Central nervous system zoning: How brain barriers establish subdivisions for CNS immune privilege and immune surveillance.

Proulx, Steven T.; Engelhardt, Britta (2022). Central nervous system zoning: How brain barriers establish subdivisions for CNS immune privilege and immune surveillance. Journal of internal medicine, 292(1), pp. 47-67. Wiley 10.1111/joim.13469

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The central nervous system (CNS) coordinates all our body functions. Neurons in the CNS parenchyma achieve this computational task by high speed communication via electrical and chemical signals and thus rely on a strictly regulated homeostatic environment, which does not tolerate uncontrolled entry of blood components including immune cells. The CNS thus has a unique relationship with the immune system known as CNS immune privilege. Previously ascribed to the presence of blood-brain barriers and the lack of lymphatic vessels in the CNS parenchyma prohibiting, respectively, efferent and afferent connections with the peripheral immune system, it is now appreciated that CNS immune surveillance is ensured by cellular and acellular brain barriers that limit immune cell and mediator accessibility to specific compartments at the borders of the CNS. CNS immune privilege is established by a brain barriers anatomy resembling the architecture of a medieval castle surrounded by two walls bordering a castle moat. Built for protection and defense this two-walled rampart at the outer perimeter of the CNS parenchyma allows for accommodation of different immune cell subsets and efficient monitoring of potential danger signals derived from inside or outside of the CNS parenchyma in addition to the efficient mounting of immune responses within the subarachnoid or perivascular spaces while leaving the CNS parenchyma relatively undisturbed. We here propose that CNS immune privilege rests on the proper function of the brain barriers, which allow for CNS immune surveillance but prohibit activation of immune responses from the CNS parenchyma unless it is directly injured. This article is protected by copyright. All rights reserved.

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