Imported: Neuro Test 2: Dickinson_Psychoneuroimmunology

Front 1

What is psychoneuroimmunology?

Back 1

Psychoneuroimmunology is the study of the relationship between immunity, the endocrine system, and the central and peripheral nervous systems

Front 2

what is Supersystem dysregulation

Back 2

there is a connection btw the nervous system, immune system, and endocrine system,

when this connection is disrupted, health, function and well-being suffer (fatigue, sleep disturbance, impaired physical and mental function, and depression)

Front 3

4. How does stress affect the immune system?

Back 3

stress leads to the release of cytokines that can affect the HPA axis and lead to widespread effects on the body (TH1 and TH2 release is modified)

Front 4

Th2 skewing vs. Th1 skewing

**Diminished cellular immunity**
predisposes to diseases caused by
intracellular pathogens (rhinovirus;
EBV reactivation)

**Enhanced humoral immunity**
- predisposes to autoimmunity (autoreactive IgG antibodies that drive MS, RA)

- allergy (IgE)

Back 4

Th2 skewing

Proinflammatory cytokines IL-1, IL-6 and TNF-alpha stimulate CRH release from the hypothalamus and thus affect the HPA axis (Th2 shift)

Front 5

Th2 skewing vs. Th1 skewing

**Diminished humoral immunity**
- predisposes to diseases caused by extracellular microbes

**Enhanced cellular immunity**
- predisposes to inflammatory diseases such as IBD

Back 5

Th1 skewing

Front 6

remember that Cells of the gut include immune cells (T cells, B cells, mast cells,
neutrophils, macrophages, NK cells, and dendritic cells) and non-immune cells (enterocytes, M cells, goblet cells, enteroendocrine cells, etc).
and all of them can be controlled by....

Back 6

The Enteric NS

Front 7

what is Indoleamine 2,3-dioxygenase (IDO)?

role?

what 2 substances does it effect, and what does this lead to?

Back 7

An immunosuppressive enzyme

Rate-limiting enzyme of tryptophan catabolism

when Trp is depleted: arrests T cells, induces T cell apoptosis, induces Tregs

also leads to increased Kyn which generates tolerogenic DCs, suppresses T cell responses

Front 8

in addition to cytokines, what role does IDO play?

Back 8

affects serotonin and melatonin

can lead to depression, SZ, etc

these ppl will have higher IDO

Front 9

psychoneuroimmunology is the study of the relationship btw what?

*TEST

Back 9

Immune, endocrine, and nervous system

Front 10

dude suffers from RA and he has just started med school. He is preparing for his first test in anatomy, he visits your office complaining of a marked increase in RA symptoms, what is responsible for this?

*TEST

Back 10

Marked increase in Th2 response

Front 11

What do you call chronic or uncontrolled activation of a complex stress response system that negatively impacts a person’s somatic, visceral and psychosocial health

Back 11

Allostasis

Front 12

Glucocorticoids and catecholamines released
in response to stress have two main effects on the immune system:

What are they?

Back 12

1) Systemic immunosuppression

2) Th2 (↓ cellular immunity, ↑ humoral immunity)

**this is b/c immune cells have GC and NE receptors and cellular function is modulated by these molecules**

Front 13

ENS & Th2 Cytokine with anti-inflammatory effects?

Back 13

Front 14

What is the pro-inflammatory peptide released by the ENS?

Back 14

Front 15

Know this shit...

Back 15

Front 16

A 23-year-old pregnant female presents with generalized anxiety disorder. As an osteopathic physician you educate her about ways to reduce stress and emphasize that during pregnancy, stress is associated with a greater risk of:

1. Allergy
2. High birth weight
3. Preterm birth
4. Scleroderma
5. Vascular disease

Back 16

3. Preterm birth

Front 17

The neuroimmune modulator released from enteric neurons that has proinflammatory effects by acting on Th1 cells and APCs is:

1. Acetylcholine
2. Epinephrine
3. Norepinephrine
4. Substance P
5. Vasoactive intestinal peptide

Back 17

4. Substance P

Front 18

Role for inflammatory processes in the etiology of depression?

Back 18

1. Elevated inflammatory markers in depressed individuals

2. Induction of depressive symptoms with the
administration of proinflammatory cytokines

3. High co-occurrence of depression and diseases that are classified as autoimmune (MS, RA)