The immune system and the nervous system.

The immune system may interfere with brain function. The central nervous system may also influence the activity of the immune system. The central nervous system is functionally protected by the blood-brain barrier. The central nervous system is functionally protected by the blood-brain barrier. The endothelial cells of the brain capillaries are linked by tight junctions, resulting in an almost continuous interior wall which restricts the transfer of plasma proteins. The barrier function is modified by inflammatory meningeal lesions, stroke and epileptic seizures. Antigenic material may penetrate the barrier and enter the nerve tissue. The phagocytic cells in the central nervous system are mainly of haematogenous origin. The number of such cells in the brain is very low. There are also few lymphocytes under normal circumstances. These cells circulate from the blood, through the vessel walls and into the perivascular spaces, along the perivascular channels and to the CSF and back to the blood. This circulation may increase enormously during inflammatory conditions. In multiple sclerosis, the number of T-lymphocytes in the CSF is increased, corresponding to a preponderance of T-lymphocytes in the perivascular cell infiltrates in and around the lesions. Thus, the individual elements of the immune system are all present in the brain, which is only partially immunologically privileged. The mechanisms underlying the brain's immunological privilege may be of a non-immunological nature. As yet there are only few data which indicate that auto-immunity is a prominent feature in diseases of the human brain. The central nervous system also exerts a modulating influence upon the immune response. This may take place both by secretion of hormones and by a nervous/neurotransmitter influence upon the immune system.