Anat Cell Biol.  2021 Jun;54(2):165-177. 10.5115/acb.20.290.

Blood-brain barrier dysfunction in ischemic stroke and diabetes: the underlying link, mechanisms and future possible therapeutic targets

• Wicha P
• Das S
• Mahakkanukrauh P

• KMID: 2516900
• DOI: http://doi.org/10.5115/acb.20.290

Abstract

Ischemic stroke caused by occlusion of cerebral artery is responsible for the majority of stroke that increases the morbidity and mortality worldwide. Diabetes mellitus (DM) is a crucial risk factor for ischemic stroke. Prolonged DM causes various microvascular and macrovascular changes, and blood-brain barrier (BBB) permeability that facilitates inflammatory response following stroke. In the acute phase following stroke, BBB disruption has been considered the initial step that induces neurological deficit and functional disabilities. Stroke outcomes are significantly worse among DM. In this article, we review stroke with diabetes-induce BBB damage, as well as underlying mechanism and possible therapeutic targets for stroke with diabetes.

Keyword

Blood-brain barrier; Diabetes mellitus; Hyperglycemia; Inflammation; Ischemic stroke

Figure

• 

  Fig. 1 Structure and functionality of the BBB. (A) Structure of BBB is composed of ECs, BM, astrocyte end feet and pericytes. (B) Tight junctions on ECs (C) Transporter of BBB for molecular traffic across the BBB. BBB, blood-brain barrier; BM, basement membrane; ECs, endothelial cells; Glut-1, glucose transporter; ZO-1, zona occuldens-1.

• 

  Fig. 2 Pathological mechanism of inflammation induced by hyperglycemia. Glut-1, glucose transporter; NF-κB, nuclear factor-kappa B; ROS, reactive oxygen species.

• 

  Fig. 3 Neuroinflammatory mechanism involved in aggravating BBB damage in stoke with diabetic. BBB, blood-brain barrier.

Reference

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