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Neuroinflammation, characterized by the activation of immune responses within the central nervous system (CNS), plays a pivotal role in the pathogenesis of numerous neurological disorders. This immune activation can be both protective and harmful, depending on its extent and context. While acute neuroinflammation is essential for clearing infections and repairing injury, chronic inflammation contributes to neurodegeneration, impairing neuronal function and accelerating disease progression in CNS disorders like Alzheimer's disease, multiple sclerosis, and Parkinson's disease. Understanding the mechanisms behind neuroinflammation is essential for developing therapeutic strategies aimed at mitigating its damaging effects [1].

Mechanisms of neuroinflammation

Neuroinflammation typically begins with the activation of glial cells, primarily microglia and astrocytes, which are the resident immune cells of the CNS. In response to injury or infection, microglia shift from a resting to an activated state, releasing pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6). Astrocytes, which maintain neuronal homeostasis, also become reactive, producing inflammatory molecules and contributing to the recruitment of peripheral immune cells into the brain.

The blood-brain barrier (BBB), a key protective structure, often becomes compromised during neuroinflammation. This disruption allows circulating immune cells and proteins to infiltrate the CNS, exacerbating the inflammatory response. Over time, prolonged neuroinflammation leads to neuronal damage, synaptic dysfunction, and ultimately neuronal death [2].

Neuroinflammation in CNS disorders

1. Alzheimer’s disease

Neuroinflammation is a central feature of Alzheimer’s disease (AD). The accumulation of amyloid-beta plaques and tau tangles triggers microglial activation and the release of pro-inflammatory cytokines. Persistent inflammation accelerates neurodegeneration, contributing to cognitive decline.

2. Multiple sclerosis

In multiple sclerosis (MS), neuroinflammation drives the autoimmune attack on myelin, the protective covering around neurons. Activated T-cells and B-cells infiltrate the CNS, targeting myelin sheaths and causing progressive demyelination, axonal damage, and neurological deficits.

3. Parkinson’s disease

Chronic neuroinflammation is implicated in the degeneration of dopaminergic neurons in Parkinson’s disease (PD). Microglial activation and elevated levels of inflammatory mediators have been observed in affected brain regions, further contributing to neuronal death and motor symptoms.

Therapeutic approaches

Targeting neuroinflammation is emerging as a promising therapeutic strategy for many CNS disorders. Anti-inflammatory treatments, such as nonsteroidal anti-inflammatory drugs (NSAIDs) have shown potential in modulating inflammatory pathways, though their long-term benefits remain uncertain. More recently, novel therapies aimed at inhibiting specific cytokines (e.g., anti-TNF therapies) and regulating microglial activation are under investigation [3-7]. Moreover, approaches aimed at restoring BBB integrity and reducing peripheral immune cell infiltration hold promise in limiting the destructive consequences of chronic neuroinflammation.

Conclusion

Neuroinflammation is a critical factor in the progression of various CNS disorders, serving both protective and harmful roles. While its regulation is necessary for maintaining CNS health, excessive or chronic inflammation can drive neurodegeneration. Continued research into the mechanisms of neuroinflammation and the development of targeted therapies holds great potential for treating CNS disorders, improving patient outcomes, and slowing disease progression. Neuroinflammation is increasingly recognized as a key factor in the pathogenesis of various CNS disorders. While it serves an essential role in defending the brain against injury and infection, prolonged or dysregulated neuroinflammation contributes to neuronal damage and accelerates neurodegenerative processes. Effective therapeutic strategies must strike a balance between controlling inflammation and preserving the beneficial aspects of the immune response. Continued research into the molecular pathways governing neuroinflammation and the development of targeted therapies holds promise for mitigating its detrimental effects, improving patient outcomes, and slowing disease progression in neurodegenerative and autoimmune CNS disorders.

References

1. Davis A, Meintjes G, Wilkinson RJ (2018). Curr Treat Opti Neurol 20: 5.

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2. Mezochow A, Thakur K, Vinnard C (2017). Curr Neurol Neurosci Rep 17:85.

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3. Heemskerk AD, Bang ND, Mai NTH, Chau TTH, Phu NH, et al. (2016). N Engl J Med 374:124-134.

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4. Van Laarhoven A, Dian S, Ruesen C, Hayati E, Damen MSMA, et al. (2017). J Infect Dis 215:1029-1039.

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5. Gunarsa RG, Simadibrata M, Syam AF, Timan IS, Setiati S, et al. (2015). Indones J Gastro Hepatol Dig Endosc 12:89-94.

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6. Rocha NP, Fortes RC (2015). Arq Bras Cir Dig 28:193-196.

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7. Feleke BE, Feleke TE, Biadglegne F (2019). BMC Pulm Med 19:1-9.

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