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. 2023 Apr 10;11:1174043. doi: 10.3389/fcell.2023.1174043

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Copyright © 2023 Qiu, Mo, Xu, Chen, Ye, Kang, Chen and Zhu.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Potential pathophysiological processes and mechanisms involved in BBB damage during perioperative period. Changes in blood-brain barrier (BBB) permeability, inflammation and neuroinflammation, oxidative stress, ferroptosis, and intestinal dysbiosis may be involved in BBB damage. Chain reaction mean that BBB damage may cause peripheral inflammatory cell infiltration into the brain and further aggravate neuroinflammation. Moreover, activation of microglia and astrocytes may play an important role in the regulation of anxiety, depression and chronic neurodegenerative diseases. MMP3 (matrix metalloproteinase 3); ROS (reactive oxygen species); TJs (tight junctions).