Norepinephrine and beta 2-adrenergic receptor stimulation regulate CD4+ T and B lymphocyte function in vitro and in vivo.

Historically, norepinephrine and the sympathetic nervous system have been associated with the "fight or flight" response, and they also contribute to the regulation of autonomic activity within the body, such as cardiovascular function. In addition, evidence over the past 30 years suggests that norepinephrine may also regulate the function of immune cells that protect the body against pathogens. The presence of sympathetic nerve fibers and the release of norepinephrine within lymphoid organs represent a mechanism by which signals from the central nervous system may influence immune cell function. The T cell-dependent antibody response is essential to successful host defense against numerous environmental pathogens. It is during this response that CD4+ T and B lymphocytes are activated to produce cytokines and antibody, respectively, leading to immune competence and protection. The goal of this review is to discuss the evidence supporting the release of norepinephrine within lymphoid organs and the expression of the beta2-adrenergic receptor by CD4+ T and B lymphocytes. We also discuss the mechanisms by which beta2-adrenergic receptor stimulation affects the level of cytokine and antibody produced by these cells both in vitro and in vivo. In cases where conflicting findings have been reported, we discuss potential variables that may have contributed to these conflicting findings. To conclude, we discuss the disease- and health-specific implications of the basic research being done in the area of sympathetic nervous system regulation of T and B lymphocyte function.