Neuroendocrine immune responses to inflammation: the concept of the neuroendocrine immune loop.

The neuroendocrine and immune responses to inflammatory stress represents an integrated circuit whose basis is reviewed in this chapter. Pro-inflammatory cytokines such as IL-1 beta, TNF-alpha and IL-6 released from inflammatory foci initiate local anti-inflammatory mechanisms and travel via the blood stream to the brain where they trigger a variety of neuroendocrine counter-regulatory mechanisms. There is therefore an important neuroendocrine-immune loop in which stimulatory signals are received by the neural systems from inflammatory foci. These signals are transduced by the hypothalamus which initiates a complex hormonal cascade reaction aimed at modulating inflammation and returning the organism to normal physiological homeostasis once the trigger has been neutralized. Abnormalities in this cross-talk can profoundly influence the susceptibility to developing chronic inflammatory disease. Thus, in conclusion, the neuroendocrine-immune loop has important pathophysiological implications for disease processes.