Breaking the fortress: a mechanistic review of meningitis-causing bacteria breaching tactics in blood brain barrier

Abstract

Abstract The blood-brain barrier is a physiological protective barrier around blood vessels in the brain. It prevents most bacteria and harmful substances from entering the brain through the blood. However, when bacterial meningitis occurs, bacteria enter the brain either from the circulation or by direct invasion from neighbouring structures, causing an inflammatory response that in severe cases may lead to death. High morbidity and mortality are prominent features of the disease. Many pathogenic bacteria can break through the blood-brain barrier and cause meningitis, such as Streptococcus pneumoniae, Group B Streptococcus, Streptococcus suis, Neisseria meningitidis, meningitis-associated Escherichia coli, etc. This article reviews the mechanisms by which these bacteria cross the blood-brain barrier when causing meningitis and the interactions between bacteria and host cells to help pathogens invade the brain. Clarifying the mechanism by which pathogens cross the blood-brain barrier can provide new ideas for developing effective treatments for bacterial meningitis.

Keywords

• Blood-brain barrier
• Bacterial meningitis
• Host-pathogen interaction
• Bacterial invasion
• Transcellular transport