The role of immune cells, glia and neurons in white and gray matter pathology in multiple sclerosis.
The role of immune cells, glia and neurons in white and gray matter pathology in multiple sclerosis.
复制标题
免疫细胞，神经胶质和神经元在多发性硬化症中的作用。
DOI：
10.1016/j.pneurobio.2015.02.003
复制
发表时间：
2015-04
影响因子：
6.7
通讯作者：
Pluchino S
中科院分区：
文献类型：
--
作者：
Mallucci G;Peruzzotti-Jametti L;Bernstock JD;Pluchino S
多发性硬化症是慢性神经功能障碍最常见的原因之一，始于成年早期到中期。多发性硬化症本质上是特发性的，但越来越多的相关证据支持一个人的遗传易感性、环境和免疫系统之间存在强烈的关联。多发性硬化症的症状主要是由于中枢神经系统白质内有髓神经束的完整性受到破坏所致。然而，最近的研究也强调了迄今为止灰质在多发性硬化症病理生理学中的参与被低估，当考虑到不可逆转的损害和进行性残疾的积累时，这可能是特别相关的。本综述旨在通过对白质和灰质病变的分析，全面综述炎症、神经胶质细胞损伤和再生在多发性硬化症发病过程中的相互作用。此外，我们描述了多发性硬化症复发和进展性形式背后的常见病理机制，并分析了当前(以及未来)治疗方法可能如何相互作用和/或干扰其病理。了解推动疾病发病机制的可能机制将是帮助开发有效的治疗策略来预防、缓解和治疗与多发性硬化症相关的各种疾病的关键。
Multiple sclerosis is one of the most common causes of chronic neurological disability beginning in early to middle adult life. Multiple sclerosis is idiopathic in nature, yet increasing correlative evidence supports a strong association between one’s genetic predisposition, the environment and the immune system. Symptoms of multiple sclerosis have primarily been shown to result from a disruption in the integrity of myelinated tracts within the white matter of the central nervous system. However, recent research has also highlighted the hitherto underappreciated involvement of gray matter in multiple sclerosis disease pathophysiology, which may be especially relevant when considering the accumulation of irreversible damage and progressive disability. This review aims at providing a comprehensive overview of the interplay between inflammation, glial/neuronal damage and regeneration throughout the course of multiple sclerosis via the analysis of both white and gray matter lesional pathology. Further, we describe the common pathological mechanisms underlying both relapsing and progressive forms of multiple sclerosis, and analyze how current (as well as future) treatments may interact and/or interfere with its pathology. Understanding the putative mechanisms that drive disease pathogenesis will be key in helping to develop effective therapeutic strategies to prevent, mitigate, and treat the diverse morbidities associated with multiple sclerosis.