Bradl M, Linington C
Max-Planck Institute for Psychiatry, Department of Neuroimmunology, Martinsried, Germany.
Brain Pathol. 1996 Jul;6(3):303-11. doi: 10.1111/j.1750-3639.1996.tb00857.x.
Demyelination is a pathological feature that is characteristic of many diseases of the central nervous system (CNS) including multiple sclerosis (MS), sub-acute sclerosing panencephalomyelitis (SSPE), metachromatic leukodystrophy and Pelizaeus-Merzbacher disease. While demyelination is a pathological end-point that is common to all of these diseases, the cellular and molecular mechanisms responsible for this pathology are very different . These range from genetic defects that affect lipid metabolism in the leukodystrophies, cytopathic effects of viral infection in SSPE to the action of immunological effector mechanisms in MS and the viral encephalopathies. Irrespective of the initial cause of myelin degradation, many of these disorders are associated with some degree of CNS inflammation, as indicated by the local activation of microglia, recruitment of macrophages or the intrathecal synthesis of immunoglobulin. Many of these phenomena are now being duplicated in animal models, providing not only new insights into the pathogenesis of human demyelinating diseases , but also unexpected interrelationships between the immune response in the CNS and the pathogenesis of diseases such as Alzheimers disease and HIV encephalopathy. Autoimmune mediated models of inflammatory demyelinating CNS disease have proved particularly valuable in this respect as they allow the effects of defined immune effector mechanisms to be studied in the absence of CNS infection.
脱髓鞘是许多中枢神经系统(CNS)疾病的病理特征,包括多发性硬化症(MS)、亚急性硬化性全脑炎(SSPE)、异染性脑白质营养不良和佩利措伊斯-梅茨巴赫病。虽然脱髓鞘是所有这些疾病共有的病理终点,但导致这种病理的细胞和分子机制却大不相同。这些机制包括影响脑白质营养不良中脂质代谢的遗传缺陷、SSPE中病毒感染的细胞病变效应,到MS和病毒性脑病中免疫效应机制的作用。无论髓鞘降解的初始原因如何,这些疾病中的许多都与一定程度的中枢神经系统炎症有关,小胶质细胞的局部激活、巨噬细胞的募集或鞘内免疫球蛋白的合成均表明了这一点。现在,许多这些现象正在动物模型中重现,这不仅为人类脱髓鞘疾病的发病机制提供了新的见解,也揭示了中枢神经系统免疫反应与阿尔茨海默病和HIV脑病等疾病发病机制之间意想不到的相互关系。在这方面,炎症性脱髓鞘中枢神经系统疾病的自身免疫介导模型已被证明特别有价值,因为它们允许在没有中枢神经系统感染的情况下研究特定免疫效应机制的作用。