SISTEMA INMUNOLÓGICO Es aquel que tiene como función la defensa del cuerpo ante la acción de cualquier agente externo potencialmente. MARIANELA CASTÉS Dr. George Solomon y Alfred Amkraut ¿Qué es? La psiconeuroinmunologia es el campo científico transdisciplinario que. HISTORIA. Aristóteles dijo: ” Psique (alma) y cuerpo reaccionan complementariamente una con otro, en mi entender, un cambio en el estado.

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The field is usually referred to as psychoneuroimmunology or “PNI”. The psychologist Robert Ader coined the term in the late ‘s, but it is also known by the equally ponderous terms neuroimmunomodulation and, less commonly, as neuroendocrinoimmunology or behavioral immunology. Its clinical aspects range from an understanding of the biological mechanisms underlying the influence of psychosocial factors on the onset and course of immunologically resisted and mediated diseases to an understanding of immunologically-generated psychiatric symptoms.

Its basic scientific aspects involve understanding the complex interaction of neuroendocrine and immunologically generated networks in maintaining health and combating disease.

Psychoneuroimmunology may provide a basis for understanding the biological dynamics of humanistic medicine and of alternative or complimentary medical techniques and offers the hope of developing new non-linear models of health and disease.

By its very nature, psychoneuroimmunology bridges the traditional disciplines of psychiatry, psychology, neurology, endocrinology, immunology, neuroscience, internal medicine, and even surgery wound healing. Interdisciplinary collaboration is generally essential and intrinsic to its research. The field is rapidly growing, as evidenced by the 14 chapters of the First Edition of it major textbook, the 46 chapters of its Second Edition 2 and the 80 chapters of the three-volume Third Edition.

Ancient and pre-modern wisdom reflected awareness of body-mind bi-directional interaction. Aristotle said, “Psyche and body react sympathetically to each other, it seems to me. A change in the state of the psyche produces a change in the structure of the body, and conversely, a change in the structure of the body produces a change in the state of the psyche.

The British physiologist George Day noted increasing difficulty in adjustment in the months prior to the onset of the disease and said, that psychological factors can and do influence the course of tuberculosis, once its is established, can be witnessed by anyone who has the opportunity of watching a patient’s progress over a reasonably long period 3.

In perhaps the most intriguing observation of this period, it was found that physically healthy relatives of patients with rheumatoid arthritis who had in their sera the autoantibody characteristics of that disease, rheumatoid factor anti-immunoglobulin Gwere better adjusted psychologically, on average, than those lacking the factor, suggesting that psychological well-being might have a protective influence in the face of a genetic vulnerability 5.

Conversely, at least one autoimmune disease, SLE, can produce psychiatric symptoms, even as an initial clinical feature 6. The relatively voluminous literature, of highly varied quality, on personality factors predisposing to cancer and psychological factors predictive of outcome are harder to interpret psychoneuroimmunologically, since only some cancers such as malignant melanoma, non-Hodgkin’s lymphoma, and some breast cancers clearly are resisted immunologically, although the case for immunological resistance to metastatic dissemination via natural killer cell cytotoxicity is impressive 7,8.

The scientific foundations of psychoneuroimmunology are the subjects of a compilation of historical papers, a few of which will be cited 9. By the late s and early s, animal experiments implied that stress could affect both humoural and cellular immunity.

Rasmussen, Marsh, and Brill found that mice subjected to avoidance learning stress were more susceptible to herpes simplex virus infection. Wistar and Haldemann found that the same stress prolonged the retention of homografts.

Psiconeuro inmunología by alejandra galvez on Prezi

The first direct experimental evidence of stress effects on immunity was that of a reduction of antibody response to antigen as a result of group housing stress in rodents by Vessey and by Solomon s. About the same time, Solomon, Levine, and Kraft demonstrated that early life experience infantile handling might affect antibody response in adult life. The larger area of immunological abnormalities that occur in conjunction with mental illnesses began with work of Solomon and Fessel on abnormal immunoglobulin levels and brain-reactive antibodies in some patients with schizophrenia.

The most definitive early research in psychoneuroimmunology, largely overlooked in the West, was that of Korneva and Khai working in then-Leningrad. Inthey reported that destructive electrolytic lesions in the dorsal hypothalamus of rabbits led to a suppression of the development of complement-fixing antibodies and prolonged retention of antigen in the blood. Thus, they had proven that the brain was involved in immunoregulation, a subject of speculation in Solomon and Moos paper, Emotions, Immunity, and Disease 3sometimes referred to as a marker of the beginning of the field.


A number of prescient papers were published in the s and s by the Yugoslav immunologist B. For example, he pointed out antigenic similarities between brain and immunological proteins.

The most critical paper to establish credibility and significance of brain-immune communication, however, was that of Robert Ader and Nicholas Cohen in on taste-aversion conditioned immunosuppression.

If a conditioned stimulus saccharin could produce the immunosuppression of an unconditioned stimulus the drug cyclophosphamidethen brain and learning must relate to immunological responses. Subsequently, Ader and Cohen discovered, relevantly both clinically and in regard to dw nature of the placebo response, the ability to utilize this type of conditioning to prolong the life of mice with an autoimmune disease, lupus, by treatment mainly with saccharin Remarkably, it was only after a general acceptance of the phenomenon of conditioning of immunity which was subsequently shown to be able to be accomplished in up-regulatory as well as down-regulatory directions was it realized that in the phenomenon had been demonstrated regarding peritoneal inflammation by Metalnikov and Chorine working at the Pasteur Institute, science truly before its time.

The critical link between the immune system and the brain in the neuroendocrine-immune axis was convincingly demonstrated by Besedovsky and Sorkin in the late s. They showed that immune activation antigenic stimulation triggers the hypothalamic-pituitary-adrenal HPA axis in an immunoregulatory role. The next milestone was the then-controversial finding by Edwin Blalock that immunologically competent cells lymphocytes can synthesize hormones ACTH and neuropeptides Ograve;-endorphinformerly thought only produced by neuroendocrine cells psiconeuroimunologia There are a variety of categories of evidence–experimental and naturalistic, basic and clinical, animal and human, in vitro and in vivo, medical and psychiatric–for bi-directional communication between the central nervous system and various components of the immune system.

Teleologically, it makes sense that these two systems should be linked. Both relate the organism to the outside world and assess its components as harmless or dangerous; both serve functions of defense and adaptation; both possesses memory and learn by experience; both contribute to homeostasis; errors of defense by each can produce illness, e.

Blalock has referred to the immune system as a sixth sense, forwarding information about the environment to the brain about molecular and cellular aspects of the environment not accessible by the five senses The classes of psiconeuroinmunoolgia for CNS-immune interaction, some of which have been mentioned, include: Regarding direct evidence of neural modulation of immunity 12pioneering work on the hypothalamus was mentioned.

Psiconeuroinmunologja neurons fire in spatial and sequential ways after antigen administration, and HPA axis is activated by antigen and pro-inflammatory cytokines in a stress-like way. Immune organs, including thymus, spleen, and bone marrow, receive sympathetic innervation with synapse-like junctions between nerve endings and immunocytes.

Immunity is regulated in a cerebrocortical laterally specific way with the left cortex influencing T cell maturation and function. Negative affect and failure of coping have been related to rate of progression, degree of incapacitation, and poorer response to medical treatment, particularly of rheumatoid arthritis.

In regard to allergies, a less well-studied area, stress, anxiety, and depression have been related to both delayed T cell psiconeuroinumnologia immediate B cell hypersensitivities and to atopic dermatitis and asthma 14, 15, There is a somewhat controversial literature suggesting that hypnosis can alter immediate and delayed hypersensitivity The psychoneuroimmunology of cancer is an area of increasing attention The antigenicity of neoplasms vary and, thus, the ability of immune system to resist specific cancers.

Immunotherapies are gaining attention, particularly for treatment of melanoma, psifoneuroinmunologia, and breast cancer. The natural killer Lq cell, a non-B, non-T lymphocyte, has cytotoxic activity that is non-specific and non-histocompatibility locus antigen HLA restricted.

Many experimental and clinical studies in human and animals have shown this cell type to be sensitive to influence in numbers and activity by stressors and psychosocial factors.

Psychoneuroimmunology: synopsis of its history, classes of evidence and their implications

The NK cell may play a role in immune surveillance against newly-emerged neoplastic cells but is clearly known to play an important role in prevention of metastatic spread of cancer. Stress increases metastatic spread of mammary carcinoma in the rat via suppression of NK cell cytotoxicity Psycho-oncology, which is the subject of a separate section of this text, is concerned with quality as well as duration of life in cancer patients. Psychoneuroimmunology suggests these two are linked. At this date, only one psychotherapeutic intervention study included immunological as well as clinical outcome variables, that of Fawzy and colleagues When compared with controls, patients with malignant melanoma undergoing a structured psychiatric group intervention at 6 month follow-up showed more effective coping, less distress, and greater stimulability of NK cells.


Intervention patients showed less recurrence and greater survival 6 years later. Psychoneuroimmunology, stress and infection, the topic of old observations and early experimental work, is now the focus of rigorous research Subjects given a variety of cold-causing viruses intranasally developed both antibody evidence of infection and clinical colds in a dose-response manner in proportion to increases in degree of perceived psychological stress There is much confirmation of earlier work on stress effects on viral and bacterial including mycobacterial infections in experimental animals.

Stress responsive hormones, including but not limited to adrenal corticosteroids and catecholamines, have a myriad of effects of various aspects of the immune response in both down- and up-regulatory fashion The HPA axis, as mentioned, triggered itself by immunological as well as psychological events, is immunoregulatory, and both corticotropin-releasing factor CRF and adrenocorticostimulating hormone ACTH have direct effects on immunity in addition to those via induction of release of cortisol.

Growth hormone increases T and NK cell functions in aged animals. Prolactin antagonizes glucocorticoid-induced immune suppression.

Gonadal hormones affect immunity. NK cell activity is higher in the luteal phase of the menstrual cycle which should influence surgeons in the timing of cancer surgery in pre-menopausal women. Cellular immunity is depressed during pregnancy. Thyroid hormones may stimulate NK activity, affect T cell development, and modulate the affect of cytokines on immune cells Beta-endorphin is a stimulant of NK cell activity.

Substance P, co-released with norepinephrine at sympathetic nerve endings, may be particularly important in local immunity and psychological influences thereon. Vasoactive intestinal peptide VIP modulates immunoglobulin production. The sympathetic neurotransmitter also a hormone norepinephrine mobilizes NK cells into the circulation and probably is responsible for their increase during acute stress.

Cerebral catecholamines and indolamines e. Experimental stress and immunity in animals, already mentioned in pioneering studies, is the subject of a very large literature Type, duration, intensity, timing in relation to antigen administrationand controllability of the stressor are all relevant to its immunological impact.

In primates, social support is a modifier of stress effects Behavioural response to the stressor, such as defeat posture, may be critical to the immunological outcome. T cell function, NK cell activity, antibody response to immunization, macrophage function, activation of latent viruses like herpes simplex controlled by cellular, not humoural immunity.

Such effects increasingly are being shown to have health implications. Social support can ameliorate stress effects.

Consulta en Psiconeuroinmunología

Natural disasters can have prolonged effects on immunity Exercise can affect immunity positively or negatively Acute aerobic exercise transiently increases NK cell numbers and activity. Overtraining without adequate periods of rest and recovery can diminish NK and T cell functions and increase incidence of infectious diseases. Several studies have reported an association between physical inactivity and risk of colon cancer, and animal tumourigensis experiments tend to show that regular exercise reduces tumour burden.

Even moderate exercise in very frail elderly people can reduce both NK and T cell functions, quite contrary to the effects of moderate endurance exercise on increasing resistance to infectious disease in psiconeugoinmunologia. Exercise psiconeuroinmunoloyia lifespan in rats fed ad libitum.

The combination of exercise and severe food restriction found in patients with anorexia nervosa leads as in experimental animals to morbid immunosuppression. Drugs of abuse, particularly alcohol, have adverse effects on various aspects of immunity and susceptibility to infectious diseases 33, Fetal alcohol exposure can permanently affect endocrine and immune responses.

Alcohol inhibits production of pro-inflammatory cytokines, reduces NK cell activity and suppresses B and T cell immunity. Although HIV-seronegative heroin addicts generally have reduced immune functions, persons maintained on methadone in a state of steady tolerance have normal immunity. Other psychoative drugs often have immune effects. Benzodiazepines antagonize CRF-induced suppression of NK cell activity and may, thus, modify stress effects on immunity Individual differences in behaviour, coping styles, and psychological traits may be accompanied by differences in immunological characteristics.

Inbred female mice that showed spontaneous fighting behaviour showed greater immunological resistance to a virus-induced tumour A pessimistic explanatory style correlated with lower measures of cell-mediated immunity The topic of immunologic abnormalities that occur in conjunction with major mental illnesses needs to be divided between those associated with depression affective disorders and with schizophrenia, a much more muddled area of research.