Monday, October 10, 2011 - 0 comments

The Mind-Body Interaction in Disease : 7. New Approaches to Treatment

By : Esther M. Sternberg and Philip W. Gold

Immune Cells. Altered Genetic Activity in immune
cells is an effect of cortisol. The
cortisol receptors in immune cells are
folded and bound to large “heat-shock”
proteins. When cortisol enters a cell and
binds to its receptor, the protein is displaced
and the receptor unfolds. The receptor
then binds to DNA in the nucleus,
changing the cell’s transcription of messenger
RNA (mRNA) and production of
proteins. (Other molecules called c-fos
and c-jun bind with the receptor and confer
more specificity on its action.) The
proteins leave the cell and directly affect
cytokine and lymphocyte production.
For centuries, taking the cure at a mountain sanatorium or a hotsprings spa was the only available treatment for many chronic diseases. New understanding of the communication between the brain and immune system provides a physiological explanation of why such cures sometimes worked. Disruption of this communication  network leads to an increase in susceptibility to disease and can worsen the course of the illness. Restoration  of this communication system, whether through pharmacological agents or the relaxing effects of a spa, can be the first step on the road to recovery.

A corollary of these findings is that psychoactive drugs may in some cases be used to treat inflammatory  iseases, and drugs that affect the immune system may be useful in treating some psychiatric disorders. There is growing evidence that our view of ourselves and others, our style of handling stresses, as well as our genetic  makeup, can affect activities of the immune system. Similarly, there is good evidence that diseases associated with chronic inflammation significantly affect on one’s mood or level of anxiety. Finally, these findings suggest that classification of illnesses into medical and psychiatric specialties, and the boundaries that have  emarcated mind and body, are artificial.

* * *

ESTHER M. STERNBERG and PHILIP W. GOLD carry out their research on stress and immune systems at the National Institute of Mental Health, where Sternberg is chief of the section on neuroendocrinology and behavior and Gold is chief of the clinical neuroendocrinology branch. Sternberg received her M.D. from McGill University. 
Her work on the mechanisms and molecular basis of neuroimmune communication has led to a growing recognition of the importance of the mindbody interaction. She also is an authority on the L-tryptophan eosinophilia myalgia syndrome, which reached almost epidemic proportions in 1989. Prior to joining the NIMH in 1974, Gold received his medical training at Duke University and Harvard University. Gold and his group were among the first to introduce data implicating corticotropin- releasing hormone and its related hormones in the pathophysiology of melancholic and atypical depression and in the mechanisms of action of antidepressant drugs.


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