Prins Robert M, Liau Linda M
Division of Neurosurgery, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California 90095, USA.
Neurosurgery. 2003 Jul;53(1):144-52; discussion 152-3. doi: 10.1227/01.neu.0000068865.34216.3a.
For many years, the central nervous system (CNS) has been described as "immunologically privileged" and devoid of conventional immune reactivity. However, our more current understanding of neuroimmunology supports a different view. Although immune mechanisms within the CNS may behave differently from those located at peripheral anatomic sites, it is now widely accepted that biologically relevant immune responses can and do occur within the brain and that these responses can play important roles in CNS disease. The objective of this present review is to explore key aspects of recent insights into the cellular interactions involved in neuroimmunology, which may suggest more rational approaches to the immunotherapy of neurosurgical disorders.
Modern advances in molecular medicine and basic immunology have yielded a plethora of new data about CNS immunobiology. The design of effective immunotherapeutic strategies for CNS diseases requires a contemporary understanding of the basic tenets of how the immune system works. The current renaissance in this field may give neurosurgeons hope that, in the future, immunotherapy-based paradigms may be able to successfully treat neurosurgical diseases that are currently refractory to traditional therapies.
多年来,中枢神经系统(CNS)一直被描述为“免疫特权”且缺乏传统免疫反应性。然而,我们目前对神经免疫学的理解支持一种不同的观点。尽管中枢神经系统内的免疫机制可能与外周解剖部位的免疫机制表现不同,但现在人们广泛接受的是,生物学上相关的免疫反应能够且确实在脑内发生,并且这些反应可在中枢神经系统疾病中发挥重要作用。本综述的目的是探讨神经免疫学中细胞相互作用的最新见解的关键方面,这可能为神经外科疾病的免疫治疗提示更合理的方法。
分子医学和基础免疫学的现代进展产生了大量关于中枢神经系统免疫生物学的新数据。设计有效的中枢神经系统疾病免疫治疗策略需要对免疫系统如何工作的基本原理有当代的理解。该领域当前的复兴可能会给神经外科医生带来希望,即在未来,基于免疫治疗的模式或许能够成功治疗目前传统疗法难以治愈的神经外科疾病。