Vascular, glial, and lymphatic immune gateways of the central nervous system.
Vascular, glial, and lymphatic immune gateways of the central nervous system.
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DOI：
10.1007/s00401-016-1606-5
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发表时间：
2016-09
影响因子：
12.7
通讯作者：
Weller RO
中科院分区：
文献类型：
--
作者：
Engelhardt B;Carare RO;Bechmann I;Flügel A;Laman JD;Weller RO
中枢神经系统（CNS）的免疫赦免归因于血脑屏障的存在和CNS实质内淋巴管的缺乏。然而，免疫反应发生在中枢神经系统内，很明显中枢神经系统与免疫系统有着独特的关系。高分辨率成像技术的最新发展促使人们重新评估CNS和免疫系统之间的关系。这篇综述将考虑到这些发展，在描述我们目前的理解，对区域淋巴结的CNS液体引流途径的解剖连接和我们目前的概念，免疫细胞贩运到中枢神经系统在免疫监视和神经炎症。脑脊液（CSF）和间质液是从CNS流向局部淋巴结的两种主要成分。CSF通过淋巴管排出，似乎携带抗原呈递细胞。另一方面，来自CNS实质的间质液通过脑毛细血管和动脉壁内狭窄且受限的基底膜通路引流至淋巴结，所述通路不允许抗原呈递细胞的运输。靶向CNS的淋巴细胞通过两步过程进入，这两步过程需要受体介导的血管内皮交叉和酶介导的覆盖CNS的胶质界膜渗透。将讨论作为神经系统疾病（如多发性硬化症和阿尔茨海默病）的发起者或贡献者的进出CNS的通路的贡献。此外，我们提出了一个明确的命名法，允许提高精度时，描述的CNS特异性通信途径与免疫系统。
Immune privilege of the central nervous system (CNS) has been ascribed to the presence of a blood–brain barrier and the lack of lymphatic vessels within the CNS parenchyma. However, immune reactions occur within the CNS and it is clear that the CNS has a unique relationship with the immune system. Recent developments in high-resolution imaging techniques have prompted a reassessment of the relationships between the CNS and the immune system. This review will take these developments into account in describing our present understanding of the anatomical connections of the CNS fluid drainage pathways towards regional lymph nodes and our current concept of immune cell trafficking into the CNS during immunosurveillance and neuroinflammation. Cerebrospinal fluid (CSF) and interstitial fluid are the two major components that drain from the CNS to regional lymph nodes. CSF drains via lymphatic vessels and appears to carry antigen-presenting cells. Interstitial fluid from the CNS parenchyma, on the other hand, drains to lymph nodes via narrow and restricted basement membrane pathways within the walls of cerebral capillaries and arteries that do not allow traffic of antigen-presenting cells. Lymphocytes targeting the CNS enter by a two-step process entailing receptor-mediated crossing of vascular endothelium and enzyme-mediated penetration of the glia limitans that covers the CNS. The contribution of the pathways into and out of the CNS as initiators or contributors to neurological disorders, such as multiple sclerosis and Alzheimer’s disease, will be discussed. Furthermore, we propose a clear nomenclature allowing improved precision when describing the CNS-specific communication pathways with the immune system.