Mechanisms, Imaging, and Targeted Strategies of Neuroinflammation-Driven Blood-Brain Barrier Damage in Neurodegenerative Diseases

Abstract

This study focuses on the mechanisms of neuroinflammation-driven blood-brain barrier (BBB) damage in neurodegenerative diseases such as ischemic stroke and Alzheimer's disease (AD), and systematically explores the integration of in vivo imaging techniques and targeted therapeutic strategies. It analyzes the effects of immune cells, cytokines, and core signaling pathways in neuroinflammation on the BBB, evaluates the application value of imaging technologies including magnetic resonance imaging (MRI), dynamic contrast-enhanced MRI (DCE-MRI), and positron emission tomography (PET) in inflammation monitoring, and discusses the roles of Interleukin-1 Receptor Antagonist (IL-1Ra) and Triggering Receptor Expressed on Myeloid Cells 2 (TREM2). The results show that neuroinflammation impairs BBB integrity through oxidative stress, activation of Matrix Metalloproteinases (MMPs), and peripheral immune infiltration; the dual regulatory effects of microglia and astrocytes, as well as the activation of signaling pathways such as NOD-like Receptor Pyrin Domain-Containing Protein 3 (NLRP3) and Toll-like Receptor 4 (TLR4)/Nuclear Factor Kappa B (NF-κB), are key mechanisms. Multimodal imaging techniques can accurately capture inflammatory dynamics, providing a basis for personalized treatment. Targeted strategies have shown significant efficacy in animal models, but species differences and time window control remain major challenges for clinical translation. This study provides a theoretical basis for understanding the inflammatory mechanisms of neurodegenerative diseases and developing novel diagnostic and therapeutic regimens.