Cell Membranes and Transport Mechanisms
The structural basis of any cellular barrier is the phospholipid bilayer. Its organization is strictly ordered: the hydrophilic heads of the molecules face outward (toward aqueous environments), while the hydrophobic tails are tucked inside the membrane. This hydrophobic core creates a reliable barrier against polar compounds.
Drugs and other substances cross membranes via two main pathways:
- Passive transport: movement of substances along a concentration gradient. This process requires no energy expenditure. Lipophilic molecules most frequently cross by passive diffusion (diffusio passiva).
- Active transport: movement of substances against a concentration gradient or with the mandatory participation of specific carriers. This process always requires energy expenditure.
Epithelial and Endothelial Barriers
Tissue barriers play a critical role in the distribution of substances throughout the body.
The epithelial barrier serves as a significant obstacle to hydrophilic compounds. For example, it accounts for the poor absorption of such substances from the lung surface and the absence of their reabsorption in the renal tubules. Lipophilic compounds generally cross the epithelium freely, but the body employs a protective efflux mechanism: specialized membrane transporter proteins (such as P-glycoprotein) can capture molecules that have entered the cell and actively pump them back out (e.g., from an enterocyte back into the intestinal lumen).
The endothelial barrier (capillary wall) varies depending on the tissue type:
- Continuous capillaries (skeletal muscle, subcutaneous tissue, internal organs). Large intercellular gaps (fenestrae) about 2 nm or more in size exist between endothelial cells (cellulae endotheliales). Hydrophilic substances easily penetrate tissues via filtration through these clefts, ensuring rapid exchange between blood and tissue fluid.
- Capillaries of the brain (CNS). Fenestrae are completely absent, and cells are tightly apposed. Transport of hydrophilic substances is prevented.
Histohematic Barriers
Histohematic barriers are specialized separating structures between the blood and the tissue fluid of specific organs. Their main function is to protect the vulnerable internal environment from toxins and xenobiotics circulating in the bloodstream.
Major types include:
- Blood-Brain Barrier (BBB) (barriera haematoencephalica). Protects the brain. Due to endothelial tight junctions, water-soluble polar xenobiotics are essentially "reflected" from the capillary wall. Only lipophilic substances can penetrate via passive diffusion.
- Blood-Ophthalmic Barrier. Isolates the intraocular fluids and is impermeable to hydrophilic polar drugs.
- Placental Barrier. Protects the developing fetus.
- Reproductive Barriers: blood-testis barrier (between blood and the contents of the seminiferous tubules) and blood-follicular / blood-ovarian barrier (protecting the ovaries). Because lipophilic substances can easily penetrate these tissues by diffusion, protection is provided by ATP-dependent transport proteins. For example, the lipophilic drug cyclosporine (Cyclosporinum), which is toxic to spermatogenesis, is actively eliminated by P-glycoprotein, minimizing its damaging effect.