Theoharides Theoharis C, Kempuraj Duraisamy, Kourelis Taxiarchis, Manola Akrivi
Department of Pharmacology and Experimental Therapeutics, Tufts University School of Medicine and Tufts Medical Center, Boston, MA 02111, USA.
Ann N Y Acad Sci. 2008 Nov;1144:74-82. doi: 10.1196/annals.1418.029.
Multiple sclerosis is an autoimmune demyelinating disease of the central nervous system mainly mediated by Th1 and/or Th17 cells, which cross the blood-brain barrier. Recent evidence indicates that Th2 cells and mast cells, typically associated with allergic reactions, are also involved. Brain mast cells are critically located perivascularly and secrete numerous proinflammatory and vasoactive molecules that can disrupt the blood-brain barrier, a finding that precedes clinical or pathologic signs of multiple sclerosis. Brain mast cells in multiple sclerosis are activated by neural factors, including substance P, myelin basic protein, and corticotropin-releasing hormone, caused by acute stress, which induce release of several inflammatory mediators. Mast cells can stimulate activated T cells coming in contact with them at the blood-brain barrier, as well as after stimulation with myelin basic protein or substance P. Pretreatment with the flavone luteolin blocks mast cell stimulation and T cell activation, as well as experimental autoimmune encephalitis. Interactions between mast cells and T cells could constitute a new and unique therapeutic target for multiple sclerosis.
多发性硬化症是一种中枢神经系统的自身免疫性脱髓鞘疾病,主要由穿过血脑屏障的Th1和/或Th17细胞介导。最近的证据表明,通常与过敏反应相关的Th2细胞和肥大细胞也参与其中。脑肥大细胞主要位于血管周围,分泌多种促炎和血管活性分子,这些分子可破坏血脑屏障,这一发现早于多发性硬化症的临床或病理体征。多发性硬化症中的脑肥大细胞由神经因素激活,包括P物质、髓鞘碱性蛋白和促肾上腺皮质激素释放激素,这些因素由急性应激引起,可诱导多种炎症介质的释放。肥大细胞可刺激在血脑屏障处与其接触的活化T细胞,以及在用髓鞘碱性蛋白或P物质刺激后。用黄酮类化合物木犀草素预处理可阻断肥大细胞刺激和T细胞活化,以及实验性自身免疫性脑脊髓炎。肥大细胞与T细胞之间的相互作用可能构成多发性硬化症一个新的独特治疗靶点。