Blood-brain barrier dysfunction, TGFβ signaling, and astrocyte dysfunction in epilepsy

Brain insults, including traumatic and ischemic injuries, are frequently followed by acute seizures and delayed development of epilepsy. Dysfunction of the blood-brain barrier (BBB) is a hallmark of brain insults and is usually surrounding the core lesion. Recent studies from several laboratories confirmed that vascular pathology is involved in the development of epilepsy and demonstrate a key role for astroglia in this process. In this review, we focus on glia-related mechanisms linking vascular pathology, and specifically BBB dysfunction, to seizures and epilepsy. We summarize molecular and physiological experimental data demonstrating that the function of astrocytes is altered due to direct exposure to serum albumin, mediated by transforming growth factor beta signaling. We discuss the reported changes and their potential role in the observed hyperexcitability as well as potential implications of these findings for the future development of new diagnostic modalities and treatments to allow a full implementation of the gained knowledge for the benefit of patients with epilepsy.