title: Mechanisms of the adaptive immune response inside the central nervous system during inflammatory and autoimmune diseases.
abstract: In this review we will discuss the unique features that make the central nervous system (CNS) a specialized microenvironment where immune responses are tightly regulated in order to properly face pathogens without damaging the neural cells. We will show how every paradigm of this theoretical model has been addressed by the scientific literature over the past decades providing new insights on the immune response within the CNS. In particular, new light has been shed on the trafficking of the immune cells inside and outside the CNS. Dendritic cells (DCs) have been described in the context of structures in direct contact with the cerebrospinal fluid (CSF) and their migration, upon antigen encounter, outside the CNS into deep cervical lymph nodes (DCLNs) has been further clarified. T-cells, B-cells, and antibody-secreting cells (ASCs) have been found in the CSF and CNS parenchymal lesions of inflammatory disorders and their phenotype depicted. Moreover, in chronically inflamed CNS, ectopic lymphoid structures have been observed and a germinal center reaction similar to the one found in peripheral lymph nodes has been described. These structures may play a role in the maintenance and expansion of the local autoimmune response. Although the complex interactions between immune and neural cells still remain far to be elucidated, the data discussed here suggest that the physiopathology of the adaptive immune response inside the CNS mimics, although in a mitigated fashion, what occurs in other organs and tissues.
authors.affiliation: Neuroimmunology Unit, Department of Neurosciences, Ophthalmology and Genetics, University of Genoa, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Pedemonte
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Mancardi
authors.forename: Debora
authors.initials: D
authors.lastname: Giunti
authors.forename: Anna
authors.initials: A
authors.lastname: Corcione
authors.forename: Federica
authors.initials: F
authors.lastname: Benvenuto
authors.forename: Vito
authors.initials: V
authors.lastname: Pistoia
authors.forename: Antonio
authors.initials: A
authors.lastname: Uccelli
mesh_terms: D000818:Animals; D001402:B-Lymphocytes / Q000276:immunology; D001812:Blood-Brain Barrier; D002465:Cell Movement; D002490:Central Nervous System / Q000276:immunology*; D004681:Encephalomyelitis, Autoimmune, Experimental / Q000276:immunology*; D006801:Humans; D007249:Inflammation / Q000276:immunology*; D009103:Multiple Sclerosis / Q000276:immunology*; D013601:T-Lymphocytes / Q000276:immunology