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Borras C, Ingles M, Mas-Bargues C, Dromant M, Sanz-Ros J, Román-Domínguez A, Gimeno-Mallench L, Gambini J, Viña J. Centenarians: An excellent example of resilience for successful ageing. Mech Ageing Dev 2019; 186:111199. [PMID: 31899226 DOI: 10.1016/j.mad.2019.111199] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 12/17/2019] [Accepted: 12/19/2019] [Indexed: 12/13/2022]
Abstract
Centenarians are remarkable not only because of their prolonged life, but also because they compress morbidity until the very last moments of their lives, thus being proposed as a model of successful, extraordinary ageing. From the medical viewpoint, centenarians do not escape the physiological decline or the age-related diseases or syndromes (i.e. frailty), but the rate of such processes is slow enough to be counterbalanced by their increased intrinsic capacity to respond to minor stresses of daily life (i.e. resilience). These new concepts are reviewed in this paper. Allostatic stresses lead to a chronic low-grade inflammation that has led to the proposal of the "inflammaging" theory of ageing and frailty. The biology of centenarians, described in this review, provides us with clues for intervention to promote healthy ageing in the general population. One of the major reasons for this healthy ageing has to do with the genetic signature that is specific for centenarians and certainly different from octogenarians who do not enjoy the extraordinary qualities of centenarians.
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Affiliation(s)
- C Borras
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain.
| | - M Ingles
- Freshage Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain
| | - C Mas-Bargues
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain
| | - M Dromant
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain
| | - J Sanz-Ros
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain
| | - A Román-Domínguez
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain
| | - L Gimeno-Mallench
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain
| | - J Gambini
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain
| | - J Viña
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain
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Qian C, Yun Z, Yao Y, Cao M, Liu Q, Hu S, Zhang S, Luo D. Heterogeneous macrophages: Supersensors of exogenous inducing factors. Scand J Immunol 2019; 90:e12768. [PMID: 31002413 PMCID: PMC6852148 DOI: 10.1111/sji.12768] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/01/2019] [Accepted: 04/11/2019] [Indexed: 12/14/2022]
Abstract
As heterogeneous immune cells, macrophages mount effective responses to various internal and external changes during disease progression. Macrophage polarization, rather than macrophage heterogenization, is often used to describe the functional differences between macrophages. While macrophage polarization partially contributes to heterogeneity, it does not completely explain the concept of macrophage heterogeneity. At the same time, there are abundant and sophisticated endogenous and exogenous substances that can affect macrophage heterogeneity. While the research on endogenous factors has been systematically reviewed, the findings on exogenous factors have not been well summarized. Hence, we reviewed the characteristics and inducing factors of heterogeneous macrophages to reveal their functional plasticity as well as their targeting manoeuvreability. In the process of constructing and analysing a network organized by disease-related cells and molecules, paying more attention to heterogeneous macrophages as mediators of this network may help to explore a novel entry point for early prevention of and intervention in disease.
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Affiliation(s)
- Caiyun Qian
- School of Basic Medical Sciences, Nanchang University, Nanchang, Jiangxi, China
| | - Zehui Yun
- Queen Mary School, Nanchang University, Nanchang, Jiangxi, China
| | - Yudi Yao
- School of Basic Medical Sciences, Nanchang University, Nanchang, Jiangxi, China
| | - Minghua Cao
- School of Basic Medical Sciences, Nanchang University, Nanchang, Jiangxi, China
| | - Qiang Liu
- School of Medicine, Nanchang University, Nanchang, Jiangxi, China
| | - Song Hu
- Queen Mary School, Nanchang University, Nanchang, Jiangxi, China
| | - Shuhua Zhang
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, Affiliated to Nanchang University, Nanchang, Jiangxi, China
| | - Daya Luo
- School of Basic Medical Sciences, Nanchang University, Nanchang, Jiangxi, China.,Affiliated Infectious Disease Hospital, Nanchang University, Nanchang, Jiangxi, China
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Schosserer M, Banks G, Dogan S, Dungel P, Fernandes A, Marolt Presen D, Matheu A, Osuchowski M, Potter P, Sanfeliu C, Tuna BG, Varela-Nieto I, Bellantuono I. Modelling physical resilience in ageing mice. Mech Ageing Dev 2018; 177:91-102. [PMID: 30290161 PMCID: PMC6445352 DOI: 10.1016/j.mad.2018.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 09/12/2018] [Accepted: 10/01/2018] [Indexed: 02/06/2023]
Abstract
Geroprotectors, a class of drugs targeting multiple deficits occurring with age, necessitate the development of new animal models to test their efficacy. The COST Action MouseAGE is a European network whose aim is to reach consensus on the translational path required for geroprotectors, interventions targeting the biology of ageing. In our previous work we identified frailty and loss of resilience as a potential target for geroprotectors. Frailty is the result of an accumulation of deficits, which occurs with age and reduces the ability to respond to adverse events (physical resilience). Modelling frailty and physical resilience in mice is challenging for many reasons. There is no consensus on the precise definition of frailty and resilience in patients or on how best to measure it. This makes it difficult to evaluate available mouse models. In addition, the characterization of those models is poor. Here we review potential models of physical resilience, focusing on those where there is some evidence that the administration of acute stressors requires integrative responses involving multiple tissues and where aged mice showed a delayed recovery or a worse outcome then young mice in response to the stressor. These models include sepsis, trauma, drug- and radiation exposure, kidney and brain ischemia, exposure to noise, heat and cold shock.
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Affiliation(s)
- Markus Schosserer
- University of Natural Resources and Life Sciences, Vienna, Department of Biotechnology, Vienna, Austria
| | - Gareth Banks
- Mammalian Genetics Unit, MRC Harwell Institute, Harwell Campus, Oxfordshire, OX11 0RD, United Kingdom
| | - Soner Dogan
- Department of Medical Biology, School of Medicine, Yeditepe University, Istanbul, Turkey
| | - Peter Dungel
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Vienna, Austria
| | - Adelaide Fernandes
- Neuron-Glia Biology in Health and Disease, iMed.ULisboa, Research Institute for Medicines, Department of Biochemistry and Human Biology, Faculty of Pharmacy, Universidade de Lisboa, Lisboa, Portugal
| | - Darja Marolt Presen
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Vienna, Austria
| | - Ander Matheu
- Oncology Department, Biodonostia Research Institute, San Sebastián, Spain
| | - Marcin Osuchowski
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Vienna, Austria
| | - Paul Potter
- Mammalian Genetics Unit, MRC Harwell Institute, Harwell Campus, Oxfordshire, OX11 0RD, United Kingdom
| | - Coral Sanfeliu
- Institute of Biomedical Research of Barcelona (IIBB) CSIC, IDIBAPS, CIBERESP, Barcelona, Spain
| | - Bilge Guvenc Tuna
- Department of Medical Biophysics, School of Medicine, Yeditepe University, Istanbul, Turkey
| | | | - Ilaria Bellantuono
- MRC/Arthritis Research-UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Department of Oncology and Metabolism, The Medical School, Beech Hill Road, Sheffield, S10 2RX, United Kingdom.
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Ni M, Wang Y, Zhang M, Zhang PF, Ding SF, Liu CX, Liu XL, Zhao YX, Zhang Y. Atherosclerotic plaque disruption induced by stress and lipopolysaccharide in apolipoprotein E knockout mice. Am J Physiol Heart Circ Physiol 2009; 296:H1598-606. [PMID: 19286965 DOI: 10.1152/ajpheart.01202.2008] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
To establish an animal model with disruptions of atherosclerotic plaques, 96 male apolipoprotein E knockout (apoE(-/-)) mice were randomly divided into stress, lipopolysaccharide (LPS), stress+LPS, and control groups (n = 24 each). All mice were fed a high-fat diet throughout the experiment, and carotid atherosclerotic lesions were induced by placement of a constrictive perivascular collar. Four weeks after surgery, mice in the LPS and stress+LPS groups were intraperitoneally injected with LPS (1 mg/kg twice per week for 8 wk). Eight weeks after surgery, mice in the stress and stress+LPS groups were treated with intermittent physical stress (electric foot shock and noise stimulation) for 4 wk. Morphological analysis revealed a plaque disruption rate of 16.7% in control, 34.8% in LPS, 54.2% in stress, and 60.9% in stress+LPS groups. The disruption rates in stress and stress+LPS groups were both significantly higher than those of controls (P = 0.007 and P = 0.002, respectively). Luminal thrombosis secondary to plaque disruption was observed only in the stress+LPS group. Both stress and LPS stimulation significantly decreased fibrous cap thickness and increased macrophage and lipid contents in plaques. Moreover, the combination of stress and LPS stimulation further lowered cap thickness and enhanced accumulation of macrophages and expression of inflammatory cytokines and matrix metalloproteinases. Stress activated the sympathetic nervous system, as manifested by increased blood pressure and flow velocity. Plasma fibrinogen levels were remarkably elevated in the stress and stress+LPS groups. In conclusion, stress- and LPS-costimulated apoE(-/-) mice provide a useful model for studies of plaque vulnerability and interventions.
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Affiliation(s)
- Mei Ni
- Shandong Univ. Qilu Hospital, No. 107, Wen Hua Xi Road, Jinan, Shandong 250012, P. R. China
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Pedraza-Sánchez S, González-Hernández Y, Escobar-Gutiérrez A, Ramachandra L. The immunostimulant RU41740 from Klebsiella pneumoniae activates human cells in whole blood to potentially stimulate innate and adaptive immune responses. Int Immunopharmacol 2006; 6:635-46. [PMID: 16504927 DOI: 10.1016/j.intimp.2005.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2005] [Revised: 08/03/2005] [Accepted: 10/07/2005] [Indexed: 11/16/2022]
Abstract
The compound RU41740 from Klebsiella pneumoniae, when used as an immunostimulant, improves responses to bacterial and yeast infections in murine models and in human trials. The aim of this study was to determine in vitro, the capacity of RU41740 to stimulate human leukocytes in whole blood. Blood samples from healthy adult donors were incubated with RU41740 for 4 or 24 h and leukocytes were assessed for levels of activation markers and cytokine production by flow cytometry and ELISA. The early activation marker CD69 was induced at 4 h in NK cells > B cells > T cells > monocytes whereas at 24 h CD80 and CD86 levels were augmented on monocytes and IL-12 was induced; HLA-DR levels increased on both B cells and monocytes. The pro-inflammatory cytokines TNF-alpha and IL-6 were produced at 4 h at similar levels to that induced by LPS and monocytes appeared to be a source of TNF-alpha. IFN-gamma, was induced at 5 h just in NK cells. Activation induced by RU41740 was not abolished by polymixin B, ruling out the possible contamination with LPS. These data indicate that RU41740 can impact not only the innate immune responses but potentially enhance adaptive immune responses by up-regulating expression of molecules involved in antigen presentation on antigen presenting cells.
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Affiliation(s)
- Sigifredo Pedraza-Sánchez
- Departamento de Investigaciones Inmunológicas, Instituto de Diagnóstico y Referencia Epidemiológicos, Secretaría de Salud, México City.
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Kanemi O, Zhang X, Sakamoto Y, Ebina M, Nagatomi R. Acute stress reduces intraparenchymal lung natural killer cells via beta-adrenergic stimulation. Clin Exp Immunol 2005; 139:25-34. [PMID: 15606610 PMCID: PMC1809256 DOI: 10.1111/j.1365-2249.2005.02672.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
There are lines of evidence that natural killer (NK) cells are sensitive to physical and psychological stress. Alterations in the immune system including NK cells are known to differ among tissues and organs. The effect of stress on the lung immune system, however, has not been well documented in spite of the fact that the lungs always confront viral or bacterial attacks as well as tumour cell metastasis. In this study, we intended to investigate the effect of restraint stress on lung lymphocytes including NK cells. C57BL/6 mice were exposed to 2 h restraint stress. The concentration of plasma epinephrine significantly rose immediately after the release from restraint as compared to home-cage control mice. Flow cytometric analysis revealed that the numbers of most lymphocyte subsets including NK cells were decreased in the lungs and blood but not in the spleen, immediately after restraint stress. Immunohistochemical examination revealed that the number of NK cells was decreased in the intraparenchymal region of the lungs, while the number of alveolar macrophages did not change. The decrease in the number of NK cells in the lungs and blood was reversed by the administration of propranolol, a nonselective beta adrenergic antagonist. Taken together, our findings suggest that acute stress reduces the number of intraparenchymal lung NK cells via activation of beta adrenergic receptors.
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Affiliation(s)
- O Kanemi
- Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, Tohoku University, Sendai, Japan.
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Godot V, Harraga S, Podoprigora G, Liance M, Bardonnet K, Vuitton DA. IFN alpha-2a protects mice against a helminth infection of the liver and modulates immune responses. Gastroenterology 2003; 124:1441-50. [PMID: 12730883 DOI: 10.1016/s0016-5085(03)00273-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND & AIMS Hepatic alveolar echinococcosis (AE), caused by the larval growth of Echinococcus multilocularis, is one of the most lethal helminthic diseases with no satisfactory treatment. Advances in the understanding of the host's immune response (Th2 responses associated with a progressive form of AE), have driven the research towards immune stimulation as an alternative possibility to treat patients. We previously reported clinical stabilization associated with a shift from a Th2 to a Th1 cytokine profile in an AE patient treated with interferon (IFN)alpha. METHODS The effects of recombinant IFN alpha-2a were analyzed in the susceptible C57BL/6J E. multilocularis infected mice. Parasitic burden, macrophage functions, and specific T-cell responses were studied 15, 45, and 90 days postinfection. RESULTS After 90 days postinfection, 75% of infected IFN alpha-2a-treated mice had no hepatic lesions and half were fully protected. IFN alpha-2a treatment markedly decreased the abnormally elevated production of IL-10 in both spleen cell cultures and peritoneal macrophage cultures from infected mice and restored phagocytosis and oxidative metabolism of macrophages. It also inhibited IL-6 and IL-13 antigen-induced secretions in spleen cell cultures. CONCLUSIONS Through its immunoregulatory properties, IFN alpha-2a may be effective in a helminthic liver infection and is a promising candidate for clinical application in AE.
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Affiliation(s)
- Véronique Godot
- World Health Organization Collaborating Center on Prevention and Treatment of Human Echinococcosis, Faculté de Médecine et de Pharmacie et Centre Hospitalier Universitaire, Université de Franche-Comte, Besançon, France
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Silva MJ, Dias A, Barreta A, Nogueira PJ, Castelo-Branco NAA, Boavida MG. Low frequency noise and whole-body vibration cause increased levels of sister chromatid exchange in splenocytes of exposed mice. TERATOGENESIS, CARCINOGENESIS, AND MUTAGENESIS 2002; 22:195-203. [PMID: 11948630 DOI: 10.1002/tcm.10012] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Chronic exposure to low frequency (LF) noise and whole-body vibration (WBV) induces both physiological and psychological alterations in man. Recently, we have shown that long-term occupational exposure to LF noise and WBV produces genotoxic effects in man expressed as an increase in sister chromatid exchange (SCE) levels in lymphocytes. The objectives of the present study were to investigate whether the observed effect could be reproduced in a murine model and, if so, which of the agents, LF noise alone or in combination with WBV, would be instrumental in the SCE induction. SCEs were analyzed in spleen lymphocytes of mice exposed to LF noise alone and in combination with WBV for 300 and 600 hr. An effect at the cell cycle kinetics level was also investigated. The results revealed significant increases in the mean SCE number per cell and in the proportion of cells with high frequency of SCEs (HFCs) in lymphocytes of mice submitted to combined noise and WBV over controls. No significant differences were found between single noise-exposed and control mice. A cell cycle delay was observed exclusively in the noise and WBV exposure groups. In conclusion, we demonstrated that, as in exposed workers, prolonged exposure to the combination of LF noise and WBV determines an increase in SCE level in mice while LF noise alone is not effective in SCE induction.
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Affiliation(s)
- M J Silva
- Center of Human Genetics, National Institute of Health, Lisbon, Portugal.
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De Castro CM, Manhães de Castro R, Fernandes de Medeiros A, Queirós Santos A, Ferreira e Silva WT, Luís de Lima Filho J. Effect of stress on the production of O(2)(-) in alveolar macrophages. J Neuroimmunol 2000; 108:68-72. [PMID: 10900339 DOI: 10.1016/s0165-5728(00)00276-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Alveolar macrophages (AM) of male rats (200-250 g), stressed or not, were evaluated with relationship to superoxide production (SP). Plasma levels of corticosterone were measured. The control group showed larger SP than the stressed group in all intervals of time. Exposure in vitro of AM to a synthetic glucocorticoid for 40 min (the same time of restraint stress) inhibits SP. Therefore, it seems under stress situations there is an increase of plasma levels of corticosterone and a decrease of SP in AM after stimulation with PMA. O(2)(-) is a potent microbicide and its reduction could cause the loss of microbicidal activity of AM.
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Affiliation(s)
- C M De Castro
- Laboratório de Imunopatologia Keizo Asami, UFPE, Setor de Microbiologia Clínica, Cidade Universitaria, 50670-901, PE, Recife, Brazil.
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de Wazieres B, Harraga S, Spehner V, Bloy C, Dupond JL, Vuitton DA, Seilles E. Effect of an auditory stress on peritoneal and alveolar cells in C57 BL/6J mice of advanced age. LUMINESCENCE 2000; 15:233-7. [PMID: 10931635 DOI: 10.1002/1522-7243(200007/08)15:4<233::aid-bio586>3.0.co;2-g] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The aim of this study was to analyse the effects of auditory stress on peritoneal and alveolar macrophages in C57 BL/6J mice of advanced age, and to compare the results to those obtained in old mice submitted to a sham stress, and to those observed in young mice submitted to the same auditory stress. We used a chemiluminescence assay to measure the production of free oxygen radicals (FOR) by macrophages. Eight 22 month-old mice were exposed to a sound stress of 110 dB for three consecutive nights; nine were submitted to a sham stress. The results were compared to those obtained in young (8 week-old) mice, 21 submitted to noise stress, and 17 controls. The corticosterone level was not increased after stress in any group. FOR production in old mice was significantly higher than that in young mice. Stress did not induce significant changes in FOR production by alveolar cells in young mice; however, the FOR production by alveolar cells was significantly higher in the stressed group than in the control group of old mice. These results show that noise stress is associated with modifications of macrophage functions that are influenced by cell localization, the behaviour of alveolar and peritoneal macrophages of old mice being clearly different in our experimental model.
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Affiliation(s)
- B de Wazieres
- Service de Médecine Interne, Immunologie Clinique et Gériatrie, C. H.U. de Besançon, 25030 Besançon Cedex, France
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Abstract
INTRODUCTION The concept of "psychoimmunology" that had long been supported by clinical observation and common sense, has acquired a sound scientific basis in the last two decades. The discovery of neuro-mediators and cytokines and their receptors shared by the central nervous system and the immune system has prompted research work using reliable methodologies to study the relationship between a 'hard' scientific field, such as immunology, and a 'soft' one, such as the behavioral sciences. CURRENT KNOWLEDGE AND KEY POINTS The complexity of the studies on stress and immunity lies upon the choice of immunological measurements and the development of reproducible stress protocols. Models of stress in experimental animals may address acute versus chronic stress, and individual versus social stress. In humans, typical situations such as academic exams, and care given to patients with dementia, for instance, have been chosen to study large groups of subjects. The development of self-questionnaires for a reliable evaluation of stress and its consequences has led to more accurate measurements of psychosocial events. In animals, acute stress usually drives the immune response towards a Th2, grossly 'immunosuppressive,' profile. In humans, acute stress associates an endocrine response (characterized by glucocorticoid secretion and hyperprolectinemia) with an immunosuppression. Chronic stress is more likely to induce a range of effects, depending on the capacity of the subject to cope with stress, and on his/her social environment. Among the numerous mediators of the hypothalamo-pituitary cascade, Corticotropin Releasing Hormone is a key factor in the stress-immunity relationship. Several studies in humans have demonstrated the influence of stress on the susceptibility to infections (including HIV infection) and on survival in malignant diseases. In autoimmune diseases, a high prevalence of depression, as well as a particular sensitivity to stressful events, seem to modify the course of conditions such as systemic lupus erythematosus, rhumatoid arthritis or Sjögren's disease. The relationship between stress and diseases is based on the pathogenic model which involves the following chain of events: stressor, reaction to stress, neuro-endocrine changes, abnormalities of the immune response, and occurrence (or aggravation) of a disease. The evolution from health to disease could be associated, at least partially, with a 'passive' immunosuppressive mode of response, mediated by the pituitary-adrenal axis, typically the opposite of an 'active,' immunostimulant mode of response, mediated by adrenergic stimulation. FUTURE PROSPECTS AND PROJECTS Concept-related problems still remain to be solved: adaptation to stress ('coping'), is both genetically and socially mediated; the significance and interpretation of stress-related abnormalities and their precise involvement in the pathogenesis of diseases may be ambiguous. However, available epidemiological and pathophysiological evidence is currently sufficient to allow physicians in their everyday practice to take stress and depression into account in order to markedly improve the prognosis of many diseases related to immune responses. Prospective studies of neuropsychological intervention, using either pharmacologic or behavioral approaches, should be made to provide the necessary rational to a psychoimmunological management of patients.
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Affiliation(s)
- D A Vuitton
- Service de médecine interne et immunologie clinique, Hôpital Jean-Minjoz, Besançon, France
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