By:Mohamed Adel El-Hadidy

Associative Professor of psychiatryMansoura Faculty of medicine

PsychoneuroimmunologyUpdated by Dr: Mohamed Adel El-Hadidy

Definition:

Psychoneuroimmunology is the field concerned with relationships among the mind (psycho), the nervous

and endocrine systems (neur) and the immune system (immunology). The central idea is that psychosocial

factors can influence immune responses through the brain as a master regulator for bodily system.

Communication between the brain and immune system

The immune system for the body like an army to the nation Stimulation of brain sites

(The hypothalamus, locus ceruleus, and the limbic system)

Enhancing immune system

inhibiting immune system

The autonomic nervous system: the sympathetic nervous system fibers provide a direct link between the brain and the lymphocytes, spleen and thymus.

Lymphocytes have receptor sites on their surfaces for certain hormones and the neurotransmitter catecholamine

Immune cells produce cytokines that act on the CNS

Antigens (threaten health) Body

Activation of immune system to defeat the body

humoral branch like navy because it operates through B cell (from bone marrow) that circulates in the blood

The cellular branch like foot army because it operates through T cell (From thymus gland) that can leave the blood stream and more through the tissues

Memory B cells

Memory T cells

remain to provide immunity against further attach with same antigen

The immune has also two responses: according to type of lymphocyte

Non-specific Response: (by non-specific lymphocytes):• Both Natural Killers (NK-cells) that destroy tumors and viruses.• Macrophages that attack bacteria and pass information about the antigen to specific Helper T cells.

Specific Response: Where specific lymphocytes using the information from macrophages to produce T Killer cells and B cells become plasma cells that secrete antibodies.

Communication between neuroendocrine and immune system

response to stress

Activation of the hypothalamic-pituitary-adrenal connection

Glucocorticoids and catecholamines influence immune cells

Endorphins from pituitary & adrenal medulla act on immune system

Activity of the immune system is correlated with neuroendocrine activity of brain cells

Feedback from hormones and other chemicals produced by lymphocytes and macrophages.

Increase apoptosis.

Connections between glucocorticoids and immune system

Anti-inflammatory hormones that enhance the organisms response to a stressor

Prevent the overreaction of the body's own defense system.

Regulators of the immune system Cause immunosuppression through Affect cell growth, proliferation & differentiation.

Suppress cell adhesion, antigen presentation, chemotaxis & cytotoxicity.

Corticosteroid

Other psychological Factors affecting immune system

Stress and personal control

Stress produces

“down-regulation” of the immune system when associated with lack of personal control

interfere with leukocyte function and antibody production

is mediated through the release of cortecosteroids

Patients taught relaxation techniques

significantly fewer stress-related symptom

had increase in nature killer cell (NK-cell) activity

2) Depression and bereavement:•Depression decrease immune system.•bereavement show 1. significant reduction in NK cell activity. 2. A significant reduction of lymphocyte

response has been found during the first two months following death of spouse with a return to normal by five months post bereavement.

Pharmaceutical advances based on psychoneuroimmunology:

Antidepressants (SSRIs, SNRIs and tricyclic) acting on serotonin, norepinephrine and dopamine receptors

Immunomodulator anti-inflammatory against pro-inflammatory cytokine processes

Tricyclic and (SNRIs) have analgesic properties

Many investigation for antidepressants for use in

Psychiatric (Anxiety, OCD, impulse control)

non-psychiatric illness (autoimmune neuritis )

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