Neurological Surgery 脳神経外科34巻10号

2006年10月発行

総説

悪性脳腫瘍における血液腫瘍関門

著者： 林康彦¹ 吉田優也¹ 濱田潤一郎¹

所属機関： ¹金沢大学大学院医学系研究科脳医科学専攻脳病態医学講座脳機能制御学

ページ範囲：P.983 - P.999

Ⅰ．は じ め に

　脳はその特殊環境を維持するために，体内循環との境界である血管壁に“血液脳関門”と呼ばれる特殊性を有していることは古くからの周知の事実である．血液脳関門とは，正確には脳の恒常性を保つため血管内皮細胞に備わった機能的かつ構造的な特異形質を意味する^67,71)．血液脳関門の機能は次の3つに要約することができる．①脳内環境を血液のものと隔離すること，②神経細胞やグリアの機能を維持するために必要な多種多様の物質を選択的かつ能動的に取り込むこと，③血液または脳内で産生された物質の代謝もしくは修飾すること，である^4,8,71)．ところが，悪性脳腫瘍においてはその腫瘍血管の機能および構造が正常血管の血液脳関門とは異なる血管内皮細胞の性質を有しているため，脳浮腫などの正常脳とは異なった現象を引き起こして臨床症状を悪化させる大きな原因となっていることも，多くの研究結果がそれを裏付けている^12,18,19)．そこで，これらの歴史を振り返りながら，現状に関して私見も交え以下に総括する．

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