The Central Nervous System and Rheumatoid Arthritis

More proof that there is a mind/body connection. This is a study regarding the central nervous system and rheumatoid arthritis.

From ScienceDaily.com:

A study by researchers at the University of California, San Diego School of Medicine shows that, in rheumatoid arthritis, inflammation in the joints can be sensed and modulated by the central nervous system (CNS). The research suggests that the CNS can profoundly influence immune responses, and may even contribute to understanding so-called placebo effects and the role of stress in inflammatory diseases.

The central nervous system is not just a passive responder to the outside world, but is fully able to control many previously unanticipated physiologic responses, including immunity and inflammation," said Gary S. Firestein, M.D., Professor of Medicine, Chief of the Division of Rheumatology, Allergy and Immunology, and Director of UCSD's Clinical Investigation Institute, who led the study.

"This is an entirely new approach," Firestein said. "Instead of targeting enzymes at the actual site of disease, our hypothesis is that the central nervous system is a controlling influence for the body and can regulate peripheral inflammation and immune responses."

The scientists used a novel drug delivery system to administer miniscule amounts of a compound that blocks signals only in the CNS and then determined the influence of the treatment on peripheral arthritis.

We observed that the p38 signal is turned on, or activated, in the central nervous system during peripheral inflammation," Firestein said. "If we blocked this enzyme exclusively in a highly restricted site but not throughout in the body, inflammation in the joints was significantly suppressed."

Not only were clinical signs of arthritis diminished in those rats where p38 inhibitors were administered into the spinal fluid, but damage to the joint was also markedly decreased. The same dose of the inhibitors administered systemically had no effect.

The group also explored whether TNFĄ might also play a role in this observation. Using a TNF-inhibitor that is approved for use in rheumatoid arthritis and is usually given throughout the body, the scientists showed that delivering small amounts of this agent into the central nervous system also suppressed arthritis and joint destruction in the rats. They proposed that inflammation in the joints increases TNF production in the central nervous system, which, in turn, activates spinal p38. By blocking this pathway only in the spinal cord, they observed the same benefit that was normally achieved by treating the entire body with much higher doses.

The study also shows that the interactions between the CNS and the body are highly complex.

Depression and the Inflammatory System ? Let's Use Hypnosis!

From ScienceDaily.com:

"A study at Emory University School of Medicine shows that depressed patients experience excessive inflammation during stressful situations.Individuals with major depression have an exaggerated inflammatory response to psychological stress compared to those who do not suffer from depression. Because an overactive inflammatory response may contribute to a number of medical disorders as well as to depression, the findings suggest that increased inflammatory responses to stress in depressed patients may be a link between depression and other diseases, including heart disease, as well as contributing to depression itself.

Results of the study are published in the Sept. 1 issue of the American Journal of Psychiatry.

The study included 28 medically healthy male participants, half of whom were diagnosed with major depression and half of whom were not depressed. The participants were exposed to two moderately stressful situations during a 20-minute time period. Blood was collected every 15 minutes starting immediately before and then up to an hour and a half after the test to check for key indicators of inflammation. The researchers measured levels of a pro-inflammatory cytokine (a regulatory protein secreted by the immune system) called interleukin-6, and the activity of a pro-inflammatory signaling molecule in white blood cells called nuclear factor-kB.

Before the stress challenge, the depressed patients had increased inflammation relative to the control group. Both the depressed and the healthy groups showed an inflammatory response to the stress challenge, but people who were currently depressed exhibited the greatest increases of interleukin-6 and nuclear factor-kB."

Even though inflammation is essential for us to fight bacterial and viral infections, too much inflammation can cause us harm. Too much inflammation whether it be at rest or by stress, is thought by this article to maybe predispose people to become depressed or stay depressed. Inflammation may play a role in a number of disorders, including heart disease, cancer, and diabetes, all of which have been associated with depression.

People in the study who suffered from depression also had higher rates of early life stressful experiences. Perhaps this is an area where hypnotherapy can be useful at an earlier stage.