Blood-Brain Barrier Alterations and Edema Formation in Different Brain Mass Lesions

Abstract

Differential diagnosis of brain lesion pathologies is complex, but it is nevertheless crucial for appropriate clinical management. Advanced imaging methods, including diffusion-weighted imaging and apparent diffusion coefficient, can help discriminate between brain mass lesions such as glioblastoma, brain metastasis, brain abscesses as well as brain lymphomas. These pathologies are characterized by blood-brain barrier alterations and have been extensively studied. However, the changes in the blood-brain barrier that are observed around brain pathologies and that contribute to the development of vasogenic brain edema are not well described. Some infiltrative brain pathologies such as glioblastoma are characterized by glioma cell infiltration in the brain tissue around the tumor mass and thus affect the nature of the vasogenic edema. Interestingly, a common feature of primary and secondary brain tumors or tumor-like brain lesions characterized by vasogenic brain edema is the formation of various molecules that lead to alterations of tight junctions and result in blood-brain barrier damage. The resulting vasogenic edema, especially blood-brain barrier disruption, can be visualized using advanced magnetic resonance imaging techniques, such as diffusion-weighted imaging and apparent diffusion coefficient. This review presents a comprehensive overview of blood-brain barrier changes contributing to the development of vasogenic brain edema around glioblastoma, brain metastases, lymphomas, and abscesses.

Role of microglia after subarachnoid hemorrhage

“…7,66 The accumulation of high-solute extracellular fluid from plasma protein leak into the brain secondary to a diminished ability of the BBB to exclude these molecules generates osmotic forces, increasing the overall volume of water within the brain. 67,68 Microglia can worsen vasogenic edema directly through their gene products. Vascular endothelial growth factor (VEGF) is upregulated following SAH in response to diminished baseline degradation of Hypoxia-inducible factor 1 (HIF-1).…”

Nanoparticles for efficient drug delivery and drug resistance in glioma: New perspectives

“…Unlike other endothelial cells, the endothelial cells of the BBB are tightly packed together, forming a tight adhesive band that forms a physical barrier. This barrier also contains a number of proteins that are involved in the formation of the BBB and regulate the permeability of the BBB 173–175 . The BBB has a protective effect on neurons, not only preventing exogenous toxins from entering the central nervous system but also preventing blocking chemotherapeutic drugs from reaching the site of the lesion, thus preventing the drugs from effectively killing tumor cells and increasing the difficulty of treatment 176–178 .…”

“…This barrier also contains a number of proteins that are involved in the formation of the BBB and regulate the permeability of the BBB. 173 , 174 , 175 The BBB has a protective effect on neurons, not only preventing exogenous toxins from entering the central nervous system but also preventing blocking chemotherapeutic drugs from reaching the site of the lesion, thus preventing the drugs from effectively killing tumor cells and increasing the difficulty of treatment. 176 , 177 , 178 Therefore, NPs‐based drug carrier systems have been developed to overcome the limitations associated with the BBB.…”

Rat model of asphyxia-induced cardiac arrest and resuscitation

“…During CA, ischemia and hypoxia lead to cell edema, which DWI can detect post-resuscitation. The apparent diffusion coefficient (ADC) value is an important quantitative index used to evaluate the extent and severity of cerebral ischemia injury ( Solar et al, 2022 ). Decreased ADC values reflect diffusion of water molecules, indicating cell membraned damage ( Norris et al, 2020 ).…”