RT Book, Section A1 Nestler, Eric J. A1 Kenny, Paul J. A1 Russo, Scott J. A1 Schaefer, Anne SR Print(0) ID 1174974294 T1 Neuroinflammation T2 Nestler, Hyman & Malenka’s Molecular Neuropharmacology: A Foundation for Clinical Neuroscience, 4e YR 2020 FD 2020 PB McGraw-Hill PP New York, NY SN 9781260456905 LK neurology.mhmedical.com/content.aspx?aid=1174974294 RD 2024/03/28 AB KEY CONCEPTSImmune mechanisms, both intrinsic to the brain and spinal cord as well as extrinsically derived from the peripheral immune system, are important in fighting central nervous system infections and mediating repair after injury.There are two main components of the immune system. The innate immune system and the adaptive immune system.The innate immune system is older from an evolutionary perspective and represents the first line of defense. It recognizes and responds to conserved patterns associated with certain pathogens and tissue injury.The adaptive immune system mounts a targeted immune response against specific antigens and includes two components, humoral immunity (mediated by antibody production by B lymphocytes) and cell–based immunity (mediated by T lymphocytes).Such immune responses can damage the nervous system through numerous mechanisms and contribute to a range of disorders through processes referred to as neuroinflammation.Autoimmune diseases are a prominent example of mistargeted immune responses that are directed against “self antigens.” These diseases involve the production of “autoantibodies” by B cells and the actions of T cells against self antigens.Many systemic autoimmune disorders can affect the nervous system. Additionally, several autoimmune disorders, such as multiple sclerosis (MS) and myasthenia gravis, selectively target the nervous system.MS occurs primarily via cell–mediated destruction of myelin sheaths and consequent damage to underlying axons.Myasthenia gravis and the related Lambert–Eaton syndrome occur primarily via antibody–mediated destruction of the neuromuscular junction.Management of autoimmune disorders involves both acute treatments to suppress an active immune response and chronic therapies to prevent disease relapse and progression.Acute treatments include corticosteroids, plasma exchange, and in some cases intravenous immunoglobulin, which broadly and nonspecifically dampen the activity of immune cells and circulating proinflammatory factors.Chronic maintenance therapies either modulate specific components of the immune system or suppress the immune system more generally.Additionally, myasthenia gravis is treated with agents that promote the function of acetylcholine, the neurotransmitter at the neuromuscular junction.