Neuroimmunology - Medical Experts

The immune system is the body’s best weapon for fighting germs and cancer cells. However, tumor cells and pathogenic cells are highly resourceful when it comes to evading the body’s immune defenses.

• Glioblastomas are among the most malignant brain tumors, as they are characterized by aggressive growth and therapy-resistant stem cells. Neuroimmunological researchers have discovered that glioblastomas can hide from the body’s own defense system. The immune system does not respond and is therefore unable to fight the tumor. Neuroimmunologists focus on this aspect in the treatment of brain tumors. They attempt to specifically activate the immune system.
• Neuroimmunology investigates the mechanisms underlying the behavior of cells in the central nervous system. It examines the influence of the CNS on the immune system and the interactions between the two systems.
• Another focus of neuroimmunology is research into multiple sclerosis.
• It also examines the immunology of brain tumors, which is closely related to neuropathology and neuroradiology.

By combining the two specialties of general neurology and neuro-oncology, patient care can be significantly improved overall.

Goals of neuroimmunological research:

• Improving the diagnosis of neuroimmunological diseases
• Improving treatment and establishing new approaches
• Identification of autoantibody markers

Neuroimmunology is a branch of clinical neurology and is evolving at a rapid pace. 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 fields.

Neuroimmunological therapy focuses on patients with dysregulated immune systems. These are autoimmune conditions, including multiple sclerosis (MS), immunoneuropathies, 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.

• It is known that a family history plays an important role in Crohn’s disease, rheumatism, and multiple sclerosis.
• Diet, lifestyle, and environmental factors also influence the onset of an autoimmune disease.
• Chemical substances can also disrupt the immune system.
• The disease often breaks out during stressful or eventful periods of life. At such times, the body’s own immune system produces autoantibodies that target healthy body cells.

Detecting these autoantibodies is essential for diagnosing an autoimmune disease, as they are often detectable many years before the disease breaks out.

Decoding immune reactions in the body has also yielded new insights in cancer research.

Multiple sclerosis (disseminated encephalomyelitis) is a chronic inflammatory autoimmune disease of the central nervous system. MS varies greatly from patient to patient, but it is always progressive.

Normally, the immune system is responsible for fighting off foreign substances such as viruses and bacteria. In an autoimmune disease, to put it simply, the immune system turns against the body itself. In MS, inflammation occurs in the nerve fibers of the brain and spinal cord.

As a result of the inflammation, neurotransmitters are no longer transmitted properly. If several inflammatory foci occur in rapid succession, this is referred to as a relapse. The acute symptoms subside after a few hours or days. The inflamed tissue forms scar tissue.

In addition to relapsing-remitting multiple sclerosis, there is also progressive MS. In this form, there is a gradual worsening of symptoms without relapses.

Multiple sclerosis is the most common chronic inflammatory disease among young adults. Patients exhibit symptoms such as poor coordination, paralysis in the extremities, and sensory and visual disturbances.

There are now many medications that have a positive effect on the course of the disease. However, the success of treatment depends on the type of disease. The progressive form is particularly difficult to treat.

Multiple sclerosis is currently incurable. Treatments help slow the progression of the disease @ freshidea /AdobeStock

In addition to magnetic resonance imaging (MRI), neurophysiological procedures are also used for diagnosis.

For several years now, this has made it possible to detect aquaporin-4 antibodies and distinguish multiple sclerosis from the similar condition, neuromyelitis optica. A finding typical of MS on MRI is RIS (radiologically isolated syndrome). It does not yet show any clinical symptoms but is detectable during the examination.

Only the clinically isolated syndrome (CIS) reveals the typical, active inflammatory lesions. In interferon therapy (immunomodulation), pharmacological substances (medications) are capable of influencing the immune system. They affect the body’s immune response in the same way as physical stimuli (heat and cold).

Doctors often administer immunomodulatory substances as part of combination therapies. Patients must also undergo intensive physical therapy. 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 diagnose the symptoms, physicians use electrophysiological, clinical-chemical, and molecular-biological analytical methods.

Treatment involves various immunotherapeutic agents as well as symptom-specific treatment methods.

The goal 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 are incurable, but their course can be significantly milder. Treatment successes are demonstrable, particularly thanks to findings in neuroimmunology.

In multiple sclerosis, the immune system attacks the protective layer of individual nerve fibers. The immune system is responsible for the relapses, for which the doctor prescribes anti-inflammatory medications. Relapsing-remitting multiple sclerosis is the most common form of MS.

The rarer, progressive form of MS is more difficult to treat. Nevertheless, prompt treatment is important because nerve cells die off in this form. The better the individualized care, the more positive the prognosis.

A new treatment method currently appears very promising: repairing the damaged nerve fibers. In experiments with mice, experts were able to demonstrate that the myelin sheath regrows more quickly when mice are given the protein Lingo.