Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, Essen, Germany; Health Sciences Department, Metropolitan Autonomous University (UAM), Campus Lerma, Mexico; and Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden.
Physiol Rev. 2020 Jan 1;100(1):357-405. doi: 10.1152/physrev.00033.2018. Epub 2019 Aug 22.
The phenomenon of behaviorally conditioned immunological and neuroendocrine functions has been investigated for the past 100 yr. The observation that associative learning processes can modify peripheral immune functions was first reported and investigated by Ivan Petrovic Pavlov and his co-workers. Their work later fell into oblivion, also because so little was known about the immune system's function and even less about the underlying mechanisms of how learning, a central nervous system activity, could affect peripheral immune responses. With the employment of a taste-avoidance paradigm in rats, this phenomenon was rediscovered 45 yr ago as one of the most fascinating examples of the reciprocal functional interaction between behavior, the brain, and peripheral immune functions, and it established psychoneuroimmunology as a new research field. Relying on growing knowledge about efferent and afferent communication pathways between the brain, neuroendocrine system, primary and secondary immune organs, and immunocompetent cells, experimental animal studies demonstrate that cellular and humoral immune and neuroendocrine functions can be modulated via associative learning protocols. These (from the classical perspective) learned immune responses are clinically relevant, since they affect the development and progression of immune-related diseases and, more importantly, are also inducible in humans. The increased knowledge about the neuropsychological machinery steering learning and memory processes together with recent insight into the mechanisms mediating placebo responses provide fascinating perspectives to exploit these learned immune and neuroendocrine responses as supportive therapies, the aim being to reduce the amount of medication required, diminishing unwanted drug side effects while maximizing the therapeutic effect for the patient's benefit.
行为条件免疫和神经内分泌功能的现象已经被研究了 100 年。伊万·彼得罗维奇·巴甫洛夫(Ivan Petrovic Pavlov)及其同事首次报道并研究了联想学习过程可以改变外周免疫功能的现象。他们的工作后来被遗忘了,这也是因为人们对免疫系统的功能知之甚少,更不知道学习这一中枢神经系统活动如何影响外周免疫反应的潜在机制。45 年前,通过在大鼠中使用味觉回避范式,人们重新发现了这一现象,它是行为、大脑和外周免疫功能之间相互作用的最迷人的例子之一,并将心理神经免疫学确立为一个新的研究领域。依靠对大脑、神经内分泌系统、主要和次要免疫器官以及免疫细胞之间传出和传入通讯途径的不断增长的认识,实验动物研究表明,细胞和体液免疫和神经内分泌功能可以通过联想学习方案进行调节。这些(从经典角度来看)习得的免疫反应具有临床相关性,因为它们影响免疫相关疾病的发展和进展,更重要的是,在人类中也是可诱导的。关于引导学习和记忆过程的神经心理学机制的新知识,以及最近对介导安慰剂反应的机制的了解,为利用这些习得的免疫和神经内分泌反应作为支持性治疗提供了迷人的视角,其目的是减少所需药物的数量,减少不必要的药物副作用,同时最大限度地提高治疗效果,使患者受益。