Distilling the Complexity of the Body

The field of psychoneuroimmunology has blossomed over the last three decades, as researchers and physicians alike have sought to elucidate the multifactorial nature of a variety of diseases. The specialty bridges the fields of psychology, neuroscience, and immunology. The central tenet to this new specialty is the hypothesis that the body’s system do not exist in isolation. A disease or outside factor that has effects on one part of the body appears to affect other systems. Thus, researchers in the field of psychoneuroimmunology attempt to discover the way that the brain and immune system interplay and interact with one another.

The most intriguing connection for researchers is how changes in mood and overall feeling can induce a response from our body’s immune system. For instance, researchers have suggested that stress alone can induce an immune response similar to that of an infection. Of particular interest is the ability of chronic, or long term, stress to cause an immune response that mimics that of an actual chronic disease such as rheumatoid arthritis.

For psychoneuroimmunologists, the ability to communicate the effects of stress on the immune system is vital to providing possible solutions. A factor that affects the body’s immune response is when in a human’s life the infection or stressor occurs. Interestingly, stress in a mother before giving birth, called Maternal Immune Activation (MIA), can alter brain development in their neonate. Therefore, researchers now believe that stress at any point throughout gestation can both alter fetal development and subsequent behavior/mood throughout the baby’s lifetime.

The implications of these complex connections extend far beyond known mechanisms of action. While understanding the cytokines involved and proposing potential pharmacological interventions is important, the multifactorial nature of disease states brings about many issues for physicians and anyone in healthcare. Take breast cancer survivors, and the fact that most will suffer from cancer-related fatigue for years after remission. While conventional approaches to medicine are primarily focused on advancements in chemotherapy, those patients that successfully battle cancer are left with a complex set of symptoms to deal with. Research in psychoneuroimmunology has suggested a possible role of the HPA axis, that is the hypothalamic-pituitary-adrenal axis. Essentially the cancer itself and the subsequent treatment has permanently altered this endocrine and immune pathway. Currently, researchers across the globe are attempting to understand this complex pathway and offer solutions. This is just one example of how psychoneuroimmunologists investigate complex disease states.

The ability of medical writers to communicate the multifactorial nature of disease is paramount for creating awareness and increasing communication around the subject. The aforementioned disease states are just one example of the complex nature of our bodies. Another obstacle to overcome is how those within the healthcare community can most effectively communicate these complex states. First, it is essential to effectively communicate with others in healthcare at a high level to collaborate. This offers the most promising way to discover solutions and drive progress in the field for patients. Second, and perhaps most difficult, is the ability to explain these complex states and conditions to patient populations. This remains a difficult proposition because researchers themselves are still in dark with regards to how these diseases arise and progress.

Much progress has been made in the field of psychoneuroimmunology in the past decades. The acknowledgement of the multifactorial nature of disease, and thus the birth of this field alone was a monumental step in medicine. Looking forward, it is of the utmost importance to continue to elucidate the mechanisms which underlie these diseases and how to continue to learn how to best communicate this information across healthcare settings.

References

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Moriarity D. P. (2022). A primer on common analytic concerns in psychoneuroimmunology: Alternatives and paths forward. Brain, behavior, and immunity, 102, 338–340. https://doi.org/10.1016/j.bbi.2022.03.007

Han, V. X., Patel, S., Jones, H. F., & Dale, R. C. (2021). Maternal immune activation and neuroinflammation in human neurodevelopmental disorders. Nature reviews. Neurology, 17(9), 564–579. https://doi.org/10.1038/s41582-021-00530-8

Han, V. X., Patel, S., Jones, H. F., Nielsen, T. C., Mohammad, S. S., Hofer, M. J., Gold, W., Brilot, F., Lain, S. J., Nassar, N., & Dale, R. C. (2021). Maternal acute and chronic inflammation in pregnancy is associated with common neurodevelopmental disorders: a systematic review. Translational psychiatry, 11(1), 71. https://doi.org/10.1038/s41398-021-01198-w

Nutma, E., Willison, H., Martino, G., & Amor, S. (2019). Neuroimmunology – the past, present and future. Clinical and experimental immunology, 197(3), 278–293. https://doi.org/10.1111/cei.13279