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Gastroenterology Research and Practice
Volume 2013 (2013), Article ID 841707, 7 pages
Review Article

Alterations of Blood-Brain Barrier and Associated Factors in Acute Liver Failure

Department of Infectious Diseases, The First Affiliated Hospital, China Medical University, Shenyang 110001, China

Received 31 January 2013; Revised 8 April 2013; Accepted 7 May 2013

Academic Editor: Fabio Marra

Copyright © 2013 Wei Cui et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Brain edema in acute liver failure (ALF) remains lethal. Cytotoxic mechanisms associated with brain edema have been well recognized, but the role of vasogenic mechanisms of brain edema has not been explored. Intact tight junctions (TJs) between brain capillary endothelial cells are critical for normal BBB function. Recent reports found significant alterations in the tight junction elements including occludin and claudin-5, suggesting a vasogenic injury in the blood-brain barrier (BBB) integrity. However, the role of TJ in ALF has not been completely understood. This paper reviews the role of the paracellular tight junction in the increased selective BBB permeability that leads to brain edema in ALF and furthermore explores the effect of systemic inflammatory cytokines on the tight junction dysfunction.