Special article / Article spécial
Neuroimmune mechanisms in health and disease: 2. Disease
Hymie Anisman, PhD; Malcolm G. Baines, PhD; Istvan Berczi, DVM,
PhD; Charles N. Bernstein, MD, FRCPC; Michael G. Blennerhassett, PhD;
Reginald M. Gorczynski, MD, PhD; Arnold H. Greenberg, MD, PhD;
Fred T. Kisil, PhD; Ronald D. Mathison, PhD; Eva Nagy, MD;
Dwight M. Nance, PhD; Mary H. Perdue, PhD; David K. Pomerantz, PhD; Edris R. Sabbadini, MD, PhD; Andrzej Stanisz, PhD; Richard J. Warrington, MD, BS, PhD, FRCPC
Canadian Medical Association Journal 1996; 155: 1075-1082
[résumé]
[Author information]
The first part of this article appeared in the Oct. 1, 1996, issue
of CMAJ [abstract / résumé].
Paper reprints may be obtained from: Dr. Istvan Berczi, Department of Immunology,
University of Manitoba, 795 McDermot Ave., Winnipeg MB R3E 0W3;
fax 204 772-7924; berczi@bldghsc.lan1.umanitoba.ca
The full text may also be ordered from the Canada Institute for Scientific and Technical Information (CISTI) or Ovid Technologies.
© 1996 Canadian Medical Association (text and abstract/résumé)
Abstract
In the second part of their article on the emerging field of neuroimmunology,
the authors present an overview of the role of neuroimmune mechanisms
in defence against infectious diseases and in immune disorders.
During acute febrile illness, immune-derived cytokines initiate
an acute phase response, which is characterized by fever, inactivity,
fatigue, anorexia and catabolism. Profound neuroendocrine and
metabolic changes take place: acute phase proteins are produced
in the liver, bone marrow function and the metabolic activity
of leukocytes are greatly increased, and specific immune reactivity
is suppressed. Defects in regulatory processes, which are fundamental
to immune disorders and inflammatory diseases, may lie in the
immune system, the neuro-endocrine system or both. Defects in the hypothalamuspituitaryadrenal
axis have been observed in autoimmune and rheumatic diseases,
chronic inflammatory disease, chronic fatigue syndrome and fibromyalgia.
Prolactin levels are often elevated in patients with systemic
lupus erythematosus and other autoimmune diseases, whereas the
bioactivity of prolactin is decreased in patients with rheumatoid
arthritis. Levels of sex hormones and thyroid hormone are decreased
during severe inflammatory disease. Defective neural regulation
of inflammation likely plays a pathogenic role in allergy and
asthma, in the symmetrical form of rheumatoid arthritis and in
gastrointestinal inflammatory disease. A better understanding
of neuroimmunoregulation holds the promise of new approaches to
the treatment of immune and inflammatory diseases with the use
of hormones, neurotransmitters, neuropeptides and drugs that modulate
these newly recognized immune regulators.
Dans la deuxième partie de leur article sur le nouveau
domaine de la neuro-immunologie, les auteurs présentent
un aperçu du rôle des mécanismes neuro-immunitaires
dans la défense contre les maladies infectieuses et les
troubles immunitaires. Au cours d'une maladie fébrile aiguë,
des cytokines immunodérivées provoquent une réaction
de phase aiguë caractérisée par la fièvre,
l'inactivité, la fatigue, l'anorexie et le catabolisme.
Il se produit de profonds changements neuro-endocriniens et métaboliques
: le foie produit des protéines de phase aiguë, la
fonction de la moelle osseuse et l'activité métabolique
des leucocytes augmentent considérablement, et l'immunoréactivité
spécifique est supprimée. Des défauts des
mécanismes de régulation qui jouent un rôle
fondamental dans les troubles immunitaires et les maladies inflammatoires
peuvent résider dans le système immunitaire, le
système neuro-endocrinien, ou les deux. On a observé
des défauts de l'axe hypothalamushypophysesurrénales
dans des cas de maladies auto-immunes et rhumatismales, de maladies
inflammatoires chroniques, de syndrome de fatigue chronique et
de fibromyalgie. Les taux de prolactine sont souvent élevés
chez les patients atteints de lupus érythémateux
général et d'autres maladies auto-immunes, tandis
que la bioactivité de la prolactine diminue chez les patients
atteints de polyarthrite rhumatoïde. Les taux d'hormones
sexuelles et d'hormones thyroïdiennes diminuent au cours
de maladies inflammatoires graves. Un trouble de la régulation
neurale de l'inflammation joue probablement un rôle pathogène
dans l'allergie et l'asthme, dans la forme symétrique de
la polyarthriterhumatoïde et dans l'inflammation gastro-intestinale.
Une meilleure compréhension de la neuro-immunorégulation
pourrait déboucher sur de nouvelles façons de traiter
des maladies immunitaires et inflammatoires au moyen d'hormones,
de neurotransmetteurs, de neuropeptides et de médicaments
qui modulent ces immunorégulateurs que l'on vient tout
juste de reconnaître.
Dr. Anisman is with the Department of Psychology, Carleton
University, Ottawa, Ont.; Dr. Baines is with the Department
of Microbiology and Immunology, McGill University, Montreal, Que.;
Dr. Berczi is with the Department of Immunology, University
of Manitoba, Winnipeg, Man.; Dr. Bernstein is with the Department
of Internal Medicine, University of Manitoba, Winnipeg, Man.;
Dr. Blennerhassett is with the Department of Pathology, McMaster
University, Hamilton, Ont.; Dr. Gorczynski is with the Department
of Surgery and Immunology, University of Toronto, Toronto, Ont.;
Dr. Greenberg is director of the Manitoba Institute of Cell
Biology, Winnipeg, Man.; Dr. Kisil is with the Department
of Immunology, University of Manitoba, Winnipeg, Man.; Dr. Mathison
is with the Department of Medical Physiology, University of Calgary,
Calgary, Alta.; Dr. Nagy is with the Department of Immunology,
University of Manitoba, Winnipeg, Man.; Dr. Nance is with
the Department of Pathology, University of Manitoba, Winnipeg,
Man.; Dr. Perdue is with the Intestinal Disease Research
Unit, McMaster University, Hamilton, Ont.; Dr. Pomerantz
is with the Department of Physiology, University of Western Ontario,
London, Ont.; Dr. Sabbadini is with the Department of Immunology,
University of Manitoba, Winnipeg, Man.; Dr. Stanisz is with
the Department of Pathology and the Intestinal Disease Research
Program, McMaster University, Hamilton, Ont.; and Dr. Warrington
is with the Department of Internal Medicine, University of Manitoba,
Winnipeg, Man.
| CMAJ October 15, 1996 (vol 155, no 8) /
JAMC le 15 octobre 1996 (vol 155, no 8) |