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Brain endothelial cells (BECs) are specialized cells that form the primary structural and functional basis of the blood-brain barrier (BBB), maintaining CNS homeostasis by strictly regulating the exchange of ions, molecules, and cells between the blood and the brain (Daneman & Prat, 2015). Unlike peripheral endothelial cells, BECs are characterized by continuous tight junctions—composed of proteins like Claudin-5 and Occludin—that severely limit paracellular permeability and a lack of fenestrations (Abbott et al., 2010). They express a variety of specific transporters, such as GLUT1 for glucose uptake and P-glycoprotein for the efflux of potentially toxic xenobiotics, which often complicates the delivery of therapeutic agents to the brain (Pardridge, 2005). Dysfunction of the cerebral vasculature is a hallmark of several neurological conditions, including stroke, where barrier breakdown leads to edema, and Alzheimer's disease, where impaired clearance of amyloid-beta across the BECs contributes to plaque formation (Sweeney et al., 2019). Pharmacological strategies targeting BECs often focus on either bypassing the barrier using receptor-mediated transcytosis (e.g., targeting the transferrin receptor) or restoring barrier integrity in inflammatory diseases like multiple sclerosis (Obermeier et al., 2013).
Modulation of tight junction integrity, inhibition of efflux transporters (e.g., P-glycoprotein), and receptor-mediated transcytosis for CNS drug delivery.
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