Discipline of Pharmacology, School of Medical Sciences, University of Adelaide, Adelaide, SA 5005, Australia.
Brain Behav Immun. 2011 Oct;25(7):1322-32. doi: 10.1016/j.bbi.2011.04.003. Epub 2011 Apr 7.
Recent evidence implicates an adaptive immune response in the central nervous system (CNS) mechanisms of neuropathic pain. This review identifies how neuropathic pain alters CNS immune privilege to facilitate T cell infiltration. Once in the CNS, T cells may interact with the local antigen presenting cells, microglia, via the major histocompatibility complex and the costimulatory molecules CD40 and B7. In this way, T cells may contribute to the maintenance of neuropathic pain through pro-inflammatory interactions with microglia and by facilitating the activation of astrocytes in the spinal dorsal horn. Based on the evidence presented in this review, we suggest that this bidirectional, pro-inflammatory system of neurons, glia and T cells in neuropathic pain should be renamed the pentapartite synapse, and identifies the latest member as a potential disease-modifying therapeutic target.
最近的证据表明，适应性免疫反应参与了中枢神经系统（CNS）神经性疼痛的机制。本综述确定了神经性疼痛如何改变 CNS 免疫特权以促进 T 细胞浸润。一旦进入中枢神经系统，T 细胞可能通过主要组织相容性复合体和共刺激分子 CD40 和 B7 与局部抗原呈递细胞小胶质细胞相互作用。通过这种方式，T 细胞可能通过与小胶质细胞的促炎相互作用以及促进脊髓背角星形胶质细胞的激活，有助于维持神经性疼痛。基于本综述中提出的证据，我们建议将神经性疼痛中神经元、神经胶质和 T 细胞的这种双向促炎系统重新命名为五重突触，并将最新成员确定为潜在的疾病修饰治疗靶点。
