Innate and adaptive immune mechanisms regulating central nervous system remyelination

Neuroinflammation is a hallmark of many neurodegenerative diseases and is considered their underlying cause. However, certain aspects of neuroinflammation favour beneficial outcomes after damage including the regeneration of myelin (remyelination). Both innate and adaptive immune mechanisms have been recognised as central to remyelination success. In particular, central nervous system (CNS) microglia and macrophages are established as key regulators of remyelination in the injured CNS with recently discovered novel mechanisms that underpin remyelination. How the adaptive immune system contributes to and regulates remyelination, however, is less established. Owing to their immunomodulatory and recently discovered proregenerative functions including in the CNS, regulatory T cells were identified as key for successful remyelination, but many gaps in the underlying mechanisms remain. As there are no therapies yet that enhance remyelination after damage, harnessing the beneficial aspects of neuroinflammation could underpin proregenerative CNS therapies of the future.