The editors and authors should be congratulated on completing the task of producing the second edition of Clinical neuroimmunology. The contents live up to its title and cover a wide spectrum of conditions falling within the remit of clinical neuroimmunology and more. A generous number of chapters are dedicated to basic science and animal models of immune‐mediated disorders. The book starts with an introductory chapter on immunology and separate chapters on the principles of autoimmunity and immunotherapy. This is followed by chapters relevant to neuroimmunology, which include the organisation and development of the central nervous system (CNS), immune properties of the CNS, the role of the immune response in tissue damage and repair, neural immune interactions in autoimmune disease, immunological properties of the peripheral nervous system, genetics of immune‐mediated neurological diseases, principles of immune–virus interactions in the nervous system, immunity to bacterial infections and animal models of neurological disease.
Not unexpectedly, the lion's share of the book goes to multiple sclerosis and related disorders, with chapters on acute disseminated encephalomyelitis, the pathology and immunology of multiple sclerosis, imaging the immunobiology of multiple sclerosis, effects of immune mediators on neurophysiological function in multiple sclerosis, myelin repair in multiple sclerosis and immune‐directed treatments in multiple sclerosis. The last chapter is testament to how far we have advanced with the treatment of multiple sclerosis and includes some of the emerging treatments that are considerably more effective than the current licensed multiple sclerosis disease‐modifying treatments.
There are several excellent chapters on immune‐mediated disorders of the peripheral nervous system. These include chapters on the Guillain–Barré syndrome and chronic inflammatory demyelinating polyradiculopathy, antibody‐mediated disorders of the neuromuscular junction, neuropathies associated with monoclonal gammopathy and immune mechanisms in inflammatory myopathies.
There are three chapters dedicated to specific infectious diseases, namely HIV‐1, HTLV‐1 and Lyme disease or neuroborelliosis. In the next edition, the editors may consider expanding this list to include other infectious diseases or agents in which the neurological manifestations of the infection are also immune‐mediated.
It is very reassuring that the editors had the wisdom to include sections on the role of the immune system in neurodegenerative diseases and ischaemic stroke; these chapters review the important role the innate immune system has in the pathogenesis of neurodegeneration and the therapeutic implications that have arisen from these recent observations. Other valuable reviews include the chapters on the neuro‐Behcets, vasculitis and paraneoplastic syndromes. A notable omission is a chapter or chapters dedicated to the neurological manifestations of common systemic autoimmune diseases—for example, CNS lupus and thrombotic thrombocytopenic purpura. A particularly thought‐provoking chapter is the penultimate chapter by Angela Vincent on antibodies in CNS disorders. The chapter covers anti‐glutamic acid decarboxylase antibodies in stiff person syndrome and cerebellar ataxia, anti‐voltage‐gated potassium antibodies in limbic encephalitis and epilepsy, and the questionable role of anti‐glutamate receptor 3 antibodies in Rasmussen's encephalitis. There is a provocative section on the role of humoral factors in neurodevelopmental disorders, such as autism, and the potential role of maternal immunity in these and other disorders. The book concludes with a personal perspective on the history of neuroimmunology by Byron Waksman.
The book will be useful for both students studying basic mechanisms in immunology and neuroimmunology and for clinicians managing patients with immune‐mediated disorders of the nervous system.