Chapter 3 - Central Nervous System Immune Inflammation

Abstract

Although regarded as a site of relative immune privilege, the recurrent and varying course of multiple sclerosis (MS) highlights the dynamic nature of the mechanisms that regulate the development and effects of inflammatory responses within the central nervous system (CNS). Immune regulatory processes to be considered in the context of MS include (1) trafficking of cells, macromolecules, and/or antigens to and from the CNS via the choroid plexus/cerebrospinal fluid/draining vein and blood–brain barrier pathways and (2) participation of cells within the CNS parenchyma in mediating immune regulatory and effector functions. Such cells include the endogenous glial cells, astrocytes, and microglia, and infiltrating innate immune cells. Although both the trafficking and intraparenchymal processes provide targets for therapeutic interventions, such opportunities are to be viewed in context of risks for enhancing susceptibility to infection and modulating potential tissue protection and repair processes.