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Cytokines and the Brain: Implications for Clinical Psychiatry

 Someone posted a question about their CFS and PTSD and wanted to know which came first. This is a murky and difficult analysis. The mind/body connection is well known but more recent articles indicate that the body/mind connection can be as pertinent as the mind/body connection. 

Cytokines are immune cells that activate immune response but they also act on the neurological. This article explores the idea of psychiatric conditions and immunity. 


Abstract

OBJECTIVE: This article reviews recent developments in cytokine biology that are relevant to clinical psychiatry.METHOD: The authors reviewed English-language literature of the last 15 years that pertains to the biology of cytokines with emphasis on central nervous system effects in general and psychiatric disorders in particular.RESULTS: Growing evidence suggests that, in addition to providing communication between immune cells, specific cytokines play a role in signaling the brain to produce neurochemical, neuroendocrine, neuroimmune, and behavioral changes. This signaling may be part of a generalized, comprehensive mechanism to mobilize resources in the face of physical and/or psychological stress and to maintain homeostasis. The clinical implications of these findings are far-reaching and include a possible role for cytokines in the pathophysiology of specific psychiatric disorders such as major depression, schizophrenia, and Alzheimer’s disease. The effects of cytokines in the central nervous system may provide a possible mechanism for the “sickness behavior” of patients with severe infection or cancer, as well as for the neuropsychiatric adverse effects of treatment with interferons and interleukins.CONCLUSIONS: A better understanding of the role of cytokines in various brain activities will enhance knowledge of specific psychobiological mechanisms in health and disease and provide opportunities for novel treatment interventions.

Neuroscience and immunology are two of the fastest growing fields of knowledge in the medical sciences. One area where these two fields overlap is the biology of cytokines. Cytokines are generally known as chemical messengers between immune cells. As such, they play a crucial role in mediating inflammatory and immune responses. The discovery a decade or two ago that cytokines signal the brain and serve as mediators between immune and nerve cells is far-reaching in its implications. The brain is now seen as capable of influencing immune processes. Conversely, changes in brain activity can occur in association with an immunologic response. In this context, the immune system is seen as a sensory organ, monitoring not so much the external world, but rather the internal milieu of the organism. Information regarding infection or injury is conveyed to the brain, which in turn sets in motion important metabolic and behavioral pathways directed toward maintenance of homeostasis and restoration of health. Many of these functions are mediated by cytokines, which can often act both as immunomodulators and as neuromodulators. A large body of literature is now emerging that details interactions between brain cells and immune cells and the role of specific cytokines in these complex interactions (1–3).

On the clinical level, advances in cytokine research have had a profound effect on our understanding of the pathophysiology of various medical conditions and on the formulation of new treatments (4). These developments are particularly relevant to immune-related disorders such as infection, allergy, autoimmune diseases, and cancer. Furthermore, clinicians dealing with various clinical entities are incorporating specific cytokines in their patients’ treatment regimens. Clinical psychiatrists can benefit from familiarizing themselves with principles of cytokine physiology, both to better understand the role cytokines may play in the pathophysiology of specific psychiatric disorders and to deal more effectively with the neuropsychiatric adverse effects of treatment with cytokines.


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