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Editorial commentary
Untangling neuroinflammation in amyotrophiclateral sclerosis
  1. Alexander Guy Thompson,
  2. Martin R Turner
  1. Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
  1. Correspondence to Dr Alexander Guy Thompson, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, UK; alexander.thompson{at}ndcn.ox.ac.uk

https://doi.org/10.1136/jnnp-2019-321242

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    A broad body of evidence supports both pathogenic and neuroprotective roles for inflammation in amyotrophic lateral sclerosis (ALS)1 but trials of several immunomodulatory drugs have not yielded a beneficial effect in an increasingly complex disorder with multiple upstream cellular causes.2 There has been interest in proteins involved in the microglial response as potential biomarkers for well over a decade.3 4 Recently this has focused on a group of three chitinase proteins, thought to be macrophage-derived, identified in proteomic analysis of cerebrospinal fluid (CSF) taken from ALS patients.5 6 Chitinases have also been studied the pathologically related disorder frontotemporal dementia (FTD).7 8 Although chitin is not produced by mammals, it is suggested that chitinases might act on N-acetylglucosamine-containing extracellular matrix polymers, such …

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    Footnotes

    • AGT and MRT contributed equally.

    • Contributors AGT and MRT drafted and edited the manuscript.

    • Funding This study has been funded by Motor Neurone Disease Association.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Commissioned; internally peer reviewed.

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