Klein Robyn S, Hunter Christopher A
Departments of Medicine, Pathology and Immunology, Neuroscience, Washington University School of Medicine, St. Louis, MO 63110, USA.
Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
Immunity. 2017 Jun 20;46(6):891-909. doi: 10.1016/j.immuni.2017.06.012.
The concept of immune privilege of the central nervous system (CNS) has dominated the study of inflammatory processes in the brain. However, clinically relevant models have highlighted that innate pathways limit pathogen invasion of the CNS and adaptive immunity mediates control of many neural infections. As protective responses can result in bystander damage, there are regulatory mechanisms that balance protective and pathological inflammation, but these mechanisms might also allow microbial persistence. The focus of this review is to consider the host-pathogen interactions that influence neurotropic infections and to highlight advances in our understanding of innate and adaptive mechanisms of resistance as key determinants of the outcome of CNS infection. Advances in these areas have broadened our comprehension of how the immune system functions in the brain and can readily overcome immune privilege.
中枢神经系统（CNS）免疫豁免的概念一直主导着对脑部炎症过程的研究。然而，临床相关模型已强调，固有途径限制病原体对中枢神经系统的侵袭，而适应性免疫介导对许多神经感染的控制。由于保护性反应可能导致旁观者损伤，因此存在平衡保护性炎症和病理性炎症的调节机制，但这些机制也可能使微生物持续存在。本综述的重点是考虑影响嗜神经感染的宿主-病原体相互作用，并强调我们对作为中枢神经系统感染结果关键决定因素的固有和适应性抵抗机制理解的进展。这些领域的进展拓宽了我们对免疫系统在脑部如何发挥作用以及如何轻易克服免疫豁免的理解。
