Well today the subject of my talk is sex hormones, are they the next generation of psychotropics and immunomodulators? In attempting to answer this question, we have to look at psychoneuroendoimmunology. The convergence of the field of psychiatry, neurology, endocrinology and immunology is one of the most exciting and rapidly advancing areas of medical science. By considering these classically defined systems as a single interconnected super system, the emerging field is empowering clinicians with an expanded interdisciplinary perspective for addressing today’s most challenging health concerns.
A particularly intriguing area of this evolving paradigm is a growing body of evidence and the role of sex steroids, endogens, oestrogens, progesterone, neural and immune function. These discoveries are setting the stage for novel endocrine based approaches to managing neurological and immunological conditions. So our learning objective today is to review psychoneuroendoimmunology as an emerging medical paradigm, to review endocrine immune interactions with effects of sex steroids on immunity, to review the effects of sex steroids in the central nervous system and on various neurotransmitter systems and look at some practical applications of PNEI by doing some case reviews.
Now this is a very interesting topic and I provided you many more slides in your conference CD than I’m able to present this afternoon. Please enjoy perusing these, I do want to spend a fair amount of time on two selected case studies which I believe will help illuminate the points I’m making today.
So where did psychoneuroendoimmunology PNEI systems start? To answer that question we need to go back to 1964. We now understand the science behind psychoneuroendoimmunology long before we understood the science behind it, people knew there was a relationship. In 1964, George F. Solomon of the University of California in Los Angeles coined a term psychoimmunology and published a landmark paper, Emotions, Immunity and Disease; A Speculative Theoretical Integration. In 1975, Robert Ader a psychologist and Nicholas Cohen an immunologist at the University of Rochester, advanced this concept with their demonstration of classic conditioning of immune function and coined the term psychoneuroimmunology. Then in 1981, David Felten then working at Indiana University of Medicine discovered a network of nerves leading to blood vessels as well as cells of the immune system. This discovery provided one of the first indications of how neuroimmune interactions occur. Felten, along with Ader and Cohen, went onto edit the ground-breaking book Psychoneuroimmunology in 1981 which laid out the underlying premise that the brain and immune system represent a single integrated system of defence. In 1985, research by neuropharmacologist Candace Pert of the NIMH and at Georgetown University and her colleagues, made the radical discovery that every neuropeptide receptor we could find in the brain is also on the surface of the human monocyte. So she revealed that neuropeptide specific receptors are present on the cell walls of both the brain and the immune system, which has had an impact on the understanding of emotions as well as of disease. In 1997, Candace Pert published her book Molecules of Emotion; it was considered a landmark work by establishing the biomolecular basis for our emotions and her pioneering research on how the chemicals inside our bodies form a dynamic network linking mind and body was considered not only provocative but was revolutionary.
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