National Institute of Neurological Disorders and Stroke, The National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA.
J Neuroimmune Pharmacol. 2010 Sep;5(3):370-86. doi: 10.1007/s11481-010-9208-9. Epub 2010 Apr 18.
The central nervous system (CNS) is a finely tuned organ that participates in nearly every aspect of our day-to-day function. Neurons lie at the core of this functional unit and maintain an active dialogue with one another as well as their fellow CNS residents (e.g. astrocytes, oligodendrocytes, microglia). Because of this complex dialogue, it is essential that the CNS milieu be tightly regulated in order to permit uninterrupted and efficient neural chemistry. This is accomplished in part by anatomical barriers that segregate vascular components from the cerebral spinal fluid (CSF) and brain parenchyma. These barriers impede entry of noxious materials and enable the CNS to maintain requisite protein and ionic balances for constant electrochemical signaling. Under homeostatic conditions, the CNS is protected by the presence of specialized endothelium/epithelium, the blood brain barrier (BBB), and the blood-CSF barrier. However, following CNS infection these protective barriers can be comprised, sometimes resulting in severe neurological complications triggered by an imbalance or blockage of neural chemistry. In some instances, these disruptions are severe enough to be fatal. This review focuses on a selection of microbes (both viruses and parasites) that compromise vascular barriers and induce neurological complications upon gaining access to the CNS. Emphasis is placed on CNS diseases that result from a pathogenic interplay between host immune defenses and the invading microbe.
中枢神经系统(CNS)是一个精细调节的器官,参与我们日常生活的几乎所有方面。神经元是这个功能单元的核心,它们彼此之间以及与中枢神经系统的其他居民(如星形胶质细胞、少突胶质细胞、小胶质细胞)保持着活跃的对话。由于这种复杂的对话,中枢神经系统的环境必须得到严格的调节,以允许不间断和有效的神经化学。这部分是通过将血管成分与脑脊液(CSF)和脑实质分开的解剖屏障来实现的。这些屏障阻碍有害物质的进入,并使中枢神经系统能够维持必要的蛋白质和离子平衡,以保持恒定的电化学信号。在稳态条件下,中枢神经系统受到特殊的内皮/上皮、血脑屏障(BBB)和血脑脊液屏障的保护。然而,在中枢神经系统感染后,这些保护屏障可能会被破坏,有时会导致严重的神经并发症,这些并发症是由神经化学的失衡或阻塞引起的。在某些情况下,这些干扰严重到足以致命。这篇综述重点介绍了一些破坏血管屏障并在进入中枢神经系统时引起神经并发症的微生物(包括病毒和寄生虫)。重点介绍了由于宿主免疫防御和入侵微生物之间的致病相互作用而导致的中枢神经系统疾病。