the re Basal lamina Astrocyte 5 concentration or alt tion protein occludi Figure 6 | Astroglial–endothelial signalling under pathological conditions. TNFα, histamine an Examples of astroglial–endothelial signalling in infection or inflammation, stroke or matory pain can also
  • 80. 28 Kapilare-sarea
  • 81. 28 Kapilare-sarea
  • 86. Odol hodien garapena Kraniokanpokoa Kraniobarnekoa Enbor perpendikularrak Zuhaitzea 29
  • 87.
  • 90.
  • 91.
  • 93. 0 dpn 34
  • 94. 7 dpn 35
  • 95. 14 dpn 36
  • 96. 21 dpn 37
  • 97. 60 dpn 38
  • 98.
  • 104. 41 VEGF-ren ekintzak I. Indukzioa: . Proliferazio endoteliala . Migrazio endoteliala . Apoptosiaren inhibizioa II. Ondorio neurotrofikoak eta neurobabesleak III. Odol hodien iragazkortasuna