Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea & Westminster Hospital, London SW10 9NH, UK.
Brain Res. 2012 Mar 29;1446:144-55. doi: 10.1016/j.brainres.2012.01.061. Epub 2012 Feb 2.
Inflammation is part of the innate immune response following insults to the body. This inflammatory reaction can spread throughout the systemic circulation and also into the central nervous system (CNS). CNS involvement has been demonstrated following acute peripheral insults including sepsis, surgery, burns and organ injury. It has also been observed in chronic conditions including obesity, diabetes and rheumatoid arthritis. Inflammation within the CNS is part of the pathogenesis of neurodegenerative diseases, in particular Alzheimer's disease, multiple sclerosis and Parkinson's disease. These diseases are prone to exacerbation as a result of increased inflammation within the CNS following peripheral insult. The effect of inflammation within the CNS can also be modulated by other factors including age and also oestrogen, although how pro-inflammatory cytokines within the CNS cause clinical changes remains to be elucidated. The mechanism underlying the passage of inflammation from the periphery into the CNS also remains unclear. Evidence has led to the suggestion of two main pathways: blood brain barrier (BBB) dependent and BBB independent. This uncertainty has led to an increasing body of work exploring the processes involved in both the passage of inflammation into, and the effect of cytokines on, the CNS.
炎症是机体受到损伤后固有免疫反应的一部分。这种炎症反应可以在全身循环中扩散，也可以进入中枢神经系统 (CNS)。在急性外周损伤后，包括败血症、手术、烧伤和器官损伤，已经证明了 CNS 的受累。在慢性疾病中，包括肥胖、糖尿病和类风湿性关节炎，也观察到了这种情况。CNS 内的炎症是神经退行性疾病发病机制的一部分，特别是阿尔茨海默病、多发性硬化症和帕金森病。由于外周损伤后 CNS 内炎症增加，这些疾病容易恶化。CNS 内的炎症也可以通过其他因素进行调节，包括年龄和雌激素，尽管 CNS 内的促炎细胞因子如何导致临床变化仍有待阐明。炎症从外周进入中枢神经系统的机制也不清楚。有证据表明存在两种主要途径：血脑屏障 (BBB) 依赖性和 BBB 非依赖性。这种不确定性导致越来越多的工作探索炎症进入 CNS 以及细胞因子对 CNS 影响的相关过程。
