本综述的目的是描述转移性疾病侵袭中枢神经系统时，硬脑膜发生的免疫学变化。作者们假设硬脑膜的解剖结构和居住免疫细胞群体在促进肿瘤转移至大脑和软脑膜中起到了一定作用。通过广泛的文献搜索，找出支持硬脑膜参与中枢神经系统转移的证据。作者的假设根据最近对硬脑膜在转移性疾病、中枢神经系统感染和自身免疫性方面的研究有了新的突破。他们综述了这些文献，以及免疫治疗在处理脑转移瘤中的应用以及这些治疗如何改变脑膜免疫景观以克服和逆转促进肿瘤免疫抑制现象的情况。证据表明，与中枢神经系统其他免疫组织区域相比，硬脑膜独特的结构和免疫细胞特征有助于转移性肿瘤细胞进入大脑。一旦这些肿瘤细胞穿透硬脑膜屏障，它们会形成免疫抑制的肿瘤微环境。因此，免疫治疗可能有助于克服这种免疫抑制环境，释放促炎性免疫细胞以抵抗转移性疾病。作者预计，在接下来的几年内，将会有更多的科学研究加入文献中，进一步强调硬脑膜作为神经肿瘤学中重要参与者和神经解剖屏障的地位。

The objective of this review was to describe the immunological changes that take place in the dura mater in response to metastatic disease that seeds the CNS. The authors hypothesized that the dura's anatomy and resident immune cell population play a role in enabling metastasis to the brain and leptomeninges.An extensive literature search was conducted to identify evidence that supports the dura's participation in metastasis to the CNS. The authors' hypothesis was informed by a recent upsurge in studies that have investigated the dura's role in metastatic development, CNS infections, and autoimmunity. They reviewed this literature as well as the use of immunotherapy in treating brain metastases and how these therapies change the meningeal immune landscape to overcome and reverse tumor-promoting immunosuppression.Evidence suggests that the unique architecture and immune cell profile of the dura, compared with other immune compartments within the CNS, facilitate entry of metastatic tumor cells into the brain. Once these tumor cells penetrate the dural barrier, they propagate an immunosuppressive tumor microenvironment. Therefore, immunotherapy may serve to overcome this immunosuppressive environment and liberate proinflammatory immune cells in an effort to combat metastatic disease.Within the next few years, the authors expect the addition of several more scientific studies into the literature that further underscore the dura as a chief participant and neuroanatomical barrier in neuro-oncology.