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Introducing PsychoneuroimmunologyAncient cultures in America, Asia, Africa, and Europe seemed to have accepted an interconnection between the brain and our ability to ward off disease. Since the late nineteenth century, scientific evidence has been illuminating the bidirectional communication between the nervous, endocrine, and immune systems. In the 1980’s the mechanisms involved in this connection had come to be known as neuroimmunomodulation (NIM). NIM originally dealt less with endocrine and more with neural communications. Hundreds of NIM articles are indexed in the National Library of Medicine database MEDLINE. Neuroendocrinimmunology (NEI) refers to the interrelationships of immune functioning cells and neural and endocrine functions. In the late 1980’s, the overall study of these interactions began to be most commonly called psychoneuroimmunology (PNI). PNI generally deals with the relationship of psychological processes to immune function. The most appropriate name for the current field should be psychoneuroendocrinimmunology (PNEI). But, I suppose that name really pushes the bounds of utility. So, until the major luminaries in the field come up with another idea, PNI is likely to be the umbrella term used when we mean PNEI. PNI uses techniques from molecular biology and psychology to investigate a wide array of interactions. Information has been integrated from medicine and its related sciences including, biochemistry, chronobiology, genetics, anatomy, and ethology (the study of biology of animal behavior). Evidence has accumulated along ontogenic, phylogenetic, and anatomic lines as well as biochemical. Embryologically, some parts of the thymus (an important immune system organ) derive from neural crest ectoderm. Evolutionarily, many hormones and their receptors may have originated in microbes, and it is possible that later diversity resulted in the immune, neural and endocrine systems. Adrenocorticotropic hormone (ACTH) related genes and other stress related homeostatic cytokines (cellular communication molecules) are represented in a variety of primitive organisms (, ). Hormones of the neuroendocrine system and direct innervations by the autonomic nervous system can modulate immune system associated bone marrow and thymus functions, and activity of macrophages and lymphocytes (two important types of immune system cells) (). Immune competent cells have receptors for hormones and neurotransmitters. Indeed, a recent review states that cells of the immune system possess receptors for all of the known neurotransmitters and hormones (). And, certain areas of the brain express lymphocyte associated cytokines and cytokine and complement receptors (important soluble elements of the immune system) (, ). Immunocytes can produce neuropeptides, and nerve cells can produce immune-associated cytokines (). Immunohistochemical staining of tissues in the skin has revealed neuropeptides in cutaneous nerve fibers as well as in all the cutaneous cells that were examined (). These cells include Langerhans cells, fibroblasts, lymphocytes, endothelial cells, and keratinocytes. These neuropeptides include neurotransmitters, hormones, neuromodulators, and growth factors. Neuromediators have been shown to be critical components in regulating the dermal immune system (). Mast cells (another powerful immune system cell), found in almost all tissues including the brain, produce at least 50 mediators including biogenic amines that may function as neuromodulators (e.g., epinephrine, serotonin, and dopamine) or peptides that may function as hormones (e.g., corticotropin releasing hormone, somatostatin, substance P, and vasoactive intestinal peptide) (). It is now generally acknowledged that the nervous, endocrine, and immune systems are parts of an integrated system of adaptive processes (). Abundant evidence exists for the following.
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