Papiri Giulio, D'Andreamatteo Giordano, Cacchiò Gabriella, Alia Sonila, Silvestrini Mauro, Paci Cristina, Luzzi Simona, Vignini Arianna
Neurology Unit, Ospedale Provinciale "Madonna del Soccorso", 63074 San Benedetto del Tronto, Italy.
Section of Biochemistry, Biology and Physics, Department of Clinical Sciences, Università Politecnica delle Marche, 60100 Ancona, Italy.
Curr Issues Mol Biol. 2023 Feb 8;45(2):1443-1470. doi: 10.3390/cimb45020094.
Multiple sclerosis (MS) represents the most common acquired demyelinating disorder of the central nervous system (CNS). Its pathogenesis, in parallel with the well-established role of mechanisms pertaining to autoimmunity, involves several key functions of immune, glial and nerve cells. The disease's natural history is complex, heterogeneous and may evolve over a relapsing-remitting (RRMS) or progressive (PPMS/SPMS) course. Acute inflammation, driven by infiltration of peripheral cells in the CNS, is thought to be the most relevant process during the earliest phases and in RRMS, while disruption in glial and neural cells of pathways pertaining to energy metabolism, survival cascades, synaptic and ionic homeostasis are thought to be mostly relevant in long-standing disease, such as in progressive forms. In this complex scenario, many mechanisms originally thought to be distinctive of neurodegenerative disorders are being increasingly recognized as crucial from the beginning of the disease. The present review aims at highlighting mechanisms in common between MS, autoimmune diseases and biology of neurodegenerative disorders. In fact, there is an unmet need to explore new targets that might be involved as master regulators of autoimmunity, inflammation and survival of nerve cells.
多发性硬化症(MS)是中枢神经系统(CNS)最常见的后天性脱髓鞘疾病。其发病机制与自身免疫相关机制的既定作用并行,涉及免疫、神经胶质和神经细胞的几个关键功能。该疾病的自然史复杂、异质性强,可能会在复发缓解型(RRMS)或进展型(PPMS/SPMS)病程中演变。由中枢神经系统外周细胞浸润驱动的急性炎症被认为是最早阶段和复发缓解型多发性硬化症中最相关的过程,而与能量代谢、生存级联反应、突触和离子稳态相关的神经胶质和神经细胞通路的破坏被认为在长期疾病中最为相关,例如在进展型疾病中。在这种复杂的情况下,许多最初被认为是神经退行性疾病特有的机制在疾病一开始就越来越被认为是至关重要的。本综述旨在强调多发性硬化症、自身免疫性疾病和神经退行性疾病生物学之间的共同机制。事实上,迫切需要探索可能作为自身免疫、炎症和神经细胞存活的主要调节因子的新靶点。