251 ACTH = adrenocorticotropin; AVP = arginine vasopressin; CNS = central nervous system; CRH = corticotropin-releasing hormone; DHEA = dehydroepiandrosterone; GH = growth hormone; GR = glucocorticoid receptor; HPA = hypothalamic-pituitary-adrenal; HPG = hypothalamicpituitary-gonadal; HPT = hypothalamic-pituitary-thyroid; IFA = incomplete Freund's adjuvant; IGF = insulin-like growth factor; IL = interleukin; NF-κB = nuclear factor-κB; PBMCs = peripheral blood mononuclear cells; RA = rheumatoid arthritis; T 3 = triiodothyronine; T 4 = thyroxine; Th = T helper cells; TNF = tumor necrosis factor; TRH = thyrotropin-releasing hormone; TSH = thyroid-stimulating hormone.Available online http://arthritis-research.com/content/5/6/251
IntroductionThe inflammatory response is modulated in part by a bidirectional communication between the brain and the immune systems. This involves hormonal and neuronal mechanisms by which the brain regulates the function of the immune system and, in the reverse, cytokines, which allow the immune system to regulate the brain. In a healthy individual this bidirectional regulatory system forms a negative feedback loop, which keeps the immune system and central nervous system (CNS) in balance. Perturbations of these regulatory systems could potentially lead to either overactivation of immune responses and inflammatory disease, or oversuppression of the immune system and increased susceptibility to infectious disease. Many lines of research have recently established the numerous routes by which the immune system and the CNS communicate. This review will focus on these regulatory systems and their involvement in the pathogenesis of inflammatory diseases such as rheumatoid arthritis (RA). For other reviews on the involvement of these regulatory pathways in RA and other inflammatory diseases, see reviews by Eijsbouts and Murphy There are two major pathways by which the CNS regulates the immune system: the first is the hormonal response, mainly through the hypothalamic-pituitaryadrenal (HPA) axis, as well as the hypothalamic-pituitary-gonadal (HPG), the hypothalamic-pituitary-thyroid (HPT) and the hypothalamic-growth-hormone axes; the second is the autonomic nervous system, through the release of norepinephrine (noradrenaline) and acetylcholine from sympathetic and parasympathetic nerves. In turn, the immune system can also regulate the CNS through cytokines.
Review
Neural immune pathways and their connection to inflammatory diseases
AbstractInflammation and inflammatory responses are modulated by a bidirectional communication between the neuroendocrine and immune system. Many lines of research have established the numerous routes by which the immune system and the central nervous system (CNS) communicate. The CNS signals the immune system through hormonal pathways, including the hypothalamic-pituitary-adrenal axis and the hormones of the neuroendocrine stress response, and through neuronal pathways, including the autonomic nervous system. The hypothalamic-pituitary-gonadal axis and sex hormones a...