Immunologic privilege in the central nervous system and the blood-brain barrier

Leslie L. Muldoon, Jorge I. Alvarez, David J. Begley, Ruben J. Boado, Gregory J. Del Zoppo, Nancy D. Doolittle, Britta Engelhardt, John M. Hallenbeck, Russell R. Lonser, John R. Ohlfest, Alexandre Prat, Maurizio Scarpa, Richard J. Smeyne, Lester R. Drewes, Edward A. Neuwelt

Research output: Contribution to journalReview articlepeer-review

231 Scopus citations


The brain is in many ways an immunologically and pharmacologically privileged site. The blood-brain barrier (BBB) of the cerebrovascular endothelium and its participation in the complex structure of the neurovascular unit (NVU) restrict access of immune cells and immune mediators to the central nervous system (CNS). In pathologic conditions, very well-organized immunologic responses can develop within the CNS, raising important questions about the real nature and the intrinsic and extrinsic regulation of this immune privilege. We assess the interactions of immune cells and immune mediators with the BBB and NVU in neurologic disease, cerebrovascular disease, and intracerebral tumors. The goals of this review are to outline key scientific advances and the status of the science central to both the neuroinflammation and CNS barriers fields, and highlight the opportunities and priorities in advancing brain barriers research in the context of the larger immunology and neuroscience disciplines. This review article was developed from reports presented at the 2011 Annual Blood-Brain Barrier Consortium Meeting.

Original languageEnglish (US)
Pages (from-to)13-21
Number of pages9
JournalJournal of Cerebral Blood Flow and Metabolism
Issue number1
StatePublished - Jan 2013


  • blood-brain barrier
  • multiple sclerosis
  • neuroimaging
  • neuroinflammation
  • neurovascular unit


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