Pedemonte Enrico, Mancardi Gianluigi, Giunti Debora, Corcione Anna, Benvenuto Federica, Pistoia Vito, Uccelli Antonio
Neuroimmunology Unit, Department of Neurosciences, Ophthalmology and Genetics, University of Genoa, Italy.
Pharmacol Ther. 2006 Sep;111(3):555-66. doi: 10.1016/j.pharmthera.2005.11.007. Epub 2006 Jan 26.
In this review we will discuss the unique features that make the central nervous system (CNS) a specialized microenvironment where immune responses are tightly regulated in order to properly face pathogens without damaging the neural cells. We will show how every paradigm of this theoretical model has been addressed by the scientific literature over the past decades providing new insights on the immune response within the CNS. In particular, new light has been shed on the trafficking of the immune cells inside and outside the CNS. Dendritic cells (DCs) have been described in the context of structures in direct contact with the cerebrospinal fluid (CSF) and their migration, upon antigen encounter, outside the CNS into deep cervical lymph nodes (DCLNs) has been further clarified. T-cells, B-cells, and antibody-secreting cells (ASCs) have been found in the CSF and CNS parenchymal lesions of inflammatory disorders and their phenotype depicted. Moreover, in chronically inflamed CNS, ectopic lymphoid structures have been observed and a germinal center reaction similar to the one found in peripheral lymph nodes has been described. These structures may play a role in the maintenance and expansion of the local autoimmune response. Although the complex interactions between immune and neural cells still remain far to be elucidated, the data discussed here suggest that the physiopathology of the adaptive immune response inside the CNS mimics, although in a mitigated fashion, what occurs in other organs and tissues.
在本综述中，我们将讨论使中枢神经系统（CNS）成为一个特殊微环境的独特特征，在这个微环境中，免疫反应受到严格调控，以便在不损害神经细胞的情况下妥善应对病原体。我们将展示在过去几十年里，科学文献是如何探讨这一理论模型的每个范例的，从而为中枢神经系统内的免疫反应提供新的见解。特别是，中枢神经系统内外免疫细胞的 trafficking 有了新的认识。树突状细胞（DCs）已在与脑脊液（CSF）直接接触的结构背景下被描述，并且它们在遇到抗原后从中枢神经系统迁移到深部颈淋巴结（DCLNs）的过程也得到了进一步阐明。在炎症性疾病的脑脊液和中枢神经系统实质病变中发现了T细胞、B细胞和抗体分泌细胞（ASCs），并描述了它们的表型。此外，在慢性炎症的中枢神经系统中，观察到了异位淋巴结构，并描述了一种类似于外周淋巴结中的生发中心反应。这些结构可能在局部自身免疫反应的维持和扩展中发挥作用。尽管免疫细胞和神经细胞之间的复杂相互作用仍远未阐明，但此处讨论的数据表明，中枢神经系统内适应性免疫反应的生理病理学虽然以一种减轻的方式模仿了其他器官和组织中发生的情况。
