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多发性硬化症的免疫学

The immunology of multiple sclerosis.

作者信息

Attfield Kathrine E, Jensen Lise Torp, Kaufmann Max, Friese Manuel A, Fugger Lars

机构信息

Oxford Centre for Neuroinflammation, Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, University of Oxford, Oxford, UK.

Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.

出版信息

Nat Rev Immunol. 2022 Dec;22(12):734-750. doi: 10.1038/s41577-022-00718-z. Epub 2022 May 4.

Abstract

Our incomplete understanding of the causes and pathways involved in the onset and progression of multiple sclerosis (MS) limits our ability to effectively treat this complex neurological disease. Recent studies explore the role of immune cells at different stages of MS and how they interact with cells of the central nervous system (CNS). The findings presented here begin to question the exclusivity of an antigen-specific cause and highlight how seemingly distinct immune cell types can share common functions that drive disease. Innovative techniques further expose new disease-associated immune cell populations and reinforce how environmental context is critical to their phenotype and subsequent role in disease. Importantly, the differentiation of immune cells into a pathogenic state is potentially reversible through therapeutic manipulation. As such, understanding the mechanisms that provide plasticity to causal cell types is likely key to uncoupling these disease processes and may identify novel therapeutic targets that replace the need for cell ablation.

摘要

我们对多发性硬化症(MS)发病和进展所涉及的原因及途径的认识尚不完整,这限制了我们有效治疗这种复杂神经疾病的能力。近期研究探讨了免疫细胞在MS不同阶段的作用,以及它们如何与中枢神经系统(CNS)的细胞相互作用。此处呈现的研究结果开始对仅由抗原特异性引发疾病的观点提出质疑,并凸显出看似不同的免疫细胞类型如何能够共享驱动疾病的共同功能。创新技术进一步揭示了新的与疾病相关的免疫细胞群体,并强化了环境背景对其表型及随后在疾病中所起作用的重要性。重要的是,通过治疗手段,免疫细胞向致病状态的分化可能是可逆的。因此,了解赋予致病细胞类型可塑性的机制可能是解开这些疾病进程的关键,并且可能确定无需进行细胞消融的新型治疗靶点。

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