Microglia: gatekeepers for neuropathic pain
Evolving Concepts Introduction Where acute pain protects an individual from further damage, chronic pain serves no adaptive purpose. Approximately 1 in 5 people suffer from chronic pain, which exacts a substantial toll on the both the individual and on national economies [1–3]. Chronic pain can arise due to unresolved inflammation (e.g., rheumatoid arthritis), damage to […]
The Cross-talk between the Dopaminergic System and Innate Immunity: An Evolving Concept
Evolving Concept Dopamine (DA) is a well-known neurotransmitter in the central nervous system (CNS). An increasing body of evidence, however, indicates that DA is also an important communication mediator at the neural-immune interface [1-3]. Most research and studies to date have put the emphasis on DA and it’s regulation of adaptive immunity. Comparatively little is […]
An Evolving Concept: The Pathologic Level of Brain TNF is a Therapeutic Target for Chronic Pain Treatment
Evolving Concept Chronic pain is a serious healthcare dilemma with many treatment options available, such as antidepressants, non-steroidal anti-inflammatory drugs, opioids, and anticonvulsants; nevertheless, chronic pain presently is not appropriately managed. A fundamental reason for the lack of effective treatment is that none of these drugs specifically target a process that is essential in eliciting […]
Understanding the Role of Inflammation in Fatigue Requires Multidimensional Assessments
Evolving concepts Introduction “I am tired”. What does this sentence actually imply? In a recent review published in Frontiers in Immunology [1], we suggest that the different dimensions of fatigue (Figure 1) should be specifically investigated, in subjective as well as objective ways. This is especially important if we are to comprehend the role of […]
The selfishness of the brain and immune systems provoke energy deficiency in aging and chronic inflammation
Evolving Concepts “I feel exhausted with mental stress and with systemic inflammation, but why?” In recent publications [1-5], in highly active chronic inflammatory diseases, I demonstrated how energy shortage due to an active and selfish immune system can stimulate a plethora of common signs and symptoms listed here (list is not complete): daytime fatigue and […]
Pro-Inflammatory Th17 Cells and Glucocorticoid Resistance: Implications for Chronic Inflammatory Diseases and Their Treatment
Evolving Concepts Summary Th17 have heterogeneous phenotypes and functions, and can have pro- or anti-inflammatory activities. Pathogenic Th17 cells have been associated to several inflammatory and autoimmune diseases. Besides IL-17A and IL-17F, they also produce GM-CSF and IFN-γ, and express high levels of IL-23R. These cells are refractory to glucocorticoid (GC)-mediated T cell suppression, with […]
Beta-Adrenoceptors and Tumor Development: Novel Concepts and Clinical Implications
Evolving Concepts Over the last 3 decades, an increasing body of evidence suggests that catecholamine-dependent signalling may represent a major link between chronic stress and tumor progression. Studies addressing the relationship between stress-activated pathways and cancer progression suggest that stress-induced production of adrenaline and noradrenaline, besides affecting the anti-tumor immune response also displays direct tumor-promoting […]
The Nervous System’s Relationship to Immune Events: ‘Broadly Based but Cell-Faced’ – ‘wAPC’ as Hardwired Antigen Presenting Cells
Evolving Concepts In many textbooks, predominantly targeting medical students, i.e. anatomy, histology and physiology, or in more specialized areas of interest such as immunology or neurobiology, the innervation of immune organs is still something of a mystery as concerns the peripheral nervous system. One reason may be that the fields of immunology and neurobiology have […]
Perispinal Delivery of CNS Drugs: From Corning to Perispinal Etanercept
Evolving Concepts Introduction Familiarity with the anatomy and physiology of the cerebrospinal venous system (CSVS) is necessary to understand the therapeutic potential of perispinal injection for treatment of central nervous system (CNS) disorders [1, 2]. The CSVS is composed of the confluence of the venous systems of the spine and the brain, which together constitute […]
Sympathetic Dysautonomia in Fibromyalgia: Brief Overview
Evolving Concepts Fibromyalgia (FM) is a stress-related disorder that predominately affects women. FM’s outstanding clinical features are chronic widespread pain, paresthesias, allodynia, fatigue, sleep difficulties and cognitive impairment. Other FM associated symptoms relate to irritable bowel, temporo-mandibular dysfunction and interstitial cystitis [1]. FM pathogenesis has not been elucidated. Our group has proposed dysautonomia as an […]
