neural immune pathways and their connection to inflammatory diseases神经免疫途径及其连接炎性疾病.pdfVIP

Available online /content/5/6/251 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 inflamma