Neural Immune Pathways

[Guest guest]

http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=333413 & blobtype=pdf

Review

Neural immune pathways and their connection to inflammatory

diseases

Farideh Eskandari, Jeanette I Webster and Esther M Sternberg

Section on Neuroendocrine Immunology and Behavior, NIMH/NIH, Bethesda, MD, USA

Corresponding author: Esther M. Sternberg (e-mail: ems@...)

Received: 1 May 2003 Revisions requested: 4 Jun 2003 Revisions received: 8 Aug 2003 Accepted: 18 Aug 2003 Published: 23 Sep 2003

Arthritis Res Ther 2003, 5:251-265 (DOI 10.1186/ar1002)

Abstract

Inflammation 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 also have an

important immunoregulatory role. The immune system signals the CNS through immune mediators and

cytokines that can cross the blood–brain barrier, or signal indirectly through the vagus nerve or second

messengers. Neuroendocrine regulation of immune function is essential for survival during stress or

infection and to modulate immune responses in inflammatory disease. This review discusses

neuroimmune interactions and evidence for the role of such neural immune regulation of inflammation,

rather than a discussion of the individual inflammatory mediators, in rheumatoid arthritis.

Keywords: cytokine, hypothalamic–pituitary–adrenal axis, immune, inflammatory, neural, rheumatoid arthritis