The role of crosstalk between cerebral immune cells and peripheral immune cells in the damage and protection of blood–brain barrier after intracerebral hemorrhage

Blood-brain barrier (BBB) damage is a major pathological change after intracerebral hemorrhage (ICH) and is both the cause and result of brain edema and the inflammatory response post-ICH. Cerebral immune cells (CICs), including microglia, pericytes, and astrocytes play a crucial role in the damage and protection of the BBB after ICH. Recent evidence suggests that peripheral immune cells (PICs) also play an important role in BBB damage and protection, brain edema, and neurological function impairment. Therefore, regulating interactions between glial cells and immune cells is expected to alleviate ICH-induced BBB damage. In this review, we first introduce the role of CICs, endothelial cells (ECs), oligodendrocytes (OLs), and PICs in BBB damage and protection after ICH, focusing on their polarization and inflammatory response. Next, we specifically discuss the crosstalk between CICs and PICs, such as the brain-spleen axis and brain-gut axis after ICH. Finally, we suggest that glial cells, PICs and, meningeal lymphatic system may be potential targets for alleviating BBB damage after ICH, and discuss some molecular targets and potential strategies for alleviating BBB damage after ICH by modulating CICs, ECs, and PICs.