中国神经再生研究(英文版) ›› 2025, Vol. 20 ›› Issue (3): 779-793.doi: 10.4103/NRR.NRR-D-23-01508

• 综述:退行性病与再生 • 上一篇    下一篇

单核细胞浸润在中枢神经系统及在多发性硬化中的作用:治疗策略思考

  

  • 出版日期:2025-03-15 发布日期:2024-06-26

Infiltration by monocytes of the central nervous system and its role in multiple sclerosis: reflections on therapeutic strategies

Guangyong Zhang1, 2, Qing Yao1, 2, Chubing Long1, 2, Pengcheng Yi1, 2, Jiali Song1, 2, Luojia Wu1, 2, Wei Wan1, 2, Xiuqin Rao1, 2, Yue Lin1, 2, Gen Wei1, 2, Jun Ying1, 2, Fuzhou Hua1, *   

  1. 1Department of Anesthesiology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China; 2Key Laboratory of Anesthesiology of Jiangxi Province, Nanchang, Jiangxi Province, China
  • Online:2025-03-15 Published:2024-06-26
  • Contact: Fuzhou Hua, MD, huafuzhou@126.com.
  • Supported by:
    This work was supported by the National Natural Science Foundation of China, Nos. 82060219, 82271234; the Natural Science Foundation of Jiangxi Province, Nos. 20212ACB216009, 20212BAB216048; Jiangxi Province Thousands of Plans, No. jxsq2019201023; Youth Team Project of the Second Affiliated Hospital of Nanchang University, No. 2019YNTD12003 (all to FH).

摘要:

中枢神经系统中的单核巨噬细胞浸润是神经炎症的一个显著特征。最近对多发性硬化发病机制和进展的深入研究凸显了单核巨噬细胞在神经炎症过程中的多重作用。单核细胞在神经炎症中发挥着重要作用,通过外周单核细胞控制神经炎症是治疗多发性硬化的有效策略,可改善患者的预后。此综述概述了骨髓单核细胞进入中枢神经系统以进行有效干预的几个步骤:激活骨髓造血、单核细胞在血液中迁移以及单核细胞穿透血脑屏障。最后,还根据表型差异总结了不同的单核细胞亚群及其对中枢神经系统的影响。由于活化的小胶质细胞与单核细胞衍生的巨噬细胞相似,因此准确识别单核细胞衍生的巨噬细胞在疾病中的作用非常重要。根据单核细胞源性巨噬细胞在疾病不同阶段所扮演的角色,可以对其中几个过程进行干预,以限制神经炎症并改善患者预后。在此,将讨论针对神经系统疾病中单核细胞的治疗策略,重点关注单核细胞浸润中枢神经系统的三个关键方面,这可能会为神经退行性疾病的治疗提供新思路。

https://orcid.org/0000-0002-6718-6490 (Fuzhou Hua)

Abstract: Mononuclear macrophage infiltration in the central nervous system is a prominent feature of neuroinflammation. Recent studies on the pathogenesis and progression of multiple sclerosis have highlighted the multiple roles of mononuclear macrophages in the neuroinflammatory process. Monocytes play a significant role in neuroinflammation, and managing neuroinflammation by manipulating peripheral monocytes stands out as an effective strategy for the treatment of multiple sclerosis, leading to improved patient outcomes. This review outlines the steps involved in the entry of myeloid monocytes into the central nervous system that are targets for effective intervention: the activation of bone marrow hematopoiesis, migration of monocytes in the blood, and penetration of the blood–brain barrier by monocytes. Finally, we summarize the different monocyte subpopulations and their effects on the central nervous system based on phenotypic differences. As activated microglia resemble monocyte-derived macrophages, it is important to accurately identify the role of monocyte-derived macrophages in disease. Depending on the roles played by monocyte-derived macrophages at different stages of the disease, several of these processes can be interrupted to limit neuroinflammation and improve patient prognosis. Here, we discuss possible strategies to target monocytes in neurological diseases, focusing on three key aspects of monocyte infiltration into the central nervous system, to provide new ideas for the treatment of neurodegenerative diseases.

Key words: blood–brain barrier, macrophages, monocytes, multiple sclerosis, neuroinflammation, review, therapy