[神经系统疾病的免疫学基础]。

IF 0.9 4区 医学 Q4 CLINICAL NEUROLOGY Nervenarzt Pub Date : 2024-10-01 Epub Date: 2024-07-02 DOI:10.1007/s00115-024-01696-4
Hansjörg Schild, Tobias Bopp
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引用次数: 0

摘要

背景:神经退行性疾病是老龄化社会面临的一个日益严峻的挑战,因为目前可供选择的治疗方法非常有限:新的研究方法和不同学科间的互动改变了人们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。从神经系统自身免疫性疾病(如多发性硬化症)开始,近年来有关免疫过程参与其他情况(如中风或脑外伤)的知识得到了显著扩展: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:免疫系统在抗感染方面发挥着核心作用,但在无菌条件下也能对人体自身的信号做出反应,并通过释放免疫介质以及招募和分化某些免疫细胞类型来引起炎症和随后的适应性免疫反应。这对启动愈合过程是有益的;但慢性炎症通常会对组织和机体造成破坏性后果,必须加以阻断:现在人们已经知道,免疫系统的不同细胞在神经系统疾病中扮演着重要角色。由调节性 T 细胞或 Th2 细胞介导的调节机制通常预后良好,而炎症过程和 Th1 或 Th17 极化则具有破坏性。新型免疫调节剂也越来越多地用于癌症治疗,现在可以以组织特异性的方式使用,因此在神经系统疾病方面具有巨大的应用潜力。
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[Immunological foundations of neurological diseases].

Background: Neurodegenerative diseases represent an increasing challenge in ageing societies, as only limited treatment options are currently available.

Objective: 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.

Material and methods: This review article provides an overview of the role of the immune system and the resulting potential for novel treatment approaches.

Results: 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.

Conclusion: 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.

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来源期刊
Nervenarzt
Nervenarzt 医学-精神病学
CiteScore
2.50
自引率
18.20%
发文量
169
审稿时长
4-8 weeks
期刊介绍: Der Nervenarzt is an internationally recognized journal addressing neurologists and psychiatrists working in clinical or practical environments. Essential findings and current information from neurology, psychiatry as well as neuropathology, neurosurgery up to psychotherapy are presented. Review articles provide an overview on selected topics and offer the reader a summary of current findings from all fields of neurology and psychiatry. Freely submitted original papers allow the presentation of important clinical studies and serve the scientific exchange. Review articles under the rubric ''Continuing Medical Education'' present verified results of scientific research and their integration into daily practice.
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