title: Get It through Your Thick Head: Emerging Principles in Neuroimmunology and Neurovirology Redefine Central Nervous System "Immune Privilege".
abstract: The central nervous system (CNS) coordinates all aspects of life, autonomic and sentient, though how it has evolved to contend with pathogenic infections remains, to a great degree, a mystery. The skull and cerebrospinal fluid (CSF) provide protection from blunt force contacts, and it was once thought that the blood-brain barrier (BBB) was a fortress that restricted pathogen entry and limited inflammation. Recent studies, however, have caused a revision of this viewpoint: the CNS is monitored by blood-borne lymphocytes, but can use alternative strategies to prevent or resolve many pathogenic challenges. In this Review, we discuss emerging principles that indicate how the CNS is immunologically unique from peripheral tissues. We focus on developments that include glymphatics, recently characterized brain lymphatic vessels, distinctions in innate and adaptive immune strategies, novel points of entry for neurotropic viruses, and, finally, how the periphery can influence CNS homeostasis and immune responses within the brain. Collectively, these attributes demand a re-evaluation of immunity in the brain: not privileged, but distinct.
authors: Fox Chase Cancer Center , 333 Cottman Avenue, Philadelphia, Pennsylvania 19111, United States.|Department of Microbiology and Immunology, Drexel University College of Medicine , 2900 W Queen Ln, Philadelphia, Pennsylvania 19129, United States.
authors: Andreas C
authors: AC
authors: Solomos
authors: Fox Chase Cancer Center , 333 Cottman Avenue, Philadelphia, Pennsylvania 19111, United States.
authors: Glenn F
authors: GF
authors: Rall
mesh_terms: D000818:Animals; D001812:Blood-Brain Barrier / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology; D001921:Brain / Q000276:immunology / Q000473:pathology / Q000821:virology; D020805:Central Nervous System Viral Diseases / Q000276:immunology / Q000473:pathology; D006801:Humans; D007249:Inflammation; D008208:Lymphatic System / Q000276:immunology / Q000378:metabolism / Q000821:virology; D015213:Neuroimmunomodulation / Q000502:physiology*; D009474:Neurons / Q000145:classification / Q000276:immunology / Q000821:virology
keywords: Immune privilege; interferons; polymicrobial infections; virus