Section of General Pathology, Department of Medicine, University of Verona, Verona, Italy.
The Center for Biomedical Computing (CBMC), University of Verona, Verona, Italy.
Front Immunol. 2021 Feb 19;12:639369. doi: 10.3389/fimmu.2021.639369. eCollection 2021.
Neurodegenerative diseases are closely related to inflammatory and autoimmune events, suggesting that the dysregulation of the immune system is a key pathological factor. Both multiple sclerosis (MS) and Alzheimer's disease (AD) are characterized by infiltrating immune cells, activated microglia, astrocyte proliferation, and neuronal damage. Moreover, MS and AD share a common pro-inflammatory signature, characterized by peripheral leukocyte activation and transmigration to the central nervous system (CNS). MS and AD are both characterized by the accumulation of activated neutrophils in the blood, leading to progressive impairment of the blood-brain barrier. Having migrated to the CNS during the early phases of MS and AD, neutrophils promote local inflammation that contributes to pathogenesis and clinical progression. The role of circulating T cells in MS is well-established, whereas the contribution of adaptive immunity to AD pathogenesis and progression is a more recent discovery. Even so, blocking the transmigration of T cells to the CNS can benefit both MS and AD patients, suggesting that common adaptive immunity mechanisms play a detrimental role in each disease. There is also growing evidence that regulatory T cells are beneficial during the initial stages of MS and AD, supporting the link between the modulatory immune compartments and these neurodegenerative disorders. The number of resting regulatory T cells declines in both diseases, indicating a common pathogenic mechanism involving the dysregulation of these cells, although their precise role in the control of neuroinflammation remains unclear. The modulation of leukocyte functions can benefit MS patients, so more insight into the role of peripheral immune cells may reveal new targets for pharmacological intervention in other neuroinflammatory and neurodegenerative diseases, including AD.
神经退行性疾病与炎症和自身免疫事件密切相关,这表明免疫系统的失调是一个关键的病理因素。多发性硬化症 (MS) 和阿尔茨海默病 (AD) 的特征均为浸润免疫细胞、激活小胶质细胞、星形胶质细胞增殖和神经元损伤。此外,MS 和 AD 具有共同的促炎特征,表现为外周白细胞激活和向中枢神经系统 (CNS) 的迁移。MS 和 AD 均以血液中激活的中性粒细胞积累为特征,导致血脑屏障的渐进性损害。在 MS 和 AD 的早期阶段迁移到 CNS 的中性粒细胞促进了局部炎症,从而促进了发病机制和临床进展。循环 T 细胞在 MS 中的作用已得到充分证实,而适应性免疫对 AD 发病机制和进展的贡献则是最近才发现的。即便如此,阻止 T 细胞向 CNS 的迁移可以使 MS 和 AD 患者受益,这表明共同的适应性免疫机制在每种疾病中都起着有害的作用。越来越多的证据表明,调节性 T 细胞在 MS 和 AD 的早期阶段是有益的,这支持了调节性免疫细胞与这些神经退行性疾病之间的联系。在这两种疾病中,静止调节性 T 细胞的数量均下降,表明涉及这些细胞失调的共同致病机制,尽管它们在神经炎症控制中的确切作用仍不清楚。白细胞功能的调节可能使 MS 患者受益,因此,对外周免疫细胞作用的更多了解可能会揭示出其他神经炎症和神经退行性疾病(包括 AD)中药物干预的新靶点。