Psychoneuroimmunology

The mind-body connection

The recent resurgence of interest in studying our ability to ensure good health and to resist infections and diseases has been prompted in part by our increased understanding of regulatory mechanisms that affect the immune system and in part by our human desire to control and regulate our external and internal environments.

Psychoneuroimmunology is a subdiscipline of neu-roimmunology that, to date, has attracted only a few mechanistically inclined immunologists. For the most part, the existing studies of the impact of emotional and environmental conditions, stress, and emotional disturbances on specific types of immunological responses have been initiated by psychiatrists, psychologists and behavioral biologists. Nevertheless, there are numerous published accounts of the effects of factors such as environmental stress, task/reward paradigms, crowding and overpopulation, and physical trauma on immunologic functions, including suppression of NK cell activity, antibody responses, and cell-mediated immune responses, as well as a

Immun« system

Nervous system

Macrophage

T Lymphocyte

Blood-

brain barrier

6 Lymphocyte

Astrocyte

Figure 8 Production of cytokines by cells in the immune system (A) and nervous system (B). Some of the cytokines produced in each system act on cells within that system, but can also act on cells of the other system. Some of these cytokines cross the blood-brain barrier. In general, the cytokines involved mediate cell growth, cell differentiation, and serve as tropic factors in each system generalized reduction in the functioning of the immune system, relative to psychological well-being. Thus, evidence for such a link is growing.

The darker side of this area is represented by those who, in concert with the lay press, have promulgated the notion that the individual is capable of emotional control over the body's immune functions. In this context, it has been suggested that behavioral modification and one's emotional outlook can be used to defeat life-threatening diseases such as cancer, intractable pain and chronic debilitating viral infections including the acquired immune deficiency syndrome (AIDS). To date, there is no scientifically sound evidence that the nervous system, positive thoughts, neural activity and/or neuropeptides can separately or together defeat or reverse terminal conditions in human beings. It is evident that a positive attitude and a good mental outlook undoubtedly help an individual's passage through a terminal disease, bur it is not evident that such an outlook can prevent or cure such conditions. Unfortunately, this area of psychoneuroimmunology has been used as a basis on which to sell the public a variety of nostrums - puta-tively chemo- and/or psychotherapeutic - that may-do more harm than good.

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