Foe or friend? Janus-faces of the neurovascular unit in the formation of brain metastases

Imola Wilhelm, Csilla Fazakas, Kinga Molnár, Attila G. Végh, János Haskó, István A. Krizbai

Research output: Contribution to journalReview article

7 Citations (Scopus)

Abstract

Despite the potential obstacle represented by the blood–brain barrier for extravasating malignant cells, metastases are more frequent than primary tumors in the central nervous system. Not only tightly interconnected endothelial cells can hinder metastasis formation, other cells of the brain microenvironment (like astrocytes and microglia) can also be very hostile, destroying the large majority of metastatic cells. However, malignant cells that are able to overcome these harmful mechanisms may benefit from the shielding and even support provided by cerebral endothelial cells, astrocytes and microglia, rendering the brain a sanctuary site against anti-tumor strategies. Thus, cells of the neurovascular unit have a Janus-faced attitude towards brain metastatic cells, being both destructive and protective. In this review, we present the main mechanisms of brain metastasis formation, including those involved in extravasation through the brain vasculature and survival in the cerebral environment.

Original languageEnglish
Pages (from-to)563-587
Number of pages25
JournalJournal of Cerebral Blood Flow and Metabolism
Volume38
Issue number4
DOIs
Publication statusPublished - Apr 1 2018

Keywords

  • Astrocyte
  • blood–brain barrier
  • brain metastasis
  • cerebral endothelial cell
  • neurovascular unit

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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