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Spinal Cord Involvement in MS and Other Demyelinating Diseases
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Possible Correlation between Cholinergic System Alterations and Neuro/Inflammation in Multiple Sclerosis

Department of Psychological, Health and Territorial Sciences, School of Medicine and Health Sciences, “G. d’Annunzio” University, 66100 Chieti, Italy
IIBB-CSIC, IDIBAPS, CIBERNED, 08036 Barcelona, Spain
Department of Medical, Oral and Biotechnological Science, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy
Department of Biology and Biotechnologies C. Darwin, “Sapienza” University of Rome, 00185 Rome, Italy
Research Center of Neurobiology Daniel Bovet, “Sapienza” University of Rome, 00185 Rome, Italy
Author to whom correspondence should be addressed.
Biomedicines 2020, 8(6), 153;
Received: 12 May 2020 / Revised: 5 June 2020 / Accepted: 6 June 2020 / Published: 8 June 2020
(This article belongs to the Special Issue Multiple Sclerosis: Diagnosis and Treatment II)
Multiple sclerosis (MS) is an autoimmune and demyelinating disease of the central nervous system. Although the etiology of MS is still unknown, both genetic and environmental factors contribute to the pathogenesis of the disease. Acetylcholine participates in the modulation of central and peripheral inflammation. The cells of the immune system, as well as microglia, astrocytes and oligodendrocytes express cholinergic markers and receptors of muscarinic and nicotinic type. The role played by acetylcholine in MS has been recently investigated. In the present review, we summarize the evidence indicating the cholinergic dysfunction in serum and cerebrospinal fluid of relapsing–remitting (RR)-MS patients and in the brains of the MS animal model experimental autoimmune encephalomyelitis (EAE). The correlation between the increased activity of the cholinergic hydrolyzing enzymes acetylcholinesterase and butyrylcholinesterase, the reduced levels of acetylcholine and the increase of pro-inflammatory cytokines production were recently described in immune cells of MS patients. Moreover, the genetic polymorphisms for both hydrolyzing enzymes and the possible correlation with the altered levels of their enzymatic activity have been also reported. Finally, the changes in cholinergic markers expression in the central nervous system of EAE mice in peak and chronic phases suggest the involvement of the acetylcholine also in neuro-inflammatory processes. View Full-Text
Keywords: cholinergic system; acetylcholine; multiple sclerosis; inflammation; cytokines; EAE cholinergic system; acetylcholine; multiple sclerosis; inflammation; cytokines; EAE
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MDPI and ACS Style

Gatta, V.; Mengod, G.; Reale, M.; Tata, A.M. Possible Correlation between Cholinergic System Alterations and Neuro/Inflammation in Multiple Sclerosis. Biomedicines 2020, 8, 153.

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