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NEUROSCIENCIE IN IMMUNOLOGY

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Abstract
The field of immunology is principally focused on the molecular mechanisms by which hematopoietic
cells initiate and maintain innate and adaptive immunity. That cornerstone of attention has been expanded by recent discoveries that neuronal signals occupy a critical regulatory niche in immunity. The discovery is that neuronal circuits operating reflexively regulate innate and adaptive immunity. One particularly well-characterized circuit regulating innate immunity, the inflammatory reflex, is dependent upon action potentials transmitted to the reticuloendothelial system via the vagus and splenic nerves. This field has grown significantly with identification of several other reflexes regulating discrete immune functions. As reviewed here, the delineation of these mechanisms revealed a new understanding of immunity, enabled a first in class clinical trial using bioelectronic devices to inhibit cytokines and inflammation in rheumatoid arthritis patients, and provided a mosaic view of immunity as the integration of hematopoietic and neural responses to infection and injury.

Index
Reflexes maintain health in organ systems
The Inflammatory Reflex
Splenic neural circuits modulating antibody production
Vagus nerve-adrenal reflex
Enteric neural reflexes
Sensory axon-axon reflex
Nociceptive reflexes in lung
A gateway reflex
Neural reflexes in cancer

Conclusions
The discovery that neurons operating reflexively are functional components of the immune system represents a fundamentally new insight into understanding of immunity. Cells of hematopoetic origin share the frontline of host defense with neurons. Monocytes and neurons both detect changes in the environment. Macrophages can respond by producing cytokines and other mediators, and neurons respond by producing action potentials. Neurons and macrophages indeed share the responsibility for mobilizing host responses to infection and injury and share responsibilities for producing a coordinated and balanced immune response. Highly conserved neural circuits act reflexively to maintain homeostasis during the development of immunity, and inflammation. This discovery has raised many more questions that future students of immunology will likely approach, expanding their research focus from cells of hematopoetic origin to include neurons. These new studies of immunology that exploit essentials from neuroscience will continue to enlighten our understanding of basic principles governing immunity.


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