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  lüll Fluids and barriers of the CNS establish immune privilege by confining immune  surveillance to a two-walled castle moat surrounding the CNS castle Engelhardt B; Coisne CFluids Barriers CNS  2011[Jan]; 8 (1): 4Neuronal activity within the central nervous system (CNS) strictly depends on  homeostasis and therefore does not tolerate uncontrolled entry of blood  components. It has been generally believed that under normal conditions, the  endothelial blood-brain barrier (BBB) and the epithelial blood-cerebrospinal  fluid barrier (BCSFB) prevent immune cell entry into the CNS. This view has  recently changed when it was realized that activated T cells are able to breach  the BBB and the BCSFB to perform immune surveillance of the CNS. Here we propose  that the immune privilege of the CNS is established by the specific morphological  architecture of its borders resembling that of a medieval castle. The BBB and the  BCSFB serve as the outer walls of the castle, which can be breached by activated  immune cells serving as messengers for outside dangers. Having crossed the BBB or  the BCSFB they reach the castle moat, namely the cerebrospinal fluid  (CSF)-drained leptomeningeal and perivascular spaces of the CNS. Next to the CNS  parenchyma, the castle moat is bordered by a second wall, the glia limitans,  composed of astrocytic foot processes and a parenchymal basement membrane. Inside  the castle, that is the CNS parenchyma proper, the royal family of sensitive  neurons resides with their servants, the glial cells. Within the CSF-drained  castle moat, macrophages serve as guards collecting all the information from  within the castle, which they can present to the immune-surveying T cells. If in  their communication with the castle moat macrophages, T cells recognize their  specific antigen and see that the royal family is in danger, they will become  activated and by opening doors in the outer wall of the castle allow the entry of  additional immune cells into the castle moat. From there, immune cells may breach  the inner castle wall with the aim to defend the castle inhabitants by  eliminating the invading enemy. If the immune response by unknown mechanisms  turns against self, that is the castle inhabitants, this may allow for continuous  entry of immune cells into the castle and lead to the death of the castle  inhabitants, and finally members of the royal family, the neurons. This review  will summarize the molecular traffic signals known to allow immune cells to  breach the outer and inner walls of the CNS castle moat and will highlight the  importance of the CSF-drained castle moat in maintaining immune surveillance and  in mounting immune responses in the CNS.ä |