Psychoneuroendocrinoimmunology: claim for a comprehensive vision in medical studies
RESEARCH PAPER

 

Psychoneuroendocrinoimmunology: claim for a comprehensive vision in medical studies

La Psiconeuroendocrinoinmunología: reclamo de una visión integral en los estudios médicos

 

Lutgarda María Pérez de Alejo Rodríguez1*
Carmen Xiomara Moré Chang2
Yusimí González Álvarez1
Adialys Alemán Zamora1

 

1Villa Clara University of Medical Sciences. Clinical-Surgical Hospital "Arnaldo Milián Castro". Cuba.
2Villa Clara University of Medical Sciences. Municipal Health Office. Santa Clara. Villa Clara. Cuba.

 

*Author for correspondence: E-mail: lutgardapr@infomed.sld.cu

 

 

ABSTRACT

Knowing that man's health is a complex equilibrium process sustained on the basis of biopsychosocial factors, it can be understood that both the body and the mind are affected in the presence of diseases, and in that direction patients are diagnosed and treated. This relationship allows us to understand the profound healing power since attending to these two aspects of the human being offers a more comprehensive vision in the healing process. It is the objective of the authors of this research paper to recommend the knowledge and proper use of Psychoneuroendocrinoimmunology in undergraduate and postgraduate medical studies so that physicians can offer a more comprehensive and adequate approach to the diagnosis and treatment of dissimilar diseases.

MeSH: interdisciplinary studies, medicine, education, medical.

RESUMEN

Conociendo que la salud del hombre es un proceso de equilibrio complejo sustentado sobre la base de factores biopsicosociales se puede entender que en la enfermedad se afectan tanto el cuerpo como la mente, y en esa dirección es que se diagnostican y tratan los pacientes. Esta relación permite comprender el profundo poder curativo pues atender estos dos aspectos del ser humano ofrece una visión más integral en el proceso de sanación. Es objetivo de los autores de esta comunicación recomendar el conocimiento y uso adecuado de la Psiconeuroendocrinoinmunología en los estudios médicos de pregrado y posgrado para que los galenos pueden ofrecer un enfoque más integral y adecuado al diagnóstico y tratamiento de las disimiles enfermedades.

DeSC: estudios interdisciplinarios, Medicina, educación médica.

 

 

Submitted:24/05/2019
Accepted:28/05/2019

 

 

Psychoneuroendocrinoimmunology (PNEI) is an important medical discipline and its contributions to the healing of patients should be promoted among physicians. It studies the interaction between the processes of the nervous, immune and endocrine systems of the human body. It is oriented from a transdisciplinary perspective because it brings together various specialties: Psychology, Psychiatry, Behavioral Medicine, Neuroscience, Physiology, Pharmacology, Molecular Biology, Endocrinology, Immunology, Herbal and Folk Medicine and Rheumatology, among others. It investigates the mechanisms of interaction and communication between the brain (mind/behavior) and the systems responsible for the homeostatic maintenance of the organism, guaranteed by several systems such as the nervous system (central and autonomous), the immunological and the neuroendocrine, all interrelated with the clinical implications in individuals.(1)

Thus, it is necessary to take advantage of all the teaching and scientific communication spaces that are offered in publications such as this one to emphasize the formation of a holistic doctor who deepens and strengthens his knowledge to the fullest extent about this topic. Man´s health is a complex equilibrium process sustained on the basis of biopsychosocial factors. Adaptation to the environment implies a balance of the functions of the systems of your organism; in the presence of a disease both body and mind are affected.(2,3)

Among the multiple antecedents of the PNEI it is described that in the mid-nineteenth century, Claude Bernard, a French physiologist, used for the first time the concept of "internal environment" to refer to the environment inside the human body. In the year 1878, Louis Pasteur and colleagues found that chickens subjected to adverse stimuli were more susceptible to getting sick from anthrax. Later Walter Cannon (Harvard University) observed the effects of emotions and perceptions on the autonomic nervous system, evidenced by the fact that when changes occurred in the emotional state of an animal, such as stress, anxiety or anger, it looked accompanied by the total arrest of stomach movements.(4)

In the 1950s, psychiatrist George Solomon of the University of California found that some rodents reduced the production of antibodies in situations of stress. Later the psychologist Robert Ader and the immunologist Nicholas Cohen showed that a negative signal transmitted by nerve impulses conditioned the response of the immune system:

Psychoneuroimmunology was born. Later J.E. Blalock discovered a bidirectional circuit in which the latter system acted as a sensor that communicated with the endocrine by means of lymphocyte signals through hormones that modified the internal balance of the body. After these approaches the neuropharmacologist Candace Pert revealed specific receptors (of neuropeptides) located in the cell membranes both in the brain and in the immune system and that pointed to an intimate relationship between this one and emotions.(4)

The nervous, immune and endocrine systems are interconnected. Thus, before a stimulus the organism responds with stimulation of the hypothalamic pituitary axis, this generates production of a large number of mediators such as hormones, neurotransmitters, chemokines, neuropeptides, cytokines, etc. It can be said, therefore, that the nervous and immune systems communicate and share the same molecular language composed of the aforementioned neurotransmitters, hormones, etc. It has also been discovered that lymphocytes produce neuropeptides, and these also have receptors that they were thought to be exclusive to the pituitary gland and the brain. From this group of secreted substances there is a group of molecules called peptides, also known as endorphins that are messengers that facilitate "conversation" between the nervous, endocrine and immune systems, concluding that all of them actually behave as a single system, which forms a psychosomatic network.(1)

It is described that the negative antigenic stimuli stimulate the hypothalamic pituitary adrenal axis generating the neurohormonal cascade of stress, they additionally induce sleep, fever, fatigue, weight loss, decreased libido, and in the liver they slow down the synthesis of albumin and stimulate the production of inflammatory acute phase reactants. Biopsychosocial factors such as psychological stress and depression can influence the immune system. Chronic and harmful stress (distress) has been associated with the suppression of immune function. However, acute psychological stressors (eustress) that are not harmful and physical exercise are triggers of the immune response.

Those who have studied the subject(4,5,6) agree in stating that there are some clear ways to improve psychoneuroendocrine-immune function:

 

  • The techniques of relaxation or meditation, mind control, positive thinking, the resolution of pending conflicts and the doctor's support to teach the patient to deal with psychosocial problems correctly.
  • Physical exercise improves mood and metabolism, reduces tension, generates positive emotions, calms mind, regulates functioning, raises the defenses and increases the HDL cholesterol that protects the cardiovascular system.
  • Healthy diet with vegetables, fruits and cereals to avoid toxins and ensure good hydration, and the way they eat are vital for cellular, metabolic and immune function.
  • Adequate lifestyles: elimination of toxic habits in general, sleep well and sufficiently.
  • Social support: being with friends and sharing emotions.

 

Neuroimmunomodulation(4) is very important to understand the role of psychological factors in somatic diseases (since their affectations can generate somatic pathologies and vice versa). Its correct coping will allow influencing the proper treatment of patients. Several authors(1,6) have tried to establish possible relationships between behavioral factors and the production of immunological diseases.

Psychotherapy and multiple therapies related to psychology in general influence the hypothalamic pituitary axis for good, and this mechanism proposed since long ago and strengthened today has been supported in Cuba with the current development of Herbal and Folk Medicine,(5) which has allowed among other causes that this science has had a great effectiveness in the treatment of diseases. Thus, applying psychological healing techniques have shown favorable immunological changes in patients. Other students showed that pathological psycho-affective states of anxiety and depression are accompanied by unfavorable immunological changes.(6) The psyche and the brain control all the activities of the affective sphere(7) and also influence the immune system; in theory, the human being must be able to modify the negative tendencies and direct its immune system towards an optimal state of functioning. Everything that in man manages to maintain emotional stability and away from unpleasant experiences can contribute to the optimal functioning of the immune system. An example is laughter that also provides a physical release of accumulated tensions.

It is the objective of the authors of this research paper to encourage knowledge and proper use of PNEI, as well as to deepen its contents in undergraduate and postgraduate medical studies so that physicians can give a more comprehensive and adequate approach to the diagnosis and treatment of the dissimilar diseases. Applying the knowledge of PNEI is necessary and can not be postponed because it is a tool for working from a curative point of view. This proposal is not aimed at promoting advances in diagnosis or treatment techniques, but it means broadening the conception of the relationships between the doctor and the patient, enhancing the responsibility and vision of the former by integrating individual and social needs. In this way ancestral healing patterns would be used and this would undoubtedly favor holistic healing.

 

BIBLIOGRAPHICAL REFERENCES

1. Pérez Martín OG, Vega García IG. Inmunología en el humano sano. Psiconeuroendocrinoinmunología. [Internet]. La Habana: Ecimed; 2017. Disponible en: http://www.bvs.sld.cu/libros/inmunologia_humano_sano/indice_p.htm

2. Díaz Juan FA, López Calichs E. Sistema de medios de enseñanza sobre tronco encefálico y dirección del trabajo independiente. Educ Med Super [Internet]. 2014 [citado 30/01/2018];28(4):[aprox. 10 p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21412014000400002&lng=es

3. Milián Vázquez P, Vázquez Montero L, Mesa González O, Albelo Amor M, Reyes Cabrera H, Bermúdez-Martínez J. La superación profesional de los profesores de Medicina para el perfeccionamiento del proceso de enseñanza aprendizaje. Medisur [Internet]. 2014 [citado 27/01/2018];12(1):[aprox. 9 p.]. Disponible en: http://medisur.sld.cu/index.php/medisur/article /view/2697/1449

4. Fors López M, Quesada Vilaseca M, Peña Amador D. La psiconeuroinmunología, una nueva ciencia en el tratamiento de enfermedades. Rev Cubana Invest Biomed 1999;18(1):49-53.

5. Moré Chang CX, Cabrera Hernández A, Blanco Ramos C, Morón Vázquez AM, Junco Bringa D, Hernández Moré EJ. Miniguía homeopática para instruir sobre el tratamiento de la hipertensión arterial. EDUMECENTRO [Internet]. 2018 [citado 04/01/2018];10(4):[aprox. 12 p.]. Disponible en: http://scielo.sld.cu/pdf/edu/v10n4/edu09418.pdf

6. González Álvarez Y, Pérez de Alejo Rodríguez L, León Medina A, Moré Chang CX, Alemán Zamora A. Marcadores inmunológicos humorales y su asociación con el estado psicoafectivo de pacientes con lupus eritematoso sistémico. Medisan [Internet]. 2017 [citado 27/01/2018];21(11):[aprox. 8p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1029-30192017001100015&lng=es&nrm=iso&tlng=es

7. Cabrera-Macías Y, Alonso-Remedios A, López-González E, López-Cabrera E. ¿Nos enferman las preocupaciones? Una respuesta desde la Psiconeuroinmunoendocrinología. Medisur [Internet]. 2017 [citado 14/02/2018];15(6):[aprox. 13 p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1727-897X2017000600013

 

 

Declaration of interests

The authors declare no conflict of interests

 

 

Contribution of the authors

Lutgarda María Pérez de Alejo Rodríguez y Carmen Xiomara Moré Chang: carried out the bibliographic review and the analysis of the content.
Yusimí González Álvarez: wrote the final report.
Adialys Alemán Zamora: revises the text from the scientific, didactic and semantic point of view.

 

 

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