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Dual immune modulation of microglia in viral encephalitis: current understanding and future perspectives
Li Zong1, Pei Chen2, Jing Shi3,4,5
1Department of Rehabilitation Medicine, The People's Hospital of Xishuangbanna Dai Nationality Autonomous Prefecture, Xishuangbanna, Yunnan, China.
Abstract:
Viral encephalitis, characterized by inflammation of the brain parenchyma, poses a significant threat to public health due to its high rates of morbidity and mortality. Microglia, the central nervous system's resident immune cells, are crucial in the pathophysiology and development of this condition. These microglia exhibit a dual function, being involved in both neuroprotection and neurotoxicity during viral encephalitis. To address this complex interplay, targeted therapeutic strategies that modulate microglia activation state have emerged as a promising approach. These strategies aim to either inhibit excessive microglia activation or promote their neuroprotective functions. By targeting microglia, these therapies hold the potential to improve outcomes for patients with viral encephalitis. This review synthesizes current evidence revealing that microglial responses during viral encephalitis exhibit context-dependent heterogeneity that extends beyond traditional M1/M2 paradigms. Critically, our review reveals a significant translational gap, with no current clinical trials investigating microglial-targeted therapies for viral encephalitis despite promising preclinical evidence. This review provides a comprehensive framework for understanding microglial complexity in viral encephalitis and establishes research priorities for advancing these insights toward clinical application.
Insights
Microglia, the brain's immune cells, play a complex role in viral encephalitis. Therapies targeting these cells show promise, but a gap exists between preclinical findings and clinical trials for this serious brain inflammation.
Area of Science:
- Neuroscience
- Immunology
- Pathology
Background:
- Viral encephalitis is brain inflammation with high morbidity and mortality.
- Microglia, the CNS immune cells, have dual roles in neuroprotection and neurotoxicity during viral encephalitis.
- Modulating microglial activation is a potential therapeutic strategy.
Purpose of the Study:
- To review the complex role of microglia in viral encephalitis.
- To identify therapeutic strategies targeting microglia.
- To highlight the translational gap in microglial-targeted therapies.
Main Methods:
- Literature review of current evidence on microglial responses in viral encephalitis.
- Analysis of preclinical and clinical research on microglial-targeted therapies.
- Synthesis of information on microglial heterogeneity beyond M1/M2 paradigms.
Main Results:
- Microglial responses in viral encephalitis are context-dependent and heterogeneous, exceeding M1/M2 classifications.
- Preclinical studies show promise for microglial-targeted therapies.
- A significant translational gap exists, with no ongoing clinical trials for microglial-targeted viral encephalitis therapies.
Conclusions:
- Understanding microglial complexity is key to developing effective treatments for viral encephalitis.
- Further research is needed to bridge the gap between preclinical promise and clinical application of microglial-targeted therapies.
- Establishing research priorities is crucial for advancing microglial-based treatments for viral encephalitis.
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