Schwartz Michal
a Department of Neurobiology , The Weizmann Institute of Science , Rehovot , Israel.
J Spinal Cord Med. 2003 Jan;26(sup1):S6-S10. doi: 10.1080/10790268.2003.11753719.
Spinal cord injury often has devastating consequences, due to the poor regenerative capacity of the central nervous system (CNS), and because the injury triggers self-destructive processes that lead to degeneration of directly injured fibers, and fibers that survived the lesion but subsequently undergo "secondary degeneration." The highly complex, multifaceted dialogue between the immune system and the damaged spinal cord is complicated further by factors related to species, strain, and gender. It is suggested that following an injury to the CNS, the resident and systemic immune cells are recruited and activated, to reduce the self-destruction and facilitate the repair of the damaged nerve. Both of these functions can benefit from a well-controlled immune response that critically involves the innate and adaptive arms of the immune system, represented by macrophages/ microglia and autoimmune T cells, respectively. A poorly controlled immune response can be non-efficient or even destructive, leading in extreme cases even to autoimmune disease. The beneficial autoimmune response can be boosted by posttraumatic T cell-based vaccination with peptides that activate weak self-reactive T cells, thereby ensuring timely and adequate immune activation without the risk of autoimmune disease. It is proposed that the notion of "bad" or "good" inflammation be replaced by a concept that views inflammation in the CNS as a repair mechanism and thus as beneficial if well regulated, and supports therapy for spinal cord and other CNS injuries by immunomodulation.
脊髓损伤往往会带来毁灭性后果，这是由于中枢神经系统（CNS）再生能力差，而且损伤会引发自我破坏过程，导致直接受损纤维以及在损伤中存活但随后发生“继发性变性”的纤维发生退化。免疫系统与受损脊髓之间高度复杂、多方面的相互作用因物种、品系和性别的相关因素而更加复杂。有人提出，中枢神经系统损伤后，驻留和全身免疫细胞会被募集并激活，以减少自我破坏并促进受损神经的修复。这两种功能都可受益于精心控制的免疫反应，这种反应关键涉及免疫系统的固有和适应性分支，分别由巨噬细胞/小胶质细胞和自身免疫性T细胞代表。控制不佳的免疫反应可能效率低下甚至具有破坏性，在极端情况下甚至会导致自身免疫性疾病。创伤后基于T细胞的肽疫苗接种可以增强有益的自身免疫反应，激活弱的自身反应性T细胞，从而确保及时且充分的免疫激活，同时没有自身免疫性疾病的风险。有人提出，用一种将中枢神经系统中的炎症视为一种修复机制的概念取代“不良”或“良好”炎症的观念，因此如果调节得当则是有益的，并支持通过免疫调节治疗脊髓和其他中枢神经系统损伤。
