Lissoni Paolo
Divisione di Radioterapia Oncologica, Ospedale San Gerardo, 20052 Monza (Milano), Italy.
Neuro Endocrinol Lett. 1999;20(6):343-349.
Even though cytokines may fundamentally act as local factors, the recent advances in the knowledge of neuroimmunomodulation (NIM) would suggest the existence of a central regulation of their secretion and activity. Several neuroactive substances have appeared to influence cytokine secretion, and on the other hand cytokines may modulate the neuroendocrine functions. However, at present only for the pineal gland, whose fundamental NIM role is well known, it is possible to recognize reciprocal influences between cytokine action and pineal endocrine activity, suggesting the existence of feedback mechanisms responsible for a central regulation of cytokine network. Melatonin (MLT), which is the most investigated pineal immunomodulating hormone, may stimulate IL-2 release by T helper-1 (TH-1) lymphocytes and that of IL-12 by dendritic cells (DC), whereas both IL-2 and IL-12 would inhibit MLT release. The physiological significance of IL-2-IL-12-MLT interactions would be the maintenance of an effective TH-1-dependent cellular immunity, including the anticancer immune response. A third possible pineal-cytokine feedback mechanism involves tumor necrosis factor-alpha (TNF-alpha) secretion, with a stimulatory effect of TNF-alpha on MLT release and an inhibitory one of MLT on TNF-alpha production. This finding would explain the anti-cachectic property of MLT itself. A further knowledge of pineal-cytokine interactions, as well as of other endocrine-immune circuits, will allow a better definition of the physiopathology of human chronic immunoinflammatory diseases, whose clinical course has appeared to be influenced by psychoemotional factors.
尽管细胞因子可能从根本上作为局部因子起作用,但神经免疫调节(NIM)知识的最新进展表明,其分泌和活性存在中枢调节。几种神经活性物质似乎会影响细胞因子的分泌,另一方面,细胞因子可能调节神经内分泌功能。然而,目前仅对于松果体,其基本的NIM作用是众所周知的,才有可能识别细胞因子作用与松果体内分泌活性之间的相互影响,这表明存在负责细胞因子网络中枢调节的反馈机制。褪黑素(MLT)是研究最多的松果体免疫调节激素,它可能刺激辅助性T细胞1(TH-1)淋巴细胞释放白细胞介素-2(IL-2)以及树突状细胞(DC)释放IL-12,而IL-2和IL-12都会抑制MLT的释放。IL-2-IL-12-MLT相互作用的生理意义在于维持有效的TH-1依赖性细胞免疫,包括抗癌免疫反应。第三种可能的松果体-细胞因子反馈机制涉及肿瘤坏死因子-α(TNF-α)的分泌,TNF-α对MLT释放有刺激作用,而MLT对TNF-α的产生有抑制作用。这一发现可以解释MLT本身的抗恶病质特性。对松果体-细胞因子相互作用以及其他内分泌-免疫回路的进一步了解,将有助于更好地定义人类慢性免疫炎症性疾病的病理生理学,其临床病程似乎受到心理情绪因素的影响。