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In the Name of God Neuroimmunoendocrinology PharmD Class, 25-Ordibehesht-95 Dr F Noorbakhsh, Dept. of Immunology, TUMS Longest name for a field! Neuroimmunoendocrinology PsychoNeuroImmunoEndocrinology! Dr F Noorbakhsh, Dept. of Immunology, TUMS Longest English Word! PsychoNeuroImmunoEndocrinology + a bit of Pharmacology Pneumonoultramicroscopicsilicovolcanoconiosis Dr F Noorbakhsh, Dept. of Immunology, TUMS Immune system Endocrine system Nervous system Dr F Noorbakhsh, Dept. of Immunology, TUMS Immune system Endocrine system Nervous system Dr F Noorbakhsh, Dept. of Immunology, TUMS Immune system Endocrine system Nervous system Dr F Noorbakhsh, Dept. of Immunology, TUMS OK! Let’s open this up! Immune infiltration of CNS Immune system Endocrine system Nervous system Dr F Noorbakhsh, Dept. of Immunology, TUMS Neuroimmune interactions OK! Let’s open this up! Immune infiltration of endocrine glands Immunoendocrine interactions Immune system Endocrine system Nervous system Dr F Noorbakhsh, Dept. of Immunology, TUMS Immune infiltration of endocrine glands Immune infiltration of CNS Immune system Immunoendocrine interactions Endocrine system These Nervous system Dr F Noorbakhsh, Dept. of Immunology, TUMS categorizations! are approximate Neuroimmune interactions Main questions about the interactions between NE and Immune systems • Why are they connected? • How are they connected? • What are the effects of these connections? Dr F Noorbakhsh, Dept. of Immunology, TUMS 1- Why are they connected? Dr F Noorbakhsh, Dept. of Immunology, TUMS The two-dimensional response chart Self Autologous molecules Neoplasms, injured cells Safe Microbial flora, Food, pollens Nonsafe Infectious agents Non-self There is a similarity in function! Immune system • Safe-nonsafe recognition • Self-nonself recognition • Regulates relationship with the Microbial world • Sensory-effector system Dr F Noorbakhsh, Dept. of Immunology, TUMS There is a similarity in function! Nervous system • Safe-nonsafe recognition • Self-nonself recognition • Regulates relationship with the Physical world • Sensory-effector system Dr F Noorbakhsh, Dept. of Immunology, TUMS Physical world sensor-effector Microbial world sensor-effector Dr F Noorbakhsh, Dept. of Immunology, TUMS 2- How are they connected? Dr F Noorbakhsh, Dept. of Immunology, TUMS Cytokines Hormones Neurotransmitters Dr F Noorbakhsh, Dept. of Immunology, TUMS Cytokines Hormones Neurotransmitters Dr F Noorbakhsh, Dept. of Immunology, TUMS From the NE to Immune system • Leukocytes have adrenoceptors – (mainly beta2 AR) • Leukocytes have glucocorticoid receptors • Leukocytes have receptors for other neuroendocrine factors (ACTH, FSH, LH, GH, prolactin, catecholamines, neuropeptide-Y, and enkephalins) Dr F Noorbakhsh, Dept. of Immunology, TUMS Dr F Noorbakhsh, Dept. of Immunology, TUMS From the NE to Immune system • Leukocytes have adrenoceptors • Leukocytes have glucocorticoid receptors • Leukocytes have receptors for other neuroendocrine factors (ACTH, FSH, LH, GH, prolactin, catecholamines, neuropeptide-Y, and enkephalins) Dr F Noorbakhsh, Dept. of Immunology, TUMS Leukocytes listen to adrenal (both cortex and medulla) B Cell CD4T Cortex Cathecolamines Mφ CD8T medulla NK Glucocorticoids Dr F Noorbakhsh, Dept. of Immunology, TUMS From the NE to Immune system • Leukocytes have adrenoceptors • Leukocytes have Glucocorticoid receptors • Leukocytes have receptors for other neuroendocrine factors (ACTH, FSH, LH, GH, prolactin, catecholamines, neuropeptide-Y, and enkephalins) Dr F Noorbakhsh, Dept. of Immunology, TUMS Leukocytes listen to hypophysis! CRH GH B Cell CD4 T TSH Mφ CD8T PRL NK ACTH LH/FSH Dr F Noorbakhsh, Dept. of Immunology, TUMS From Immune system to the NE • Cytokine receptors are present on the surface of astrocytes and neurons • The cytokines IL-1, TNF- α and INF-α can change the function of the HPA axis. Dr F Noorbakhsh, Dept. of Immunology, TUMS Cytokines hormones neurotransmitters hormones neurotransmitters cytokines Dr F Noorbakhsh, Dept. of Immunology, TUMS • What are the effects of these interconnections? Dr F Noorbakhsh, Dept. of Immunology, TUMS Some major neuroimmune phenomena • Sickness behavior • Stress and immune system • Depression and immune system • Schizophernia and immune system Dr F Noorbakhsh, Dept. of Immunology, TUMS Sickness behavior • • • • • Depressed mood, Fatigue, Psychomotor slowing, Anorexia, fever Sleep disturbances, Cognitive dysfunction. Proinflammatory cytokines (IL-1, TNF-α) Anything else? Dr F Noorbakhsh, Dept. of Immunology, TUMS Genetic studies on obese mice The discovery of leptin (1994)! Dr F Noorbakhsh, Dept. of Immunology, TUMS Leptin; what does it do? Food intake Adipose tissue Arc .N PVN Leptin Appetite Satiety Neuropeptide Y Leptin; what does it do? Food intake Adipose tissue Arc .N PVN Leptin Appetite Satiety Neuropeptide Y db/db mice Ob/Ob mice Male: 1-5 ng/dl Sexually dimorphic: Female: 7-13fold ng/dl F/M: 2-3 Leptin levels Overweight Full Hungry Full Hungry Dr F Noorbakhsh, Dept. of Immunology, TUMS Normal Hungry Leptin; can we use it as a drug? Dr F Noorbakhsh, Dept. of Immunology, TUMS Adipokines! Stress and Immune system STRESS: A specific response by the body to a stimulus that disturbs or interferes with normal physiological equilibrium/homeostasis Dr F Noorbakhsh, Dept. of Immunology, TUMS Dr F Noorbakhsh, Dept. of Immunology, TUMS Stress and immune system Dr F Noorbakhsh, Dept. of Immunology, TUMS Stress and immune system Shifts the Th1/Th2 balance towards Th2. Decreases cytotoxic T-cell and NK-cell activities. Impairs cellular immune response. Increases IL-1, IL-6, TNF-α Decreases IL-2, IFN-γ Decreases MHC I and II expression Dr F Noorbakhsh, Dept. of Immunology, TUMS Risk of cancers Intracellular bacterial infections Viral infections Stress Allergy/ atopy Th1-mediated autoimmunities? Dr F Noorbakhsh, Dept. of Immunology, TUMS Stress enhances Th1-related autoimmunities! Multiple sclerosis Rheumatoid arthritis Stress Type 1 Diabetes Autoimmune thyroid disease Crohn’s disease Dr F Noorbakhsh, Dept. of Immunology, TUMS A multiple-dimensional immunohomeostasis Dr F Noorbakhsh, Dept Immunology, TUMS Stress and immune system Cathecolamines Glucocorticoides Dr F Noorbakhsh, Dept. of Immunology, TUMS Depression and immune system • An increase in plasma concentration of proinflammatory cytokines IL-1, IL-2 & IL-6 • Concentrations of proinflammatory cytokines in patients with major depression correlate with disease severity and HPA activity. Dr F Noorbakhsh, Dept. of Immunology, TUMS TCAs Antidepressants Imipramine Clomipramine Amitriptyline Nortriptyline … TCAs Imipramine Clomipramine Amitriptyline Nortriptyline … Brain adrenergic pathways’ involvement in depression Antidepressants MAOI Dr F Noorbakhsh, Dept. of Immunology, TUMS Phenelzine TCAs Antidepressants MAOI Imipramine Clomipramine Amitriptyline Nortriptyline … Phenelzine Fluoxetine Paroxetine Serteraline Citalopram … SSRI Brain serotonergic pathways’ imbalance causes depression Venlafaxine SNRI Dr F Noorbakhsh, Dept. of Immunology, TUMS Desvenlafaxine… Serotonin synthesis pathway Tryptophan TPH 5-HT IDO degradation Dr F Noorbakhsh, Dept. of Immunology, TUMS Serotonin Immune system and depression? Proinflammatory cytokines Indolamine dioxygenase (IDO) Tryptophan 5HT precursors Depression Dr F Noorbakhsh, Dept. of Immunology, TUMS KYNA Low grade inflammation QUIN Overt inflammation (neuroinflammatory disorders) Neuropsychopharmacology Reviews 2012 Any other mechanisms? Immune activity Dr F Noorbakhsh, Dept. of Immunology, TUMS Depression BH4 Tryptophan Phe TPH BH4 BH4 PAH TH Tyr 5-HT Serotonin DOPA Dopamine Norepinephrine BH4 Arginine NOS Nitric oxide Dr F Noorbakhsh, Dept. of Immunology, TUMS Another mechanism! Neuropsychopharmacology Reviews 2012 Questions and comments Dr F Noorbakhsh, Dept. of Immunology, TUMS فال اقسم بمواقع النجوم ... Quiz! کدام یک از سایتوکاین های زیر با تاثیر بر سیستم عصبی-1 میشود؟Sickness behavior باعث ایجاد عالئم TNF-a -الف TGF-b -ب IFN-gamma -ج IL-2 -د Dr F Noorbakhsh, Dept. of Immunology, TUMS