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Pathophysiology of Blood-Brain Barrier in Brain Injury in Cold and Hot Environments: Novel Drug Targets for Neuroprotection
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
Univ Med Pharm, Dept Clin Neurosci, Cluj Napoca, Romania.;RoNeuro Inst Neurol Res & Diagnost, 37 Mircea Eliade St, Cluj Napoca 400364, Romania..
Univ Basque Country, UPV EHU, Dept Neurosci, Lab Clin & Expt Neurosci LaNCE, Leioa, Bizkaia, Spain.;Univ Autonoma Chile, Fac Hlth Sci, Santiago, Chile..
Harvard Univ, Massachusetts Gen Hosp, Dept Anesthesia & Crit Care, 55 Fruit St, Boston, MA 02114 USA..
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2016 (English)In: CNS & Neurological Disorders: Drug Targets, ISSN 1871-5273, E-ISSN 1996-3181, Vol. 15, no 9, 1045-1071 p.Article, review/survey (Refereed) Published
Abstract [en]

The blood-brain barrier (BBB) plays a pivotal role in the maintenance of central nervous system function in health and disease. Thus, in almost all neurodegenerative, traumatic or metabolic insults BBB breakdown occurs, allowing entry of serum proteins into the brain fluid microenvironment with subsequent edema formation and cellular injury. Accordingly, pharmacological restoration of BBB function will lead to neurorepair. However, brain injury which occurs following blast, bullet wounds, or knife injury appears to initiate different sets of pathophysiological responses. Moreover, other local factors at the time of injury such as cold or elevated ambient temperatures could also impact the final outcome. Obviously, drug therapy applied to different kinds of brain trauma occurring at either cold or hot environments may respond differently. This is largely due to the fact that internal defense mechanisms of the brain, gene expression, release of neurochemicals and binding of drugs to specific receptors are affected by external ambient temperature changes. These factors may also affect BBB function and development of edema formation after brain injury. In this review, the effects of seasonal exposure to heat and cold on traumatic brain injury using different models i.e., concussive brain injury and cerebral cortical lesion, on BBB dysfunction in relation to drug therapy are discussed. Our observations clearly suggest that closed head injury and open brain injury are two different entities and the external hot or cold environments affect both of them remarkably. Thus, effective pharmacological therapeutic strategies should be designed with these views in mind, as military personnel often experience blunt or penetrating head injuries in either cold or hot environments.

Place, publisher, year, edition, pages
2016. Vol. 15, no 9, 1045-1071 p.
Keyword [en]
Ambient temperature, blood-brain barrier, blunt head injury, brain edema, brain pathology, cognitive dysfunction, cold exposure, concussion, cortical injury, drug therapy, hot environment, penetrating brain injury, seasonal variations, traumatic brain injury
National Category
Neurology Pharmaceutical Sciences
URN: urn:nbn:se:uu:diva-311089DOI: 10.2174/1871527315666160902145145ISI: 000387125600005PubMedID: 27592625OAI: oai:DiVA.org:uu-311089DiVA: diva2:1058564
Göran Gustafsson Foundation for promotion of scientific research at Uppala University and Royal Institute of TechnologyAstraZeneca
Available from: 2016-12-21 Created: 2016-12-21 Last updated: 2016-12-21Bibliographically approved

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