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39 Cards in this Set

  • Front
  • Back
In what 2 ways are the CNS and immune system connected?
1) Neuronal (direct)
2) Hormonal/Neuroendocrine (indirect)
Name 5 neuropeptides/neurotransmitters that are released during stress.
1) EPI
2) NE
4) ACh
5) Serotonin
What do these stress-activated neuropeptides/neurotransmitters stimulate?
Paraventricular Nucleus (PVN) of the hypothalamus to release CRH, which will stimulate ACTH release from anterior pituitary, which will result in cortisol release from the adrenal cortex.
What is the effect of cortisol on the immune system?
Generally, cortisol suppresses immune system cells.
How is the adrenal medulla activated to secrete its catecholamines?
Direct innervation by sympathetic nerves.
Hypothalamus activates the splanchnic nerves, which trigger chromaffin cells of the adrenal medulla to secrete catecholamines.
What activates bone marrow (leukocyte production)?
What activates the thymus?
NE, ACh, and neuropeptides.
What activates the spleen?
What activates the lymph nodes?
NE and neuropeptides.
What are the main functions of cortisol?
1) Suppressing inflammation by reducing cytokine production, T,B-cell reactivity, and NK cell activity.
2) Increasing gluconeogenesis
What effect does EPI and NE have on leukocytes?
Immediate (and short term) increase in leukocyte mobilization to the circulation. Increase NK cell activity.
What stimulates POMC and where is it synthesized?
CRH activates its release, and it is synthesized in the pituitary. POMC is enzymatically split into ACTH, MSH, and the endorphin opioid. ACTH produces cortisol.
What is an enkephalin?
An analgesic that binds to the same receptors as endorphins.
How do endorphins and enkephalins affect the immune response?
Both contribute to analgesic sensations, and also increase T-cell reactivity and NK cell activity.
What are the 2 types of stress?
1) Acute controllable
2) Chronic uncontrollable
During acute controllable stress, what 6 things are seen to increase?
1) EPI
2) NE
3) Heart rate
4) Cortisol
5) Circulating leukocytes
6) NK cell activity
What are the 5 circulating leukocytes that respond to acute stress and their cell surface markers?
1) T cells (CD3)
2) T-helper cells (CD4)
3) Cytotoxic T cells (CD8)
4) Monocytes (CD16)
5) NK cells (CD56)
Why does NK cell activity increase in response to acute stress/increased catecholamine levels?
Epinephrine and NE seem to cause an increase in the number of circulating NK cells, therefore, an increase in NK cell activity.
What happens to leukocyte levels in the serum about 1 hr. following the acute stress?
Decreases because these cells localize in the regional lymph nodes, in response to catecholamines and cortisol.
What mechanism allows this redistribution to the regional lymph nodes?
Hormonal modification of adhesion molecules on leukocyte surfaces (CD11a) and activation of adhesion molecules on endothelial surfaces (ICAM-1).
Why is the delayed type hypersensitivity (DTH) reaction used to measure immune function?
DTH activates the immune response function.
How does the the immune system respond to acute stress?
Enhances the immune response (DTH).
How does the the immune system respond to very high levels of stress?
Dulls the immune response and causes it to be less effective, similar to chronic stress response.
How does the immune system respond to chronic levels of stress?
Suppresses the immune response.
What specifically happens to the immune system in situations of chronic uncontrollable stress?
Decreased IL-1 production.
Decreased Ab production.
How do the immune systems of high stress patients compare with those of low stress patients?
High stress patients: decreased production of IL-2, increase in incidence of colds.
Which cytokines are produced as a result of chronic immune or inflammatory processes?
IL-1, TNF, IL-6.
How do these cytokines affect the CNS?
Increase ACTH production from the pituitary, which stimulates cortisol; long-term exposure causes sickness behavior.
What 3 components are increased during T and B-cell activation following a response to chronic stress?
2) Endorphins
3) Enkephalins
What is sickness behavior?
Fever, headache, muscle and joint pain, diminished appetite, lethargy caused by cytokines (IL-1, TNF, IL-6), which not only activate the immune response, but bind to the CNS and modify behavior.
By what 2 pathways do cytokines produce sickness behavior?
1) Circulation
2) Vagal (afferent) neurons
Describe the pathway of cytokines travelling to the CNS via the circulation to produce sickness behavior.
IL-1, TNF, and IL-6 cross the blood-brain barrier through circumventricular organs (barrier deficient areas) and bind to neurons that express receptors for IL-1, TNF, and IL-6.
What is the pathway of cytokines travelling to the CNS via the nervous system to produce sickness behavior?
IL-1 produced by leukocytes travels via the vagal afferents to the brain.
Why don't the immune system and the fight or flight response work together over the long term?
Both require very high amounts of energy and resources, so when one is activated, the other is suppressed in order to maximize energy.
Describe how the immune system responds to increases in catecholamines.
Initially, leukocytes are mobilized to the circulation and then to regional lymph nodes. Over time, cortisol will continue to be released which suppresses immune system activity.
What advantage is there immediately after the initiation of the fight or flight response?
More lymphocytes are present and waiting in regional lymph nodes to react to a potential antigenic challenge.
What disadvantage is there after prolonged state of sympathetic response?
Longer and larger cortisol release suppresses the immune response.
What happens to leukocytes immedately after the sympathetic response?
EPI and NE will result in an initial increase in plasma leukocytes, and then a drastic drop as they're mobilized to the regional lymph nodes by EPI and Cortisol.
What will restore the plasma levels of leukocytes in the circulation following exposure to long term stress (cortisol)?
A drop in EPI, NE, and Cortisol levels.