Wechselwirkungen zwischen neuroendokrinem System und Immunsystem bei chronisch-entzündlichen Systemerkrankungen

Zusammenfassung

Hormonelle und neuronale Signalwege können die Manifestation einer chronisch-entzündlichen Systemerkrankung entweder begünstigen oder verhindern. Bei bereits manifester Erkrankung modulieren Hormone und Neurotransmitter den Krankheitsverlauf, in dem sie die Krankheitsaktivität erhöhen oder abschwächen. Beispiele hierfür sind der entzündungshemmende Einfluss der körpereigenen und exogenen Glukokortikoide und die entzündungsfördernden Effekte von Stress bei chronisch-entzündlichen Systemerkrankungen. Bei chronisch-entzündlichen Systemerkrankungen ringt das aktivierte Immunsystem mit dem Gehirn und anderen Organsystemen um Energie, was zu vielfältigen Erkrankungsfolgen und Folgeerkrankungen führt: „sickness behaviour“ mit Fatigue-Symptomatik und depressiven Symptomen, Schlafstörungen, Anorexie, Fehl- und Mangelernährung, Knochenabbau, Muskelabbau und kachektische Fettsucht, Insulinresistenz mit Hyperinsulinämie (begleitet von einer Resistenz gegenüber dem Insulin-like growth factor 1), Dyslipidämie, Veränderungen der Steroidhormonachsen, Störungen der Hypothalamus-Hypophysen-Gonaden-Achse, erhöhter Sympathikotonus, herabgesetzte Aktivität des parasympathischen Nervensystems, arterielle Hypertonie und Volumenbelastung, Entzündungsanämie und zirkadiane Rhythmik der Symptomausprägung. Diese für die Patienten gravierenden Folgeerkrankungen, welche den chronisch-entzündlichen Systemerkrankungen inhärent sind, sollten konsequent therapiert werden.

Abstract

Hormonal and neuronal pathways either support or inhibit the manifestation of chronic inflammatory systemic diseases before the onset of the disease. After the onset of the disease, hormones and neurotransmitters may stimulate or inhibit the disease. Hormones and neurotransmitters modulate the course of the disease after disease onset. Examples are: 1) cortisol inhibits systemic chronic inflammatory disease, and 2) stress stimulates systemic chronic inflammatory disease. The active immune system in systemic chronic inflammatory diseases competes with the brain and other organ systems for energy-rich fuels, which leads to several disease sequelae. Chronic disease sequelae are sickness behaviour/fatigue/depressive symptoms, sleep disturbances, anorexia and malnutrition, bone loss, muscle wasting and cachectic obesity, insulin resistance with hyperinsulinaemia (accompanied by resistance to insulin-like growth factor–1), dyslipidaemia, alterations in the steroid hormone axes, disturbances of the hypothalamic-pituitary-gonadal (HPG) axis, elevated sympathetic tone, hypertension and volume overload, decreased parasympathetic tone, inflammation–related anaemia, and circadian rhythms of the symptoms. Disease sequelae are inherent to the disease and must be consistently treated.

Schlüsselwörter

Chronische Entzündungskrankheit - Hormone - Nervensysteme - Immunsystem - Energiehaushalt

Key words

Chronic inflammatory disease - hormones - nervous systems - immune system - energy regulation

Publication History

Article published online:
02 March 2021

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