Getting Nervous About Immunity

Keith W Kelley, PhD

 

During the past 80 years, Western medicine has witnessed the development and growth of more than two dozen medical specialties. These certification boards were complemented by publication of specialty biomedical scientific journals such as the Journal of Immunology (1915), Endocrinology (1927) and the Journal of Neuroscience (1981). Classic distinctions between immunology, endocrinology and neuroscience have faded during the past 25 years with the realization that the central nervous and immune systems are connected in ways that were previously unknown. During the last 50 years or so, growth of medical specialties has occurred along with the American culture of taking pills. Six out of ten Americans utilize at least one prescription drug, and more than one in ten use five or more prescription medicines. The major prescription medicines are used for chronic health conditions, many of which have been related to stress: anti-hyperlipidemic agents, anti-depressants, prescription proton-pump inhibitors and muscle relaxants. Prescription drugs have specific targets, but often they adversely affect other tissues and organs. Psychoneuroimmunology and the scientific journal, Brain, Behavior, and Immunity, searches for the underlying cause and potential efficacy of both drug and non-drug interventions. As but one example of the need for an integrative physiological approach to biomedical research, many of us have at one time or another experienced the fever, headache, fatigue, lack of appetite, sleepiness and lethargy that are caused by influenza viruses. All of these symptoms are regulated to a large degree by the brain. But, studying only the central nervous system in a vacuum that is devoid of an understanding of the immune system is not a realistic representation of the health consequences of the flu. That is because cells of the immune system recognize components of the virus and then signal the brain that an infection has occurred in the lungs. Central neuronal circuits are activated to cause physiological and behavioral changes that promote homeostasis. Similar scenarios apply to other costly major non-communicable diseases, including cancer, diabetes and cardiovascular and chronic lung diseases, as well as mental health disorders such as depression, anxiety and autism. The reciprocal brain-immune communication system is now known to regulate stress responses, appetite, fever, sleep, cognition, pain and mood. Some of the current and hottest topics in the field are investigating ancient health practices such as mindfulness-based meditation, Tai Chi, exercise, perinatal health and the gut microbiome (doi: https://doi.org/10.1016/j.bbi.2017.08.013). The American culture of taking pills would likely be reduced if these approaches to promote health were incorporated more fully into Western medical practices. Just as psychoneuroimmunology and Brain, Behavior, and Immunity originally challenged the specialization philosophy that is so prevalent today in medicine, it is now exploring the integrative physiological events that underlie century-old health practices. This approach has already revealed that some age-old interventions are just as efficacious as prescription drugs.