THE RELATIONSHIP BETWEEN HEALTH AND ILLNESS

[maria angelica sassone]

Psychoneuroimmunology, or the relationship between health and disease Psychoneuroimmunology is a branch of science that studies the complex relationships between the central nervous system (which controls biological and psychological processes ) and the immune system

Santos Leonor Santos Ruiz and Maria Ruiz Psychoneuroimmunology or, more properly, the Psiconeuroendocrinoinmunología , is a branch of science that studies the complex relationships between the central nervous system (which controls biological and psychological processes ) and the immune system . This doctrine is based on the idea that the establishment and course of disease depends on two factors: the aggressiveness of the pathogen and the degree of vulnerability of the organism attacked , the latter depending on the state, both physically and psychologically , of the body question. Of course , this idea is not new. Hippocrates said that diseases are caused by an imbalance of the ' internal moods ', which can be restored to good nutrition and rest of body and spirit. Pasteur, who believed in the microbial origin of disease , spent half my life arguing with Claude Bernard ( who defended the importance of balancing the internal milieu ) about this issue so , in his deathbed, he was right : " Bernard is right . The seed is nothing , the terrain is everything . " Without recourse to scientific or medical professionals , the ideas underlying the Psychoneuroimmunology can be found even in the lore. As shown , the mother worth urging the child to take the milk to ' be strong and do not catch diseases , "or the joke in which the doctor tells the patient: "Their ailments are not important , try to make money and see how you miss everything. " instance, it is physical strength against the disease , the second , mental or psychic strength . Psychoneuroimmunology history is not as short as , initially , we might suspect . Already in the twenties , the Soviet researchers Metalnikov and Chorin, had begun work on the conditioning of immune responses. However, this science began to be known until the work of Ader and Cohen, in the seventies , and the publication of a monograph on the subject by Ader , 1981 [ Ader , R. Psychoneuroimmunology , New York Academic Press (1981) ] . In their first experiment , published in 1975 [ Ader , R. and Cohen, N. , Psychosom Med, 37 (4) :333-340 (1975) ] , Ader and Cohen, who were studying the effects of varying the volume of a solution of saccharin in the acquisition and extinction of conditioned gustatory aversion , injected intraperitoneally cyclophosphamide -a - unconditioned aversive stimuli , 30 minutes after the rats were ingesting 1, 5, or 10 ml. saccharin solution . The magnitude of the conditioned response , and resistance to extinction, were directly proportional to the volume of solution consumed sweetened by association ' saccharine - cyclophosphamide . " Unexpectedly, some of the conditioned animals died during the tests of extinction, which was provided to animals injected with saccharin without cyclophosphamide. of this observation is demonstrated to be ascertained that cyclophosphamide has immunosuppressive properties , suggesting that during the extinction tests , the animals had reacted with immunosuppression provided conditional Serles saccharin ; immunosuppression that would make them vulnerable to opportunistic pathogens present in the medium and that, under normal conditions, are combated by the immune system . Thus, Ader and Cohen were , before their appearance in the West, a laboratory model of one of the mechanisms of action of the so-called "plague of the twentieth century ' : AIDS . The experiments were replicated Ader and Cohen , always obtaining similar results: the simple association of intake of saccharin and immunosuppressive drug gave the property saccharin solution to cause immunosuppressive response . conditioned immunosuppression has been observed by other authors in multiple experiments , showing that changes in immune reactivity produced by conditioning can occur in both directions, ie both decreasing as enhancing the immune response. Russell and colleagues provided further evidence supporting the learning ability of the immune system by demonstrating that the release of histamine (considered as a self-regulatory mechanisms of inflammation and immune responses ) may occur before the presentation of a neutral stimulus has been previously associated with immunological aggression [Russell M. et al. , Science, 225:733-734 (1984 )] . Smith and McDaniel [Smith , Jr and GR McDaniel , SM . Psychosom Med, 45:65-70 (1983 ) ] studied the possibility that they may be attenuated by conditioning (or learning ), in humans , inflammatory responses mediated by T lymphocytes Smith and McDaniel worked with a group of 7 volunteers, who underwent six times a tuberculin skin test (a substance that produces an inflammatory response upon contact with skin) at monthly intervals. In the first five sessions , a nurse who was unaware of the experimental protocol , always performed the same operation: one arm of each individual ( always the same) was treated with a substance from a green vial ( TB ) while the other was treated with a substance from a red vial (placebo ). In the sixth session , the contents of the vials was spent without the knowledge of the nurse , so that tuberculin was applied to the arm that previously received placebo and vice versa. Treatment with placebo (saline ) produced no inflammation, -which also had been expected , but the arm that received tuberculin , which formerly received placebo, experienced a much less inflammatory response than normal ( ie very response below the level recorded in previous sessions .) Kiecolt -Glaser and colleagues published in 1985 [ Kiecolt -Glaser et al. , Health Psychol , 4:25-41 (1985 ) ] the results of an experiment in which they could be improved by psychological intervention, the immune system functions a group of elders . Assigned at random to 45 residents of several nursing homes to one of three treatments: 1 .- Training in progressive relaxation 2 .- Social contact 3 .- No intervention All three groups had blood taken before treatment, at the end of the month of treatment, and one month after completion thereof. The experiment results showed a significant increase in the activity of cytotoxic K cells (' Killers ') in individuals of the first group to finish the month of treatment , whereas there were no significant changes in the components of the other two groups . In the first group, after a month without practicing relaxation exercises , the K -cell activity returned to baseline . Many more experiments , along with a slew of observations ( onset of immune diseases associated with mental illness , increased incidence of disease in people who suffer from stress or depression , etc. . ) have been demonstrated that , as advocates Psychoneuroimmunology , all diseases are the result of multiple interacting factors, which depend on both the injurious agent (bacteria , virus, carcinogen) , and the beaten body (genetic , endocrine , neurological , immunological , emotional and behavioral ). All these data, and in particular the experiment Kiecolt- Glaser et al break new ground in clinical medicine , offering the possibility to use the psychological treatment and support to drug treatment , or even as a preventive treatment of disease. Leonor Santos Ruiz is predoctoral fellow in the Department of Cell Biology and Genetics, University of Malaga. Maria Santos Ruiz is Professor of Secondary Education in the IES José Gallows in San Roque ( Cádiz)

[Myriel RAouine]