Abstract
More than 80 years ago, Pio Del Rio-Hortega recognized that one of the "main controversial points in regard to the microglia" is "whether it belongs to the reticulo-endothelial system [i.e. monocytes and macrophages] and possesses the ordinary characteristics of this system or has a more specialized function." The notion of microglia having functions that are different from those of other macrophages has gained significant support in recent years. The brain represents a unique environment and shows species, developmental and regional specialization. Thus, any consideration of microglial activity has to be thought of in this tissue context. Contexts may be normal (health, physiology) or disease conditions showing either primary or secondary microglial involvement. Subclinical, reversible "soft pathologies" (Kreutzberg) such as pain that involves microglia also exist. Here, we examine a multilayered approach to understanding microglia that illustrates the emergent character of the microglial (population) phenotype. Accordingly, terms such as microglial "activation" and microgliosis, which are of increasing importance for our understanding of neurological disorders, need to be filled with refined meaning. It is suggested that the pathophysiological context guides nomenclatorial considerations; for example, development, trauma or pain-associated microglia is preferred over the traditional but less distinctive "microglial activation." This should also help to tease out the different functional subtypes currently hidden under the umbrella term "neuroinflammation," which is being applied so widely that it has become effectively useless in practice and even inhibits research progress because both true and pseudo-inflammation are covered by this term.