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[免疫系统的调节——已可临床应用?]

[Conditioning of the immune system-Already clinically usable?].

作者信息

Jakobs M, Hadamitzky M, Schedlowski M, Heiß-Lückemann L

机构信息

Institut für Medizinische Psychologie und Verhaltensimmunbiologie, Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Deutschland.

Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, 171 77, Stockholm, Schweden.

出版信息

Z Rheumatol. 2023 Aug;82(6):472-478. doi: 10.1007/s00393-023-01384-9. Epub 2023 Jul 4.

Abstract

The brain and the immune system permanently exchange information via various neuronal and humoral signaling pathways. This communication network forms the basis for controlling peripheral immune functions via associative learning or conditioning processes. Establishing a learned immune reaction, an immunomodulatory drug that represents the unconditioned stimulus (US) is paired with a new odor or taste stimulus. Re-presentating this previously neutral odor or taste stimulus, its now functions as a conditioned stimulus (CS) and triggers reactions in the immune system similar to those formerly induced by the drug used as US. Using different learning protocols, it was possible to condition immunopharmacological effects in animal disease models, such as lupus erythematosus, contact allergy or rheumatoid arthritis, thereby reducing disease symptoms. Preliminary experimental studies in healthy volunteers and patients confirmed a possible clinical use of learned immune responses with the aim of using associative learning protocols as complementary measures to pharmacological interventions in clinical practice in order to reduce drug doses and thus undesirable drug side effects while maintaining therapeutic efficacy. However, there is still a great need for further research to understand the mechanisms of learned immune responses in preclinical studies and to optimize the associative learning processes for using them in the clinical routine in studies with healthy volunteers and patients.

摘要

大脑和免疫系统通过各种神经和体液信号通路持续交换信息。这种通信网络构成了通过联想学习或条件作用过程控制外周免疫功能的基础。建立一种习得性免疫反应时,将一种代表无条件刺激(US)的免疫调节药物与一种新的气味或味道刺激配对。再次呈现这种先前中性的气味或味道刺激时,它现在作为条件刺激(CS)起作用,并在免疫系统中引发与先前由用作US的药物诱导的反应相似的反应。使用不同的学习方案,可以在动物疾病模型(如红斑狼疮、接触性过敏或类风湿性关节炎)中调节免疫药理学效应,从而减轻疾病症状。在健康志愿者和患者中进行的初步实验研究证实了习得性免疫反应在临床上的可能用途,目的是将联想学习方案用作临床实践中药理学干预的补充措施,以减少药物剂量,从而减少不良药物副作用,同时保持治疗效果。然而,仍非常需要进一步研究,以在临床前研究中了解习得性免疫反应的机制,并优化联想学习过程,以便在针对健康志愿者和患者的研究中在临床常规中使用它们。

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