The diverse range of molecular, cellular, and systemic factors that initiate and perpetuate the chronic activation of the brain’s resident immune cells, primarily microglia and astrocytes, leading to a sustained, low-grade inflammatory state within the central nervous system. These causes are often interconnected and include systemic hormonal dysregulation, chronic peripheral infection, metabolic syndrome, and the accumulation of misfolded proteins. Identifying the specific causes is crucial for targeted clinical intervention.
Origin
This concept stems from neuroimmunology and pathology, recognizing that inflammation in the brain is a key driver, not just a symptom, of neurodegenerative and cognitive decline. The term emphasizes the etiological agents that disturb the delicate immune privilege of the brain. Research has increasingly highlighted the bidirectional communication between the endocrine system, the gut microbiome, and the brain’s immune response as primary causal pathways.
Mechanism
Key mechanistic causes involve the activation of pattern recognition receptors, such as toll-like receptors (TLRs), by circulating inflammatory cytokines or misfolded protein aggregates like amyloid-beta. Hormonal imbalance, particularly estrogen deficiency in perimenopause, can compromise the anti-inflammatory tone of the brain, leading to microglial over-activation. This persistent activation results in the chronic release of pro-inflammatory mediators, which damage neurons and impair synaptic function.
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