Classes of evidence of central nervous systemimmune system interactions

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 bidirectional 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 defence and adaptation, both possesses memory and learn by experience, both contribute to homeostasis, and errors of defence by each can produce illness, for example autoimmunity or allergies on the one hand and phobias or panic on the other. Blalock (11 has referred to the immune system as a 'sixth sense', forwarding information to the brain about molecular and cellular aspects of the environment not accessible by the five senses, and, more recently, as a 'mirror on the mind'.

The classes of evidence for central nervous system-immune system interaction, some of which have been mentioned, include the following:

• direct (lesion) evidence of brain region control of immunity and of innervation of immune organs;

• psychological (trait and state) factors in the onset and course of immunologically resisted (infectious and neoplastic) and mediated (autoimmune and allergic) diseases;

• influences of stress-response hormones on immunity;

• effects of neurotransmitters and neuropeptides on immunity;

• effects of experimental stress on immunity in animals;

• effects of experimental and naturalistic life stress and exercise on immunity in humans;

• behavioural modifiers of stress effects on immunity in animals and humans;

• effects of psychoactive drugs on immunity;

• correlation of individual psychological differences with immunity in animals and man;

• occurrence of immunological abnormalities in conjunction with mental illnesses (depression and schizophrenia);

• influence of products of the immune system on the central nervous system, including immunologically induced behaviours;

• alteration by psychological intervention and exercise of immunity and the course of immunologically related diseases.

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