Molecular and biochemical bases for central nervous system-immune interactions include immune cytokines which activate immune function and also recruit central stress-responsive neurotransmitter systems in the modulation of the immune response and in the activation of adaptive behaviors after injury or inflammation. Peripherally generated cytokines, such as Interleukin-1, signal hypothalamic corticotropin releasing hormone neurons to activate pituitary-adrenal counter-regulation of inflammation through the potent antiinflammatory effects of glucocorticoids. CRH not only activates the pituitary-adrenal axis but also sets in motion a coordinated series of behavioral and physiologic responses in which the CNS coordinates both behavioral and immunological adaptation during stressful situations. The pathophysiological perturbation of this feedback loop, through various mechanisms, results in the development of inflammatory syndromes, such as rheumatoid arthritis and behavioral syndromes such as depression. Thus, diseases characterized by both inflammatory and emotional disturbances may derive from common alterations in specific CNS pathways (e.g., the CRH system). In addition, disruptions of this communication by genetic, infectious, toxic, or pharmacological means can influence the susceptibility to disorders associated with both behavioral and inflammatory components and potentially alter their natural history.
Sternberg EM, Chrousos GP, Wilder RL, Gold PW. The stress response and the regulation of inflammatory disease. Ann Intern Med 1992 Nov 15; 117(10):854-66
COMMENT: These concepts suggest that neuropharmacological agents that stimulate hypothalamic CRH might potentially be adjunctive therapy for illnesses traditionally viewed as inflammatory or autoimmune. Another way of looking at potential interventions would be to look at the modulating and normalizing effects of cultivating positive attitudes, and participating in inner disciplines such as meditation, mindfulness meditation, and Qi gong.
COPYRIGHT 2005 The Townsend Letter Group
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