Schild Hansjörg, Bopp Tobias
Institut für Immunologie, Universitätsmedizin Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland.
Nervenarzt. 2024 Oct;95(10):894-908. doi: 10.1007/s00115-024-01696-4. Epub 2024 Jul 2.
Neurodegenerative diseases represent an increasing challenge in ageing societies, as only limited treatment options are currently available.
New research methods and interdisciplinary interaction of different disciplines have changed the way neurological disorders are viewed and paved the way for the comparatively new field of neuroimmunology, which was established in the early 1980s. Starting from neurological autoimmune diseases, such as multiple sclerosis, knowledge about the involvement of immunological processes in other contexts, such as stroke or traumatic brain injury, has been significantly expanded in recent years.
This review article provides an overview of the role of the immune system and the resulting potential for novel treatment approaches.
The immune system plays a central role in fighting infections but is also able to react to the body's own signals under sterile conditions and cause inflammation and subsequent adaptive immune responses through the release of immune mediators and the recruitment and differentiation of certain immune cell types. This can be beneficial in initiating healing processes; however, chronic inflammatory conditions usually have destructive consequences for the tissue and the organism and must be interrupted.
It is now known that different cells of the immune system play an important role in neurological diseases. Regulatory mechanisms, which are mediated by regulatory T cells or Th2 cells, are usually associated with a good prognosis, whereas inflammatory processes and polarization towards Th1 or Th17 have a destructive character. Novel immunomodulators, which are also increasingly being used in cancer treatment, can now be used in a tissue-specific manner and therefore offer great potential for use in neurological diseases.
在老龄化社会中,神经退行性疾病带来的挑战日益增加,因为目前可用的治疗选择有限。
新的研究方法以及不同学科之间的跨学科互动改变了对神经系统疾病的看法,并为20世纪80年代初建立的相对较新的神经免疫学领域铺平了道路。从诸如多发性硬化症等神经自身免疫性疾病开始,近年来,关于免疫过程在其他情况下(如中风或创伤性脑损伤)的参与情况的知识有了显著扩展。
这篇综述文章概述了免疫系统的作用以及由此产生的新型治疗方法的潜力。
免疫系统在对抗感染中起核心作用,但在无菌条件下也能够对机体自身信号作出反应,并通过释放免疫介质以及特定免疫细胞类型的募集和分化引发炎症及随后的适应性免疫反应。这在启动愈合过程中可能是有益的;然而,慢性炎症状态通常会对组织和机体产生破坏性后果,必须加以阻断。
现在已知免疫系统的不同细胞在神经疾病中发挥重要作用。由调节性T细胞或Th2细胞介导的调节机制通常与良好的预后相关,而炎症过程以及向Th1或Th17的极化具有破坏性。新型免疫调节剂如今也越来越多地用于癌症治疗,它们可以以组织特异性方式使用,因此在神经疾病治疗中具有巨大的应用潜力。