Underlying Signalings in the Neuro-Immune Communications

A special issue of Neurology International (ISSN 2035-8377).

Deadline for manuscript submissions: 31 August 2026 | Viewed by 1220

Special Issue Editors


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Guest Editor
Medical Faculty, Sofia University St. Kliment Ohridski, 1 Kozyak Str., 1407 Sofia, Bulgaria
Interests: autoimmunity; autoimmune diseases; inflammation; neuroinflammation; biomarkers; cytokines
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Guest Editor Assistant
1. Medical Faculty, Sofia University St. Kliment, Ohridski, 1 Kozyak Str., 1407 Sofia, Bulgaria
2. Multiprofile Hospital for Active Treatment “Uni Hospital”, 100 Georgi Benkovski Str., 4500 Panagyurishte, Bulgaria
3. Department of Neurology, University Multiprofile Hospital for Active Treatment in Neurology and Psychiatry "St. Naum", Medical University of Sofia, 1 Dr. Lyuben Rusev Str., 1113 Sofia, Bulgaria
Interests: autoimmune diseases of the central nervous system; cerebrovascular disease; neurodegenerative diseases

Special Issue Information

Dear Colleagues,

Interactions between the nervous and immune systems are increasingly recognized as key determinants of neurological disease onset, progression, and heterogeneity. Immune-mediated signaling influences neuronal survival, synaptic function, vascular integrity, and repair mechanisms, while neural and neurovascular pathways actively shape systemic and local immune responses. In clinical neurology, disruption of these bidirectional processes is evident across a broad range of conditions, including cerebrovascular disease, immune-mediated demyelinating disorders such as multiple sclerosis, neurodegenerative diseases, and systemic conditions with neurological involvement.

This Special Issue aims to explore the signaling mechanisms underlying neuro-immune communication with a focus on their clinical relevance. We welcome contributions that clarify how molecular and cellular immune pathways translate into structural, functional, and phenotypic changes observed in patients, including processes such as inflammation-driven demyelination, remyelination failure, and progression independent of overt inflammatory activity. Studies addressing neurovascular and glial signaling, peripheral immune contributions, biomarkers of immune activity, and modulatory influences such as the gut–brain axis are particularly encouraged. Both experimental and clinical research, as well as translational studies linking mechanistic insights to diagnostic or therapeutic implications, are within scope.

By integrating mechanistic knowledge with clinical reasoning, this Special Issue seeks to support a more coherent understanding of neuro-immune signaling and its implications for disease stratification, prognosis, and targeted intervention in neurological practice.

Dr. Tsvetelina Velikova
Guest Editor

Dr. Georgi Vasilev
Guest Editor Assistant

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Keywords

  • neuro-immune communication
  • neuroinflammation
  • immune signaling
  • demyelinating diseases
  • multiple sclerosis
  • cerebrovascular disease
  • neurodegeneration
  • neurovascular unit
  • biomarkers
  • clinical neurology

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Published Papers (1 paper)

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Review

29 pages, 2931 KB  
Review
From Phenotypes to Spectrum: Rethinking RRMS, SPMS and PPMS in the Era of PIRA—A Framework Integrating PIRA, Smouldering-Associated Worsening, and Neurologic Reserve to Facilitate Earlier Recognition of Progression
by Georgi V. Vasilev, Sonya Ivanova and Ivan Milanov
Neurol. Int. 2026, 18(5), 86; https://doi.org/10.3390/neurolint18050086 - 2 May 2026
Viewed by 949
Abstract
The conventional classification of multiple sclerosis (MS) into relapsing–remitting, secondary progressive, and primary progressive phenotypes has long guided diagnosis, prognosis, and therapeutic decision-making. However, accumulating evidence indicates that disability accumulation frequently occurs independently of clinical relapses, challenging relapse-centric and phenotype-based models of disease [...] Read more.
The conventional classification of multiple sclerosis (MS) into relapsing–remitting, secondary progressive, and primary progressive phenotypes has long guided diagnosis, prognosis, and therapeutic decision-making. However, accumulating evidence indicates that disability accumulation frequently occurs independently of clinical relapses, challenging relapse-centric and phenotype-based models of disease evolution. The concept of progression independent of relapse activity (PIRA) has emerged as a clinically relevant framework capturing this phenomenon across MS phenotypes. In this state-of-the-art narrative review, we propose a spectrum-based reinterpretation of MS, integrating PIRA with concepts of smouldering-associated worsening and neurologic reserve. We highlight the heterogeneity of relapse-independent worsening, distinguishing transient from persistent PIRA, and discuss how ageing-related decline in compensatory capacity contributes to the clinical unmasking of progression over time. Within this framework, secondary progressive MS is redefined as the clinically recognizable accumulation of persistent relapse-independent worsening, while primary progressive MS is conceptualized as early predominance of clinically manifest progression due to limited reserve rather than a distinct disease entity. Finally, we examine diagnostic and therapeutic implications of a spectrum-based model in the contemporary era, emphasizing the limitations of relapse-centric treatment strategies and unmet needs in addressing progression-related biology. By reframing MS as a dynamic continuum shaped by the interaction between ongoing pathology and evolving neurologic reserve, this review aims to support earlier recognition of clinically meaningful progression and to inform more biology-aware approaches to disease monitoring and therapy. Full article
(This article belongs to the Special Issue Underlying Signalings in the Neuro-Immune Communications)
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