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      CNS Infiltration of Peripheral Immune Cells: D-Day for Neurodegenerative Disease?

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          Abstract

          While the central nervous system (CNS) was once thought to be excluded from surveillance by immune cells, a concept known as “immune privilege,” it is now clear that immune responses do occur in the CNS—giving rise to the field of neuroimmunology. These CNS immune responses can be driven by endogenous (glial) and/or exogenous (peripheral leukocyte) sources and can serve either productive or pathological roles. Recent evidence from mouse models supports the notion that infiltration of peripheral monocytes/macrophages limits progression of Alzheimer's disease pathology and militates against West Nile virus encephalitis. In addition, infiltrating T lymphocytes may help spare neuronal loss in models of amyotrophic lateral sclerosis. On the other hand, CNS leukocyte penetration drives experimental autoimmune encephalomyelitis (a mouse model for the human demyelinating disease multiple sclerosis) and may also be pathological in both Parkinson's disease and human immunodeficiency virus encephalitis. A critical understanding of the cellular and molecular mechanisms responsible for trafficking of immune cells from the periphery into the diseased CNS will be key to target these cells for therapeutic intervention in neurodegenerative diseases, thereby allowing neuroregenerative processes to ensue.

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          Most cited references100

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          Interleukin-23 rather than interleukin-12 is the critical cytokine for autoimmune inflammation of the brain.

          Interleukin-12 (IL-12) is a heterodimeric molecule composed of p35 and p40 subunits. Analyses in vitro have defined IL-12 as an important factor for the differentiation of naive T cells into T-helper type 1 CD4+ lymphocytes secreting interferon-gamma (refs 1, 2). Similarly, numerous studies have concluded that IL-12 is essential for T-cell-dependent immune and inflammatory responses in vivo, primarily through the use of IL-12 p40 gene-targeted mice and neutralizing antibodies against p40. The cytokine IL-23, which comprises the p40 subunit of IL-12 but a different p19 subunit, is produced predominantly by macrophages and dendritic cells, and shows activity on memory T cells. Evidence from studies of IL-23 receptor expression and IL-23 overexpression in transgenic mice suggest, however, that IL-23 may also affect macrophage function directly. Here we show, by using gene-targeted mice lacking only IL-23 and cytokine replacement studies, that the perceived central role for IL-12 in autoimmune inflammation, specifically in the brain, has been misinterpreted and that IL-23, and not IL-12, is the critical factor in this response. In addition, we show that IL-23, unlike IL-12, acts more broadly as an end-stage effector cytokine through direct actions on macrophages.
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            Inflammation and Alzheimer's disease.

            Inflammation clearly occurs in pathologically vulnerable regions of the Alzheimer's disease (AD) brain, and it does so with the full complexity of local peripheral inflammatory responses. In the periphery, degenerating tissue and the deposition of highly insoluble abnormal materials are classical stimulants of inflammation. Likewise, in the AD brain damaged neurons and neurites and highly insoluble amyloid beta peptide deposits and neurofibrillary tangles provide obvious stimuli for inflammation. Because these stimuli are discrete, microlocalized, and present from early preclinical to terminal stages of AD, local upregulation of complement, cytokines, acute phase reactants, and other inflammatory mediators is also discrete, microlocalized, and chronic. Cumulated over many years, direct and bystander damage from AD inflammatory mechanisms is likely to significantly exacerbate the very pathogenic processes that gave rise to it. Thus, animal models and clinical studies, although still in their infancy, strongly suggest that AD inflammation significantly contributes to AD pathogenesis. By better understanding AD inflammatory and immunoregulatory processes, it should be possible to develop anti-inflammatory approaches that may not cure AD but will likely help slow the progression or delay the onset of this devastating disorder.
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              Local self-renewal can sustain CNS microglia maintenance and function throughout adult life.

              Microgliosis is a common response to multiple types of damage in the CNS. However, the origin of the cells involved in this process is still controversial and the relative importance of local expansion versus recruitment of microglia progenitors from the bloodstream is unclear. Here, we investigated the origin of microglia using chimeric animals obtained by parabiosis. We found no evidence of microglia progenitor recruitment from the circulation in denervation or CNS neurodegenerative disease, suggesting that maintenance and local expansion of microglia are solely dependent on the self-renewal of CNS resident cells in these models.
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                Author and article information

                Contributors
                +1-310-4231202 , terrence.town@cshs.org
                Journal
                J Neuroimmune Pharmacol
                Journal of Neuroimmune Pharmacology
                Springer US (Boston )
                1557-1890
                1557-1904
                11 August 2009
                December 2009
                : 4
                : 4
                : 462-475
                Affiliations
                [1 ]Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048 USA
                [2 ]Department of Neurosurgery, Maxine Dunitz Neurosurgical Institute, Los Angeles, CA 90048 USA
                [3 ]Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90048 USA
                [4 ]Department of Neurosurgery, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Davis building, Room 2091, Los Angeles, CA 90048 USA
                Article
                9166
                10.1007/s11481-009-9166-2
                2773117
                19669892
                a74e16b2-8aed-4b7d-879c-272b9300f048
                © The Author(s) 2009
                History
                : 28 April 2009
                : 22 July 2009
                Categories
                Invited Review
                Custom metadata
                © Springer Science+Business Media, LLC 2009

                Pharmacology & Pharmaceutical medicine
                regulatory t cell,multiple sclerosis,chemokine,interleukin-17,neuroinflammation,monocyte,parkinson's disease,lymphocyte,amyotrophic lateral sclerosis,human immunodeficiency virus,west nile encephalitis,leukocyte,brain,macrophage,central nervous system,experimental autoimmune encephalomyelitis,tumor necrosis factor,alzheimer's disease,neuroimmunology,transforming growth factor,cytokine,interleukin-23

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