Blood-Brain Barrier in Schizophrenia: Current Insights and Future Perspectives

The blood-brain barrier (BBB) plays a crucial role in regulating the transport of solutes and essential nutrients into the brain. It maintains the homeostasis of the brain microenvironment, regulates nutrient transport, and prevents pathogens and neurotoxic substances from entering brain tissue. In recent years, increasing research has shown that BBB dysfunction plays a significant role in the pathophysiology of schizophrenia. Additionally, various MRI-based neuroimaging techniques have gradually been applied to study BBB permeability in schizophrenia. They may offer boundless potential for the in vivo assessment of brain structure and neurovascular function status, along with the evaluation of treatment efficacy in future schizophrenia patients. This article aims to synthesize evidence from postmortem, serum and cerebrospinal fluid biomarker, and neuroimaging studies, highlighting the alterations in BBB permeability among schizophrenia patients and their potential links to neuroinflammation and other factors. Moreover, it intends to deepen the understanding of schizophrenia pathophysiology, explore the BBB as a therapeutic target, and provide a basis for new antipsychotic drug development.