Endocrinology 4

Immune Endocrine Interactions

Immune System Review

• Innate

• Adaptive

Cytokines

• Chemokines– Chemotactic

• Inflammatory – TNF etc

• Anti-inflammatory– IL – 6

• Growth factors– Interferon

Cytokines Communication

• Autocrine– Self

• Paracrine– Neighbor

• Juxtacrine– Specific neighbor

• Endocrine– blood

Important Cytokines

• Tumor necrosis factor– Pro-inflammatory– Mobilization of anti-microbial substances– Denial of TNF increases infections– Can induce production of other cytokines as

well as cortisol– Can induce apoptosis in T-cells and tumor

cells

Important Cytokines

• Interleukin 10– Anti-inflammatory– Immunostimulatory

• Production of B cells

• Interleukin 6– Increased in response to variety of stresses– Acute phase proteins

• Protease inhibitors• Microbial recognition proteins(C-reactive)• Cytokine antagonists• Activation of lipolysis

Stress Response

• Stressor

• Stress-response

• Systems stimulated by stress– Hormonal

• Cortisol• Endorphins

– Sympathetic nervous system• Epinephrine• norepinephrine

Stress Response

• Increases energy availability

• Increased oxygen uptake

• Changes in blood flow

• Inhibition of non-essential systems

• Decreased pain perception

• Enhancement of memory and sensory function

Stress Response

• Systems Inhibited by Stress– GnRH, FSH, LH – GH and somatomedins

• Short term stress my increase GH in humans

Stress Response

• Metabolic– Insulin inhibited– Glucagon, glucocorticoids, cathecholamines

increase– Body becomes catabolic

• Cardiovascular– HR, BP go up– Vasopressin goes up– Blood flow changes

Stress Response

• Gastrointestinal– Gastric hormones decrease– Can stress make H. pylori infections worse?

• Reproductive– Sex hormones drop– GnRH inhibited by endorphins and CRH– Implantation less likely because of diminished

progesterone

Stress response Pathology

• Catabolism• Increased CV tone• Suppression of

digestion• Suppression of

growth• Suppression of

reproduction• Suppression of

immunity

• Fatigue, myopathy• Hypertension• Ulcers

• Psychogenic dwarfism

• Anovulatory, impotence

• Impaired disease resistance