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The immune system and the nervous system

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Summary

The immune system may interfere with brain function. The central nervous system may also influence the activity of the immune system. The central nervous system is functionally protected by the blood-brain barrier. The endothelial cells of the brain capillaries are linked by tight junctions, resulting in an almost continuous interior wall which restricts the transfer of plasma proteins. The barrier function is modified by inflammatory meningeal lesions, stroke and epileptic seizures. Antigenic material may penetrate the barrier and enter the nerve tissue. The phagocytic cells in the central nervous system are mainly of haematogenous origin. The number of such cells in the brain is very low. There are also few lymphocytes under normal circumstances. These cells circulate from the blood, through the vessel walls and into the perivascular spaces, along the perivascular channels and to the CSF and back to the blood. This circulation may increase enormously during inflammatory conditions. In multiple sclerosis, the number of T-lymphocytes in the CSF is increased, corresponding to a preponderance of T-lymphocytes in the perivascular cell infiltrates in and around the lesions. Thus, the individual elements of the immune system are all present in the brain, which is only partially immunologically privileged. The mechanisms underlying the brain's immunological privilege may be of a non-immunological nature. As yet there are only few data which indicate that auto-immunity is a prominent feature in diseases of the human brain. The central nervous system also exerts a modulating influence upon the immune response. This may take place both by secretion of hormones and by a nervous/neurotransmitter influence upon the immune system.

Zusammenfassung

Das immune System beeinflußt die Hirnfunktion, und umgekehrt kann die Funktion des zentralen Nervensystems einen Einfluß auf die Aktivität des Immunsystems ausüben.

Die Funktion des zentralen Nervensystems ist durch das Bestehen einer Blut-Hirnschranke geschützt. Das Endothel der Hirnkapillaren ist — bis auf wenige Ausnahmen — überall kontinuierlich und erlaubt nicht den Übertritt von Plasmaproteinen. Diese Barrierenfunktion wird durch entzündliche meningeale Läsionen, durch einen Schlaganfall oder epileptische Anfälle modifiziert.

Antigene können die Barriere durchbrechen und in das Nervengewebe eindringen. Phagozyten im zentralen Nervensystem sind vorwiegend haematogenen Ursprungs. Im Gehirn ist deren Anzahl allerdings sehr niedrig. Auch unter normalen Bedingungen finden sich wenig Lymphozyten. Diese Zellen dringen aus dem Blut durch die Gefäßwände in die perivaskulären Räume, diesen entlang in den Liquor und zurück in das Blut. Diese Zirkulation kann im Rahmen entzündlicher Erkrankungen enorm zunehmen. Bei der Multiplen Sklerose ist die Anzahl der T-Lymphozyten im Liquor vermehrt und entsprechend findet sich ein Überwiegen von T-Lymphozyten in den perivaskulären Zellinfiltraten in und um die Läsion. Somit sind die individuellen Elemente des Immunsystems alle im Gehirn vorhanden, welches somit nur teilweise immunologisch privilegiert ist. Die Mechanismen, die der immunologischen Privilegierung des Gehirnes zugrunde liegen, können nicht-immunologischen Ursprungs sein. Vorerst liegen nur wenige Hinweise dafür vor, daß Autoimmunität eine wichtige Besonderheit bei Hirnerkrankungen des Menschen darstellen könnte.

Das zentrale Nervensystem übt einen modulierenden Einfluß auf die Immunantworten aus. Dies kann auf dem Wege über eine Hormonausschüttung stattfinden oder aber durch eine Beeinflussung des Immunsystems auf dem Wege über einen direkten nervösen Mechanismus oder durch die Vermittlung via Neurotransmitter.

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  1. Department of Neurology, University Hospital of Bergen, Haukeland sykehus, N-5016, Bergen, Norway

    Johan A. Aarli

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Aarli, J.A. The immune system and the nervous system. J Neurol 229, 137–154 (1983). https://doi.org/10.1007/BF00313738

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