Scholarlink

This chapter focuses on the relevance of the blood–cerebrospinal fluid barrier (BCSFB) in multiple sclerosis (MS). MS is a chronic autoimmune disease and causes inflammation, demyelination, and neurodegeneration in the central nervous system (CNS). Although the disease is believed to be co-triggered by genetic and environmental factors, the definite cause of MS is currently not fully understood. Much more is known about the immunopathogenesis of MS, where immune cells—presumably preactivated in the periphery—manage to migrate into the CNS and initiate an inflammatory response that ultimately leads to neural damage in the brain and spinal cord. Key players in this process are autoreactive B and T lymphocytes with specificity for components of neural antigens. The continuous damage to neurites, mediated directly and indirectly by myelin-specific B and T cells, leads, when unchecked, to a multifocal mass destruction of nerve cells. Clinically, MS causes a multitude of symptoms, such as visual disturbances, gait instability, motor, sensory, cognitive dysfunctions, and fatigue. Alongside the blood–brain barrier, the BCSFB forms a portal of entry for autoreactive B and T cells into the CNS. The fact that the CSF space, which is separated by the BCSFB from the blood, plays an important role in MS becomes clear when looking at the importance of CSF examination for diagnostic and monitoring of this disease. This is partly due to the fact that the separation of CSF and peripheral blood by the BCSFB is not absolute. Rather, under certain conditions, immune cells increasingly succeed in overcoming this barrier to migrate from the circulation into the intrathecal compartment. What these preconditions are, which immune cells migrate across the BCSFB of MS patients, and which processes take place will be described below. Prior to this, MS will be described in some detail—with emphasis on the immunopathogenesis. An overview of CSF diagnostics will complement this description, and finally the role of lymphocyte trafficking and the BCSFB in the treatment of MS will be highlighted.

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Multiple Sclerosis and the Blood–Cerebrospinal Fluid Barrier

  • 章节

  • 发表日期：

    2025年

查看全文
  • Brigitte Wildemann,
  • Jürgen Haas

摘要

This chapter focuses on the relevance of the blood–cerebrospinal fluid barrier (BCSFB) in multiple sclerosis (MS). MS is a chronic autoimmune disease and causes inflammation, demyelination, and neurodegeneration in the central nervous system (CNS). Although the disease is believed to be co-triggered by genetic and environmental factors, the definite cause of MS is currently not fully understood. Much more is known about the immunopathogenesis of MS, where immune cells—presumably preactivated in the periphery—manage to migrate into the CNS and initiate an inflammatory response that ultimately leads to neural damage in the brain and spinal cord. Key players in this process are autoreactive B and T lymphocytes with specificity for components of neural antigens. The continuous damage to neurites, mediated directly and indirectly by myelin-specific B and T cells, leads, when unchecked, to a multifocal mass destruction of nerve cells. Clinically, MS causes a multitude of symptoms, such as visual disturbances, gait instability, motor, sensory, cognitive dysfunctions, and fatigue. Alongside the blood–brain barrier, the BCSFB forms a portal of entry for autoreactive B and T cells into the CNS. The fact that the CSF space, which is separated by the BCSFB from the blood, plays an important role in MS becomes clear when looking at the importance of CSF examination for diagnostic and monitoring of this disease. This is partly due to the fact that the separation of CSF and peripheral blood by the BCSFB is not absolute. Rather, under certain conditions, immune cells increasingly succeed in overcoming this barrier to migrate from the circulation into the intrathecal compartment. What these preconditions are, which immune cells migrate across the BCSFB of MS patients, and which processes take place will be described below. Prior to this, MS will be described in some detail—with emphasis on the immunopathogenesis. An overview of CSF diagnostics will complement this description, and finally the role of lymphocyte trafficking and the BCSFB in the treatment of MS will be highlighted.