Weiss Fiona, Labrador-Garrido Adahir, Dzamko Nicolas, Halliday Glenda
University of Sydney, Brain and Mind Centre and Faculty of Medicine and Health, School of Medical Sciences, Camperdown, NSW 2050, Australia.
University of Sydney, Brain and Mind Centre and Faculty of Medicine and Health, School of Medical Sciences, Camperdown, NSW 2050, Australia.
Neurobiol Dis. 2022 Jun 15;168:105700. doi: 10.1016/j.nbd.2022.105700. Epub 2022 Mar 18.
Immune changes occur in all neurodegenerative conditions, but there are significant differences between diseases. For Parkinson's disease (PD), the immune system involvement is still being identified with considerable promise for therapeutic targeting. Post-mortem analyses of PD patient brains and pre-clinical cell and rodent models of PD identify increased inflammation in the brain and an elevation in central and peripheral pro-inflammatory cytokines. The cells involved include activated microglia surrounding degenerating neurons, currently thought to be neuroprotective in early disease stages but detrimental at later stages. Very different astrocytic reactions are found in the PD brain compared to other neurodegenerative conditions, with a loss of normal astrocyte functions contributing to a neurotoxic or dysfunctional phenotype (rather than classical astrogliosis found in all other neurodegenerative conditions). Astrocytes in PD are also actively involved in clearing α-synuclein away from vulnerable neurons, but the eventual accumulation of α-synuclein in their cytoplasm promotes a pro-inflammatory response and contributes to their dysfunctional phenotype and the spreading of PD pathology. Infiltration of peripheral immune cells also occurs in the PD brain, particularly T cells and monocytes. Both CD4 and CD8 T cells occur in regions of cell loss, with cytotoxic CD8 T cells occurring in the earliest stages and CD4 T helper cells occurring with disease progression. Current evidence points towards infiltrating monocytes as also playing a role in neuron death. Further characterisation of the successive molecular changes in both the resident and peripheral immune cells invading the PD brain will provide targets for disease modification.
在所有神经退行性疾病中都会发生免疫变化,但不同疾病之间存在显著差异。对于帕金森病(PD),免疫系统的参与仍在被确定,具有很大的治疗靶点潜力。对PD患者大脑的尸检分析以及PD的临床前细胞和啮齿动物模型表明,大脑中的炎症增加,中枢和外周促炎细胞因子升高。涉及的细胞包括围绕退化神经元的活化小胶质细胞,目前认为在疾病早期具有神经保护作用,但在后期则有害。与其他神经退行性疾病相比,PD大脑中发现了非常不同的星形胶质细胞反应,正常星形胶质细胞功能的丧失导致神经毒性或功能失调的表型(而不是在所有其他神经退行性疾病中发现的经典星形胶质细胞增生)。PD中的星形胶质细胞也积极参与将α-突触核蛋白从易损神经元中清除,但α-突触核蛋白最终在其细胞质中的积累促进了促炎反应,并导致其功能失调的表型和PD病理的传播。外周免疫细胞也会浸润到PD大脑中,尤其是T细胞和单核细胞。CD4和CD8 T细胞都出现在细胞丢失区域,细胞毒性CD8 T细胞出现在最早阶段,CD4辅助性T细胞随着疾病进展而出现。目前的证据表明浸润的单核细胞也在神经元死亡中起作用。对侵入PD大脑的常驻和外周免疫细胞中连续分子变化的进一步表征将为疾病修饰提供靶点。