title: Neuroinflammation in the peripheral nerve: Cause, modulator, or bystander in peripheral neuropathies?
abstract: The role of innate and adaptive inflammation as a primary driver or modifier of neuropathy in premorbidly normal nerves, and as a critical player in amplifying neuropathies of other known causes (e.g., genetic, metabolic) is incompletely understood and under-researched, despite unmet clinical need. Also, cellular and humoral components of the adaptive and innate immune system are substantial disease modifying agents in the context of neuropathies and, at least in some neuropathies, there is an identified tight interrelationship between both compartments of the immune system. Additionally, the quadruple relationship between Schwann cell, axon, macrophage, and endoneurial fibroblast, with their diverse membrane bound and soluble signalling systems, forms a distinct focus for investigation in nerve diseases with inflammation secondary to Schwann cell mutations and possibly others. Identification of key immunological effector pathways that amplify neuropathic features and associated clinical symptomatology including pain should lead to realistic and timely possibilities for translatable therapeutic interventions using existing immunomodulators, alongside the development of novel therapeutic targets.
authors.affiliation: Department of Neurology, Developmental Neurobiology, University Hospital Würzburg, Würzburg, D-97080, Germany.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Martini
authors.affiliation: Institute of Infection, Immunity and Inflammation College of Medical Veterinary and Life Sciences, Glasgow Biomedical Research Centre, University of Glasgow, Glasgow, G12 8TA.
authors.forename: Hugh
authors.initials: H
authors.lastname: Willison
mesh_terms: D000818:Animals; D006801:Humans; D015213:Neuroimmunomodulation / Q000502:physiology; D010525:Peripheral Nerves / Q000276:immunology*; D010523:Peripheral Nervous System Diseases / Q000276:immunology*
keywords: adaptive immune system; fibroblast; innate immune system; lymphocytes; macrophage; nodes of Ranvier