Department of General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China.
Qingdao University Affiliated Qingdao Municipal Hospital, Qingdao, Shandong, China.
Am J Med Sci. 2018 Dec;356(6):552-560. doi: 10.1016/j.amjms.2018.08.018. Epub 2018 Sep 5.
Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system and is characterized by demyelination, axonal loss, gliosis and inflammation. The last plays a major role in the onset and propagation of the disease. MS presents with heterogeneous lesions containing a broad range of cells and soluble mediators of the immune system such as T cells, B cells, macrophages, microglia, cytokines, chemokines, antibodies, complement and other toxic substances. This review outlines, analyzes and discusses the different immune mechanisms of MS that are responsible for the initiation and propagation of active lesions, demyelination, axonal injury, remyelination and cell loss as well as the role of cytokines in the disease process. Proinflammatory cytokines such as interleukin-17 (IL-17), IL-22, tumor necrosis factor-α, IL-1, IL-12 and interferon-γ may cause MS through several signaling pathways. Conversely, anti-inflammatory circulating cytokines such as IL-4 and IL-10 are reduced and theoretically can exert a direct protective effect in this condition. Future studies are necessary to develop effective, safe and long-lasting strategies to reduce the abnormal cytokine cascades and to treat MS.
多发性硬化症（MS）是一种影响中枢神经系统的慢性自身免疫性疾病，其特征是脱髓鞘、轴突丢失、神经胶质增生和炎症。后者在疾病的发生和传播中起主要作用。MS 表现为异质性病变，包含广泛的细胞和免疫系统的可溶性介质，如 T 细胞、B 细胞、巨噬细胞、小胶质细胞、细胞因子、趋化因子、抗体、补体和其他毒性物质。这篇综述概述、分析和讨论了 MS 的不同免疫机制，这些机制负责引发和传播活性病变、脱髓鞘、轴突损伤、髓鞘再生和细胞丢失，以及细胞因子在疾病过程中的作用。促炎细胞因子，如白细胞介素-17（IL-17）、IL-22、肿瘤坏死因子-α、IL-1、IL-12 和干扰素-γ，可能通过几种信号通路导致 MS。相反，抗炎的循环细胞因子，如 IL-4 和 IL-10，减少，并在理论上可以在这种情况下发挥直接的保护作用。未来的研究有必要开发有效、安全和持久的策略来减少异常的细胞因子级联反应，从而治疗 MS。
