Kerschensteiner Martin, Stadelmann Christine, Dechant Georg, Wekerle Hartmut, Hohlfeld Reinhard
Brain Research Institute, University of Zurich and Department of Biology, ETH Zurich, Switzerland.
Ann Neurol. 2003 Mar;53(3):292-304. doi: 10.1002/ana.10446.
Inflammatory reactions in the central nervous system usually are considered detrimental, but recent evidence suggests that they also can be beneficial and even have neuroprotective effects. Intriguingly, immune cells can produce various neurotrophic factors of various molecular families. The concept of "neuroprotective immunity" will have profound consequences for the pathogenesis and treatment of neuroinflammatory diseases such as multiple sclerosis. It also will prove important for neurodegenerative disorders, in which inflammatory reactions often occur. This review focuses on recent findings that immune cells produce brain-derived neurotrophic factor in multiple sclerosis lesions, whereas neurons and astrocytes express the appropriate tyrosine kinase receptor TrkB. Together with functional evidence for the neuroprotective effects of immune cells, these observations support the concept of "neuroprotective immunity." We next examine current and future therapeutic strategies for multiple sclerosis and experimental autoimmune encephalomyelitis in light of neuroprotective immunity and finally address the broader implications of this new concept for other neuroinflammatory and neurodegenerative diseases.
中枢神经系统中的炎症反应通常被认为是有害的,但最近的证据表明,它们也可能是有益的,甚至具有神经保护作用。有趣的是,免疫细胞可以产生各种分子家族的多种神经营养因子。“神经保护性免疫”的概念将对诸如多发性硬化症等神经炎症性疾病的发病机制和治疗产生深远影响。这对于经常发生炎症反应的神经退行性疾病也将被证明是重要的。本综述重点关注近期的研究发现,即在多发性硬化症病变中免疫细胞产生脑源性神经营养因子,而神经元和星形胶质细胞表达相应的酪氨酸激酶受体TrkB。连同免疫细胞具有神经保护作用的功能证据,这些观察结果支持“神经保护性免疫”的概念。接下来,我们根据神经保护性免疫来审视目前和未来针对多发性硬化症和实验性自身免疫性脑脊髓炎的治疗策略,最后探讨这一新概念对其他神经炎症性和神经退行性疾病的更广泛影响。