Inflammatory disease as chronic stress.
ABSTRACT It is now established that communication between the CNS and the immune system is bidirectional, that endocrine factors can alter immune function and that immune responses can alter both endocrine and CNS responses. In many respects CNS and endocrine responses to acute inflammation are similar to the changes associated with acute stress exposure. In contrast, during chronic inflammation associated with adjuvant induced arthritis (AA), although circulating levels of corticosterone are increased, the peptidergic regulation of the hypothalamus is different from that seen during acute stress. As the disease progresses, a paradoxical reduction occurs in CRH mRNA in the paraventricular nucleus (PVN), whereas PVN AVP mRNA increases. These data suggest that there is increased expression of AVP mRNA within the CRH cells of the PVN with an increased emphasis on AVP regulation of HPA output. Additionally, HPA function is altered during chronic inflammation such that responses to psychological stress (i.e. restraint) are significantly dampened, while responses to further inflammatory challenges are maintained. These data suggest that alterations in PVN peptide colocalization may be important in regulating the progression of peripheral inflammatory responses and that the effects of inflammation on the hypothalamus alter stress-responsive systems. In addition to the AA model, we have similarly observed alterations in PVN peptide mRNA expression with disease onset in the murine MRL lpr/lpr and MRL +/+ model of SLE. Disease onset in murine SLE is spontaneous and does not rely on exogenous application of adjuvant; however, decreased levels of CRH in the PVN were observed from early disease onset in this animal model. It is suggested that alterations in CRH regulation in response to either acute or chronic inflammation may contribute as etiological factors to both psychiatric (i.e. neuropsychiatric SLE) and stress-related disease.
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ABSTRACT: Alopecia areata is considered to be a cell-mediated autoimmune disease, in which autoreactive cytotoxic T cells recognize melanocyte-associated proteins such as tyrosinase. This review discusses recent advances in the understanding of the pathogenesis of alopecia areata, focusing on immunobiology and hormonal aspects of hair follicles (HFs). The HF is a unique "miniorgan" with its own immune and hormonal microenvironment. The immunosuppressive milieu of the anagen hair bulb modulated by immunosuppressive factors is known as "hair follicle immune privilege." The collapse of the hair follicle immune privilege leads to autoimmune reactions against hair follicle autoantigens. Alopecia areata is sometimes triggered by viral infections such as influenza that causes excess production of interferons (IFN). IFN- γ is one of the key factors that lead to the collapse of immune privilege. This paper reviews the interactions between the endocrine and immune systems and hair follicles in the pathogenesis of alopecia areata.Clinical and Developmental Immunology 01/2013; 2013:348546. · 3.06 Impact Factor
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ABSTRACT: Stress reaction provokes changes in the body involving cardiovascular alterations, autonomic reactions, neuroendocrine and immunologic as well as psychoneuroimmunologic changes. Both the primary and secondary effect of stress reaction may be of consequence for vocal function. The purpose of this questionnaire study was to determine the effect of stress symptoms on the occurrence of vocal symptoms. The study also aimed at investigating whether a possible effect was different for men and women. A total number of 1728 participants completed a questionnaire concerning speech, language, and voice. Six vocal symptoms and four possible stress symptoms were included in the questionnaire. There was a significant association between stress symptoms and the occurrence of vocal symptoms. The occurrence of muscle tension or a lump in the throat was significant regarding all the four possible stress symptoms. There were also significant results concerning gender difference. All vocal symptoms and two of four stress symptoms were more common among women. Physical changes caused by the stress reaction may result in vocal symptoms as those presented in the study. Both vocal symptoms and stress symptoms were more common among women. Stress should preferably be acknowledged as a risk factor containing and possibly entailing a number of physiological, psychological, and behavioral symptoms affecting the voice negatively.Journal of voice : official journal of the Voice Foundation. 07/2013;
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ABSTRACT: Una parte preponderante della popolazione adulta soffre o ha sofferto in più occasioni di sintomatologia vaga ed aspecifica (MUS, Medically Unexplained Symptoms, secondo la definizione più accreditata dalla letteratura internazionale), categoria alla quale si riconduce una larga famiglia di disturbi di varia natura, che solo raramente sfocia in una diagnosi precisa, mantenendosi piuttosto di frequente entro i limiti di quadri clinici alterati, ma non al punto da apparire patologici. La letteratura in materia ha conosciuto un notevole sviluppo dagli anni Ottanta ad oggi, prevalentemente a causa della crescente incidenza del fenomeno, considerato al giorno d'oggi come una delle problematiche più frequenti, dispendiose e di più complessa gestione nell'ambito della medicina generale. • alterazione della funzionalità della tiroide, • disturbi ormonali aspecifici; • disturbi funzionali a carico dell'apparato cardio-circolatorio (es. ipertensione, ipotensione); • cambio delle masse corporee non associate a cambiamenti nutrizionali (alterazioni metaboliche); • irritabilità psicofisica; • abbassamento delle difese immunitarie con maggiore vulnerabilità alle malattie; • cefalee; • problemi dermatologici; • disturbi della sfera sessuale. Alcuni disturbi riconducibili all'area dei MUS Uno degli scogli iniziali rispetto alla formulazione di un approccio al fenomeno, è stato probabilmente il confinamento di questo genere di problematiche all'interno di una non meglio precisata area di disturbi psicosociali dai quali il medico generalista si discostava ritenendoli indirizzabili verso discipline specialistiche. I passi in avanti compiuti nell'analisi delle interazioni fra i sistemi nervoso, endocrino ed immunitario, hanno dato vita a nuovi orizzonti nell'ambito della pratica clinica della medicina generale; in particolare grazie all'integrazione della copiosa letteratura in materia di stress.