Psyche and soma: New insights into the connection

Psyche and soma: New insights into the connection

Psychoneuroimmunology is the first textbook to examine the complex functional relationships between the nervous system, the neuroendocrine and the immune system. First, it provides psychologically and biologically plausible explanations for how psychological factors might influence immunity and immune system-mediated disease. All answers lie within. There could be a Nobel Prize in it for you… just don’t forget to mention me in your acceptance speech. However,  I got my bachelor’s and master’s at the University of Colorado – Boulder, at a time when the Psychology & Neuroscience department there was very focused on psychoneuroimmunology-related phenomena. Evidence for effects of stress, depression, and repression/denial on onset and progression of AIDS and cancer is less consistent and inconclusive, possibly owing to methodological limitations inherent in studying these complex illnesses, or because psychological influences on immunity are not of the magnitude or type necessary to alter the body’s response in these cases. In the past two decades, biomedical research has changed our understanding of body systems.

T or B cells, activated against the pathogen, also target these self antigens and attack them as well, causing direct damage and instigating other immune pathways against the body. Many ancient cultures felt a connection between mind, body, and spirit. In humans, injections of low-dose endotoxin deactivate the ventral striatum, a region critical for reward processing, producing anhedonia a debilitating depressive symptom [14]. Without the immune system functioning at optimal levels, the body becomes subject to health problems. Twenty years later, Lancet published a study by Ader and Cohen that concludes with the following statement: “The association between stressful life experiences and changes in immune function do not establish a causal link between stress, immune function, and disease. This chain of events has not been definitively established”.[5] Thus, the unifying link remained elusive for a large part of the late twentieth century. Only recently have major breakthroughs occurred that have revolutionized our understanding of PNI.

In this article, we will make an attempt to demonstrate the integration among body systems and also the causal link can now be established between these systems based on the available knowledge. In this context, we are not ignoring the effect of genetic inheritance, but given that the genes contribute to a particular extent, it is the individual’s environment that may decide the final manifestation of an illness. How effective are PET scans at doing something like this now? Our previous and current studies have been examining how anxiety and depression may finally affect the cardiovascular system, leading to an increase in mortality and morbidity. Recent studies have again shown a link between glutamate receptors and some of these mechanisms. This is an interesting construct if we think about the female preponderance to autoimmune conditions. Beinfield and Korngold [3] in their book Between Heaven and Earth wrote “As the breadth and depth of scientific information about the body grew, doctors and patients lost faith in the capacity of the human organism to heal itself.

Brain magnetic resonance imaging (MRI) is normal in approximately 42% of neuropsychiatric SLE cases [97]. NF-κB regulates many cytokines produced by macrophages and Th cells.[36] Thus repression of NF-κB at a transcriptional level may inhibit the secretion of these cytokines. The fibres innervate the primary (i.e, bone-marrow, thymus) and secondary (i.e, spleen, lymph nodes) immune organs including the noradrenergic, cholinergic, and peptidergic nerve fibers.[10] Neurotransmitters must be typically activated by the immune system before passing on their message. Therefore, how does the brain receive and respond to chemical and electrical information from the immune system? On recognition of the cytokine by the CNS, the information is converted to neuroendocrine signals, resulting in chemical messages being sent back to the immune system, with ensuing physiological changes. By and large, the cytokines (and their receptors) that are found in the nervous system are localized to the brain. Although most research has been performed on rodents, TNF and interferon γ (INF γ) have been found in human brain tissue and IL-1 in the tissues of human hypothalamus, thyroid, and ovary as well.

I’m not jealously guarding these ideas, I put them in the paper in the hopes that other groups would work on them too. Among the first cytokines found to have hormonal function were INF, which increased glucocorticoid production, and IL-1, which increased the hypothalamic secretion of the corticotropin-releasing hormone (CRH). However, now we know that cytokines are responsible for numerous neuroendocrine alterations. Both autoimmune diseases of the thyroid gland, Hashimoto’s and Graves’ diseases, share similarities. Psychoneuroimmunology (PNI) is a relatively new discipline within the field of neuroscience which has its origins from the work of Ader and Cohen in the 1970s. Psychiatric presentations can include normal brain MRI and cerebrospinal fluid (CSF) analysis, without encephalopathy or seizures [2,3,5,6,107]. Exposure of ovarian cancer cell lines to increasing concentrations of norepinephrine or epinephrine have shown that both independently increased levels of phosphorylated Signal Transducers and activators of transcription (STAT)3 in a dose-dependent fashion.

Psyche and soma: New insights into the connection
Activated immune cells are capable of permeating the blood-brain barrier and secreting cytokine mediators. This interaction is distinct from the cytokines independently traveling to the CNS. Studies show that these brain-born cytokines can influence peripheral neuroendocrine functions and influence behavioral effects, particularly those associated with the hypothalamus and hippocampus. These actions probably help maintain homeostasis, by modulating the interaction of the systems during antigen challenge. Moreover, a fascinating research shows that IL-1, IL-2, IL-6, TNF α, and INF γ, all cause pituitary-like hormones to be secreted by immune cells in a localized autocrine- and paracrine-type manner. But despite all of that, I still think it’s a research program that is worth pursuing. These lymphocyte-derived, pituitary-like hormones actually modulate subtle adjustments in pituitary hormone secretions.

For example, IL-1 regulates anterior pituitary cell growth, while IL-2 and IL-6 inhibit normal growth yet encourage tumor growth.[23] As for the other aspects of immune-neuroendocrine bidirectional communication, we see that the cytokines play an enormously important role in system homeostasis during immune challenges. Avoid xenoestrogens. From research on coping styles, it appears that the manner of responding to stressful events has implications both psychologically and physiologically [18]. The pathophysiology is thought to involve cross-reactivity between anti-streptococcal antibodies and basal ganglia proteins [124]. Thus, acute stress upregulates parameters of natural immunity, which requires only a minimal time and energy investment to act against invaders.[93] In fact, energy may be directed away from the specific immune response, as indexed by the decrease in the proliferative response. We can now begin to speculate that the immune system also has a memory beyond that which is specific to the antigen memory. The same sites (e.g., the hippocampus and hypothalamus) that are recognized as crucial for memory functions of stress are also fundamentally important in the immune-neuroendocrine bidirectional communication pathway.

Both these sites are important transfer stations for cytokines — the all-important interceding messengers. The ubiquitous and intricate array of electrical and chemical routes of communication that are already known to make up immune response are a compelling indication that there could be a memory for the emotional or behavioral components of an illness. What are some of the practical implications of understanding that our bodies are integrated networks? For the vast majority of their patients, CBT did not help. The impact of these events on one’s health is understood more fully from the perspective of systems integration. Our bodies have the capacity to function with separate, yet fully interactive parts maintaining homeostasis. In: Morton CC, Fagan T, editors.

Negative emotional states are as detrimental to the central nervous system as to the immune and other organ systems. We have a solid working knowledge of how stressors activate the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system, and we also have an appreciable grasp of how products of these systems affect molecular and cellular changes in the immune system. Studies have shown that HIV-positive men assigned to a ten-week, group-based cognitive behavioral stress management (CBSM) intervention, demonstrated positive effects on mood. In the 1930s Walter Cannon was one of the first to note that fear and stress contributed to the development of physical symptoms akin to heart disease.[24] Subsequently, it was noted that multiple psychological risk factors were present in a large population of patients with heart disease. These could be chronic personality traits, such as hostility; there could be episodic factors, which could include depression and exhaustion; or risk factors that could manifest in the form of something like anger, which was classified as an acute psychological trigger. As the years passed, since Cannon’s observations, the results of an increasing number of studies suggested that the immune system played an important role in the relationship between these psychological risk factors and future coronary syndromes. Stress-induced neuroendocrine interactions are also known to influence the immune system during a viral infection, which may possibly lead to an autoimmune disease.

A Theiler’s virus infection of the central nervous system model is being used for the study of multiple sclerosis (MS), and the basic pathology of the disease and the present evidence do support the role of viral infection in the etiology of MS. Find someone else. Ultimately all the hypotheses should be proven in the systematic, basic, and clinical research, not only to identify the risk and mechanisms that mediate an illness, but also to know how various treatments can be beneficial. For example, all our ongoing work on the risk factors of cardiac mortality and morbidity, associated with anxiety and depression, is a miniature attempt to understand one aspect of an elaborate phenomenon.[32] Our recent work on how physical exercise may affect the repolarization lability in ventricular myocardium is one such example.[33] In this context some other works on the effects of the brain on the mediation of cardiac repolarization is exciting, as it links the medial prefrontal cortex, the QT interval. Annu Rev Immunol. In addition to an antidiuretic effect, AVP increases peripheral vascular resistance to increase arterial blood pressure. In the modern era, the first reference to this topic was published in Psychosomatic Medicine in 1946.[34] The author reviewed the charts of 1266 consecutive patients treated by him in a year on a General Medical Section of an Army hospital in Assam, India.

Although it is not yet clear as to what extent these positive immunological changes translate into concrete improvements in relevant aspects of health (alterations in the incidence, severity, or duration of infectious or malignant disease), the preliminary evidence is promising.[123] Authors thus conclude that stress tends to have a negative impact on the immune system and makes a person more vulnerable to diseases. In other words, one out of every four general medical patients had a large emotional component to his illness. Of late, the impact of Psychoneuroimmunology has also been addressed in relation to tuberculosis[35] and the field of Medical Oncology.[36] However, an original research on the topic is lacking and further studies are needed in the Indian perspective, as the dynamics and family support structure is different in India when compared to the West. The authors have carried out a study on the Intensive Care Patients, where the outcome was compared to the coping skills of the patients (unpublished data). The coping skills were assessed using the Bell’s inventory and the style-questionnaire and were compared with the final outcome. The cohort of patients studied were patients with sepsis. In the paper I gave an example of a treatment regimen that included graded exercise therapy.

A direct correlation was noted between optimism and good coping skills to a favorable outcome. It was also noted that the immune response was more streamlined in individuals having good coping skills.

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