Intensive Care Medicine,Anesthesiology,Nijmegen Institute for Infection, Inflammation and Immunity, and
Intensive Care Medicine,Nijmegen Institute for Infection, Inflammation and Immunity, and.
Proc Natl Acad Sci U S A. 2014 May 20;111(20):7379-84. doi: 10.1073/pnas.1322174111. Epub 2014 May 5.
Excessive or persistent proinflammatory cytokine production plays a central role in autoimmune diseases. Acute activation of the sympathetic nervous system attenuates the innate immune response. However, both the autonomic nervous system and innate immune system are regarded as systems that cannot be voluntarily influenced. Herein, we evaluated the effects of a training program on the autonomic nervous system and innate immune response. Healthy volunteers were randomized to either the intervention (n = 12) or control group (n = 12). Subjects in the intervention group were trained for 10 d in meditation (third eye meditation), breathing techniques (i.a., cyclic hyperventilation followed by breath retention), and exposure to cold (i.a., immersions in ice cold water). The control group was not trained. Subsequently, all subjects underwent experimental endotoxemia (i.v. administration of 2 ng/kg Escherichia coli endotoxin). In the intervention group, practicing the learned techniques resulted in intermittent respiratory alkalosis and hypoxia resulting in profoundly increased plasma epinephrine levels. In the intervention group, plasma levels of the anti-inflammatory cytokine IL-10 increased more rapidly after endotoxin administration, correlated strongly with preceding epinephrine levels, and were higher. Levels of proinflammatory mediators TNF-α, IL-6, and IL-8 were lower in the intervention group and correlated negatively with IL-10 levels. Finally, flu-like symptoms were lower in the intervention group. In conclusion, we demonstrate that voluntary activation of the sympathetic nervous system results in epinephrine release and subsequent suppression of the innate immune response in humans in vivo. These results could have important implications for the treatment of conditions associated with excessive or persistent inflammation, such as autoimmune diseases.
过度或持续的促炎细胞因子产生在自身免疫性疾病中起着核心作用。交感神经系统的急性激活可减弱先天免疫反应。然而,自主神经系统和先天免疫系统都被认为是不能被自愿影响的系统。在此,我们评估了训练计划对自主神经系统和先天免疫反应的影响。将健康志愿者随机分为干预组(n=12)和对照组(n=12)。干预组的受试者接受冥想(第三只眼冥想)、呼吸技术(如周期性过度通气后保持呼吸)和暴露于寒冷(如浸入冰冷水中)的训练 10 天。对照组未接受训练。随后,所有受试者均接受实验性内毒素血症(静脉内给予 2ng/kg 大肠杆菌内毒素)。在干预组中,练习所学技术会导致间歇性呼吸性碱中毒和缺氧,从而导致血浆肾上腺素水平显著升高。在干预组中,内毒素给药后抗炎细胞因子 IL-10 的血浆水平更快地增加,与之前的肾上腺素水平密切相关,并且更高。促炎介质 TNF-α、IL-6 和 IL-8 的水平在干预组中较低,与 IL-10 水平呈负相关。最后,干预组的流感样症状较低。总之,我们证明了在人类体内,自主神经系统的自愿激活会导致肾上腺素释放,并随后抑制先天免疫反应。这些结果对于治疗与过度或持续炎症相关的疾病(如自身免疫性疾病)可能具有重要意义。