Scientific article
Review
English

Fundamental mechanistic insights from rare but paradigmatic neuroimmunological diseases

Published inNature reviews. Neurology, vol. 17, no. 7, p. 433-447
Publication date2021-07
First online date2021-05-28
Abstract

The pathophysiology of complex neuroimmunological diseases, such as multiple sclerosis and autoimmune encephalitis, remains puzzling - various mechanisms that are difficult to dissect seem to contribute, hampering the understanding of the processes involved. Some rare neuroimmunological diseases are easier to study because their presentation and pathogenesis are more homogeneous. The investigation of these diseases can provide fundamental insights into neuroimmunological pathomechanisms that can in turn be applied to more complex diseases. In this Review, we summarize key mechanistic insights into three such rare but paradigmatic neuroimmunological diseases - Susac syndrome, Rasmussen encephalitis and narcolepsy type 1 - and consider the implications of these insights for the study of other neuroimmunological diseases. In these diseases, the combination of findings in humans, different modalities of investigation and animal models has enabled the triangulation of evidence to validate and consolidate the pathomechanistic features and to develop diagnostic and therapeutic strategies; this approach has provided insights that are directly relevant to other neuroimmunological diseases and applicable in other contexts. We also outline how next-generation technologies and refined animal models can further improve our understanding of pathomechanisms, including cell-specific and antigen-specific CNS immune responses, thereby paving the way for the development of targeted therapeutic approaches.

Keywords
  • Animals
  • Humans
  • Immune System Diseases / diagnostic imaging
  • Immune System Diseases / immunology
  • Immune System Diseases / metabolism
  • Nervous System Diseases / diagnostic imaging
  • Nervous System Diseases / immunology
  • Nervous System Diseases / metabolism
  • Neuroimmunomodulation / physiology
  • Rare Diseases / diagnostic imaging
  • Rare Diseases / immunology
  • Rare Diseases / metabolism
  • Susac Syndrome / diagnostic imaging
  • Susac Syndrome / immunology
  • Susac Syndrome / metabolism
Citation (ISO format)
WIENDL, Heinz et al. Fundamental mechanistic insights from rare but paradigmatic neuroimmunological diseases. In: Nature reviews. Neurology, 2021, vol. 17, n° 7, p. 433–447. doi: 10.1038/s41582-021-00496-7
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Additional URL for this publicationhttps://www.nature.com/articles/s41582-021-00496-7
Journal ISSN1759-4758
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