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Inflammation : High levels of inflammation in the brain are linked to increased blood-brain barrier (BBB) permeability [5] Stress : Acute stress activates brain mast cells that secrete proinflammatory cytokines [6] Bacterial infections : Bacteria in the brain increase MMP activity, which may induce the breakdown of the BBB [7] Toxins : LPS induces inflammation [8] Mold toxins : Mold toxins and mold components trigger inflammation and increase oxidative damage in the brain [9] High-fat , high-calorie diet : High-fat diets may increase oxidative damage, hypoxia, and inflammation in the brain [10] Leaky gut : Changes in the gut have been associated with BBB permeability [11, 12] Liver damage : In acute liver failure, the damaged liver releases MMP9 into the bloodstream, which may damage tight junctions [13] Diabetes or high blood sugar : Changes in glucose levels cause oxidative stress and inflammation [14] Disrupted sleep -wake cycle : Chronic sleep disturbance decreases glucose transport across the BBB and increases inflammation [15] Anything that triggers oxidative stress in glial cells and pericytes: Oxidative stress damages the BBB and causes structural and integrity problems [16, 17] Hypoxia : Hypoxia is a condition where there is not enough oxygen available