Immune Transformations for Therapeutic Gain in Neurodegenerative Disease

Neurodegenerative diseases are a significant cause of morbidity and mortality worldwide, for which effective interventional therapies are limited. Past consideration of the central nervous system (CNS) as a site of immune privilege imparted a major impediment to the interpretation of neurodegenerative pathophysiology in the context of immune processes. Current realizations are that the resident CNS immune system and those elements from the periphery that infiltrate the brain are the main drivers of inflammation, protein misfolding and aggregation, and neuronal injury and death, all of which perpetuate the degenerative cycle. Indeed, immune responses such as microglia activation and leukocytic extravasation into the CNS provide sources of pro-inflammatory and neurotoxic mediators. Thus, the biomarkers and checkpoints that define the immune processes provide candidate targets for therapeutic strategies for immune transformations that provide beneficial outcomes in neurodegenerative disease and are the topic of this chapter.