Brain microvascular endothelial cells (BMEC) form monolayers that are an integral part of the highly specialized blood-brain-barrier (BBB). BMECs are interconnected by junctional proteins attached to a basement membrane. Together with pericytes, smooth muscle cells, astrocytic end feet and circulating blood cells they build up the so-called neurovascular unit (NVU)1. Against the previous notion of an impermeable barrier between blood and the central-nervous-system (CNS), the NVU is a dynamic, highly specific and regulated interface that controls the transition of fluids, molecules and cells between cerebral blood vessels and the CNS2. A dysfunction or dysregulation of the NVU may initiate and/or contribute to a variety of neurovascular, infectious, inflammatory or degenerative diseases of the CNS, such as ischemic stroke, HIV-encephalopathy, multiple sclerosis, Alzheimer’s or Parkinson’s disease3-6.
The BMEC monolayer is tightly sealed by a junctional complex constituted of tight (TJ) and adherens junctions (AJ)7. The high electrical resistance and the low paracellular permeability of the BBB are mainly based on TJ proteins8. The TJs are complexes formed by the transmembrane proteins of the claudin and occludin family, which are linked to the cytoskeleton of the endothelial cells by adapter molecules, such as the zonulaoccludens (ZO) proteins ZO1-34. Adherens junctions are mainly assembled by the integral membrane protein vascular endothelial (VE)-cadherin, which is linked to the cytoskeleton via catenins8.
The tight sealing of the BBB prevents the free exchange of substrates and cells between blood and CSF. Exceptions to this rule are lipophilic, small molecules with a molecular weight <400 Da, which are able to cross the BBB by lipid-mediated diffusion9. The passage of larger and/or hydrophilic molecules, such as glucose, amino acids, peptides, proteins and many drugs is restricted to highly controlled transcellular transport systems10, which can be classified into five main categories: carrier-mediated transport, ion transport, active efflux transport, receptor-mediated transport, and caveolae-mediated transport4. These transporter systems help maintaining the homeostasis of the CNS, which is required for an accurate signal generation, transduction and integration. Moreover, BMECs are able to actively control the transition of distinct molecules by the expression of a variety of ectoenzymes. These enzymes are localized on the cell surface and modify specific endogenous and exogenous substrates hindering or allowing the transition of the BBB11.
Whereas the CNS was considered as an immune-privileged organ for a long-time, recent findings suggest a rather dynamic and tightly regulated system of immune surveillance of the CNS. The BMECs are critically involved in the regulation of immune cell transmigration. By the expression of selectins on their surface lymphocytes are selectively induced to loosely attach to the endothelium. The secretion of chemokines that encounter with specific receptors on leukocytes leads to the expression or conformational changes of leukocyte integrins, such as LFA-1 (lymphocyte function associated antigen-1) and VLA-4 (very late antigen-4). The integrins mediate a firm adhesion by binding their endothelial counterreceptors, e.g. VCAM-I (vascular cell adhesion molecule), ICAM-I (intercellular adhesion molecule) enabling the transmigration into the brain parenchyma between or through BMECs of the BBB12-14. These and other findings underline the active role of the endothelium itself in regulating immune cell migration.
Furthermore, BMECs as part of the NVU are involved in the regulation of the cerebral blood flow linked to local neuronal metabolic demands. Upon astrocytic stimulation endothelial cells produce vasoactive substances such as nitric oxide leading to relaxation of vascular smooth muscle cells15.
Angiogenesis and neurogenesis in the developing as well as in the adult brain show parallel patterning and development and share many properties of regulation1,4. Endothelial cells are critically involved in these processes16,17.
In summary, BMECs provide essential features to warrant a proper development and functioning of the CNS. BBB dysfunction is linked to many severe neurologic disorders. However, only very few targets have been identified at the brain-vasculature interface for a specific and efficient treatment18. Simplified in vitro models have been used to understand the mechanisms involved in function and regulation of complex physiologic systems for a long time. The isolation as described by this manuscript and the in vitro study of murine BMECs, given the wide variety of specific mouse knockout-strains, might provide a further understanding of BBB function and regulation under physiological and pathophysiological conditions opening up new therapeutic avenues.