Neuroendocrine immunology: new pathogenetic aspects and clinical application

Neuroendocrine immunology: new pathogenetic aspects and clinical application

Straub RH.

Z Rheumatol. 2011 Nov;70(9):767-74.

After two decades of enormous improvements in anti-inflammatory therapy with biologics long-standing disease sequelae in chronic inflammatory diseases (CID) can be recognized, such as fatigue, anorexia/malnutrition, cachectic obesity, insulin resistance, dyslipidemia, changes of steroid hormone axes (e. g. loss of androgens), increased sympathetic nervous tone/decreased parasympathetic nervous tone, inflammation-related anemia and osteopenia. This article demonstrates for the first time in the German language a new theory to explain the pathophysiology of these disease sequelae. It includes concepts from evolutionary medicine and neuroendocrine regulation of energy allocation. The core statement is: the networks of energy regulation and energy allocation have been evolutionarily positively selected for transient inflammatory episodes (not for CIDs due to the negative selection pressure) but long-standing use of these adaptive programs for CID support systemic disease sequelae. These considerations might help to deviate focus from pure anti-inflammatory treatment to adequate diagnosis and therapy of systemic disease sequelae.

Source: Labor für Experimentelle Rheumatologie und Neuroendokrinoimmunologie, Klinik und Poliklinik für Innere Medizin I, Universitätsklinikum Regensburg,

supported by

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