Neuroimmunology is a new discipline that treats patients with inflammatory diseases of the central nervous system. Neuroimmunology plays a major role in the treatment of multiple sclerosis (MS) or brain tumors.
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The immune system is the best weapon for fighting germs and cancer cells. However, tumor cells and pathogenic cells are very inventive when it comes to evading the body's immune defenses.
By merging the two specialist areas of general neurology and neuro-oncology, patient care can be significantly improved overall.
Objectives of neuroimmunological research:
Neuroimmunology is part of clinical neurology and is developing extremely dynamically. Specialists in neuroimmunology are neurologists. In neurological centers such as headache centers, multiple sclerosis centers, epilepsy centers or stroke centers, they work closely with specialists from other disciplines.
Neuroimmunological therapy focuses on patients with dysregulated immune systems. These are autoimmune diseases. These include multiple sclerosis (MS), immune neuropathies and inflammatory myopathies.
Thanks to many years of research, doctors now have a much better understanding of how autoimmune diseases develop. There are many causes, including genetic ones.
The determination of autoantibodies is essential for the diagnosis of an autoimmune disease. This is because they are often detectable many years before the onset of the disease.
The decoding of immune reactions in the body has also led to new findings in cancer research.
Multiple sclerosis (encephalomyelitis disseminata) is a chronic inflammatory autoimmune disease of the central nervous system. The course of MS varies greatly from patient to patient, but it always progresses.
Normally, the immune system has the task of fighting off foreign substances such as viruses and bacteria. In an autoimmune disease, the immune system simply turns against its own body. In MS, the nerve fibers in the brain and spinal cord become inflamed.
As a result of the inflammation, messenger substances are no longer transmitted correctly. If several foci of inflammation occur in quick succession, this is referred to as an attack. The acute symptoms subside after a few hours or days. The inflamed tissue becomes scarred.
In addition to relapsing-remitting multiple sclerosis, there is also insidious MS. This is characterized by a gradual deterioration without relapses.
Multiple sclerosis is the most common chronic inflammatory disease in young adults. Patients show symptoms such as poor coordination, paralysis in the extremities as well as sensory and visual disturbances.
There are now many medications that have a positive effect on the course of the disease. However, the success of therapy depends on the type of disease. The insidious variant is difficult to treat.
Multiple sclerosis cannot yet be cured. Therapies help to slow down the progression of the disease @ freshidea /AdobeStock
In addition to magnetic resonance imaging, neurophysiological methods are also used for diagnosis.
For some years now, this has made it possible to detect the aquaporin-4 antibody and differentiate multiple sclerosis from the similar euromyelitis optica. A typical finding for MS in magnetic resonance imaging is RIS (radiologically isolated syndrome). It does not yet show any clinical symptoms, but can be detected during the examination.
Only the clinically isolated syndrome (CIS) shows the typical, active inflammatory foci. In therapy with interferons (immunomodulation), pharmacological substances (drugs) are able to influence the immune system. They influence the body's immune response in the same way as physical stimuli (heat and cold).
Doctors often administer immunomodulating substances in combination therapies. Patients must also undergo intensive physiotherapy. Many find it difficult to motivate themselves to do this, as they often feel weak and tired.
Multiple sclerosis: The immune system attacks nerve fibers in the brain and spinal cord @ designua /AdobeStock
To clarify the symptoms, doctors use electrophysiological, clinical-chemical and molecular-biological analysis methods.
Various immunotherapeutic agents and symptom-dependent treatment methods are used in therapy.
The aim is always neuroprotective therapy, which aims to protect nerve cells. This includes outpatient therapies such as deep brain stimulation, infusions and baclofen pumps. The baclofen pump is an implant that delivers medication into the spinal canal. This pump is implanted under general anesthesia.
Autoimmune diseases cannot be cured, but their course can be significantly milder. Treatment successes can be demonstrated, particularly thanks to the findings of neuroimmunology.
In multiple sclerosis, the immune system attacks the protective layer of the individual nerve fibers. The immune system is responsible for the relapses for which the doctor prescribes anti-inflammatory medication. Relapsing multiple sclerosis is the most common form of MS.
The rarer and more insidious form of MS is less treatable. Nevertheless, rapid treatment is important, as nerve cells die here. The better the individual care, the better the prognosis.
A new therapy method currently seems very promising: repairing the affected nerve fibers. In mouse experiments, experts have been able to show that the myelin layer grows back more quickly when mice are given the protein Lingo.
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