The spleen: a hub connecting nervous and immune systems in cardiovascular and metabolic diseases

Metabolic disorders have been identified as major health problems affecting a large portion of the world population. In addition, obesity and insulin resistance are principal risk factors for the development of cardiovascular diseases. Altered immune responses are common features of both hypertension and obesity and, moreover, the involvement of the nervous system in the modulation of immune system is gaining even more attention in both pathophysiological contexts. For these reasons, during the last decades, researches focused their efforts on the comprehension of the molecular mechanisms connecting immune system to cardiovascular and metabolic diseases. On the other hand, it has been reported that in these pathological conditions, central neural pathways modulate the activity of the peripheral nervous system, which is strongly involved in onset and progression of the disease. It is interesting to notice that neural reflex can also participate in the modulation of immune functions. In this scenario, the spleen becomes the crucial hub allowing the interaction of different systems differently involved in metabolic and cardiovascular diseases. Here, we summarize the major findings that dissect the role of the immune system in disorders related to metabolic and cardiovascular dysfunctions, and how this could also be influenced by neural reflexes

The Immune System

Modern biotherapy has been in use for some 30 years. The first types of biotherapy were nonspecific stimulators of the immune response, but advances in genetic engineering are allowing the mass production of pure biological products which are now being tested as pharmaceutical agents. Biotherapy connotes the administration of products (1) that are coded by the mammalian genome; (2) that modify the expression of mammalian genes; or (3) that stimulate the immune system. In this chapter the discussion of the immune system will be limited primarily to topics relevant to cancer or autoimmune diseases. Because understanding the new biological agents requires an understanding of both the immune response and the molecular basis of oncogenesis, this chapter first presents a summary of the structure and function of the immune system. Following a discussion of immune responses, and the cells involved in these responses, will be a discussion on the current concepts of oncogenesis, particularly oncogenes and growth factors. Because research efforts are beginning to identify many biological proteins as having a role in autoimmune and other diseases, a brief introduction to autoimmune diseases is also included at the end of the chapter

Histopathology of the gut in rheumatic diseases

The gastrointestinal tract regulates the trafficking of macromolecules between the environment and the host through an epithelial barrier mechanism and is an important part of the immune system controlling the equilibrium between tolerance and immunity to non-self-antigens. Various evidence indicates that intestinal inflammation occurs in patients with rheumatic diseases. In many rheumatic diseases intestinal inflammation appears to be linked to dysbiosis and possibly represents the common denominator in the pathogenesis of different rheumatic diseases. The continuative interaction between dysbiosis and the intestinal immune system may lead to the aberrant activation of immune cells that can re-circulate from the gut to the sites of extraintestinal inflammation as observed in patients with ankylosing spondylitis. The exact contribution of genetic factors in the development of intestinal inflammation in rheumatic diseases needs to be clarified

Glucocorticoids—All-Rounders Tackling the Versatile Players of the Immune System

Glucocorticoids regulate fundamental processes of the human body and control cellular functions such as cell metabolism, growth, differentiation, and apoptosis. Moreover, endogenous glucocorticoids link the endocrine and immune system and ensure the correct function of inflammatory events during tissue repair, regeneration, and pathogen elimination via genomic and rapid non-genomic pathways. Due to their strong immunosuppressive, anti-inflammatory and anti-allergic effects on immune cells, tissues and organs, glucocorticoids significantly improve the quality of life of many patients suffering from diseases caused by a dysregulated immune system. Despite the multitude and seriousness of glucocorticoid-related adverse events including diabetes mellitus, osteoporosis and infections, these agents remain indispensable, representing the most powerful, and cost-effective drugs in the treatment of a wide range of rheumatic diseases. These include rheumatoid arthritis, vasculitis, and connective tissue diseases, as well as many other pathological conditions of the immune system. Depending on the therapeutically affected cell type, glucocorticoid actions strongly vary among different diseases. While immune responses always represent complex reactions involving different cells and cellular processes, specific immune cell populations with key responsibilities driving the pathological mechanisms can be identified for certain autoimmune diseases. In this review, we will focus on the mechanisms of action of glucocorticoids on various leukocyte populations, exemplarily portraying different autoimmune diseases as heterogeneous targets of glucocorticoid actions: (i) Abnormalities in the innate immune response play a crucial role in the initiation and perpetuation of giant cell arteritis (GCA). (ii) Specific types of CD4+ T helper (Th) lymphocytes, namely Th1 and Th17 cells, represent important players in the establishment and course of rheumatoid arthritis (RA), whereas (iii) B cells have emerged as central players in systemic lupus erythematosus (SLE). (iv) Allergic reactions are mainly triggered by several different cytokines released by activated Th2 lymphocytes. Using these examples, we aim to illustrate the versatile modulating effects of glucocorticoids on the immune system. In contrast, in the treatment of lymphoproliferative disorders the pro-apoptotic action of glucocorticoids prevails, but their mechanisms differ depending on the type of cancer. Therefore, we will also give a brief insight into the current knowledge of the mode of glucocorticoid action in oncological treatment focusing on leukemia

Correlations in the T Cell Response to Altered Peptide Ligands

The vertebrate immune system is a wonder of modern evolution. Occasionally, however, correlations within the immune system lead to inappropriate recruitment of preexisting T cells against novel viral diseases. We present a random energy theory for the correlations in the naive and memory T cell immune responses. The non-linear susceptibility of the random energy model to structural changes captures the correlations in the immune response to mutated antigens. We show how the sequence-level diversity of the T cell repertoire drives the dynamics of the immune response against mutated viral antigens.Comment: 21 pages; 6 figures; to appear in Physica

Interaction between Cannabinoid System and Toll-Like Receptors Controls Inflammation

Since the discovery of the endocannabinoid system consisting of cannabinoid receptors, endogenous ligands, and biosynthetic and metabolizing enzymes, interest has been renewed in investigating the promise of cannabinoids as therapeutic agents. Abundant evidence indicates that cannabinoids modulate immune responses. An inflammatory response is triggered when innate immune cells receive a danger signal provided by pathogen- or damage-associated molecular patterns engaging pattern-recognition receptors. Toll-like receptor family members are prominent pattern-recognition receptors expressed on innate immune cells. Cannabinoids suppress Toll-like receptor-mediated inflammatory responses. However, the relationship between the endocannabinoid system and innate immune system may not be one-sided. Innate immune cells express cannabinoid receptors and produce endogenous cannabinoids. Hence, innate immune cells may play a role in regulating endocannabinoid homeostasis, and, in turn, the endocannabinoid system modulates local inflammatory responses. Studies designed to probe the interaction between the innate immune system and the endocannabinoid system may identify new potential molecular targets in developing therapeutic strategies for chronic inflammatory diseases. This review discusses the endocannabinoid system and Toll-like receptor family and evaluates the interaction between them

Neuroinflammation and Its Resolution: From Molecular Mechanisms to Therapeutic Perspectives

Neuroinflammation, the complex immune response of the central nervous system (CNS), when sustained, is a common denominator in the etiology and course of all major neurological diseases, including neurodevelopmental, neurodegenerative, and psychiatric disorders (e.g., Alzheimer's disease, AD; Parkinson's disease, PD; multiple sclerosis, MS; motor neuron disease; depression; autism spectrum disorder; and schizophrenia). Cellular (microglia and mast cells, two brain-resident immune cells, together with astrocytes) and molecular immune components (e.g., cytokines, complement and patternrecognition receptors) act as key regulators of neuroinflammation (Skaper et al., 2012). In response to pathological triggers or neuronal damage, immune cells start an innate immune response with the aim to eliminate the initial cause of injury. However, when the cellular activity becomes dysregulated, it results in an inappropriate immune response that can be injurious and affect CNS functions. Thus, limiting neuroinflammation and microglia activity represents a potential strategy to alleviate neuroinflammationrelated diseases. The Research Topic collects 20 manuscripts, divided into five sections, that include both original research articles and reviews of the emerging literature and explore the role of neuroinflammation in various neurological diseases. There is particular attention dedicated to the relevant research exploring the mechanisms and mediators involved in the resolution of neuroinflammation. Our aim was to generate a valuable discussion contributing to identify new therapeutic targets in brain damage and providing new drug development opportunities for the prevention and treatment of CNS diseases involving neuroinflammation

Immune cognition, social justice and asthma: structured stress and the developing immune system

We explore the implications of IR Cohen's work on immune cognition for understanding rising rates of asthma morbidity and mortality in the US. Immune cognition is conjoined with central nervous system cognition, and with the cognitive function of the embedding sociocultural networks by which individuals are acculturated and through which they work with others to meet challenges of threat and opportunity. Using a mathematical model, we find that externally- imposed patterns of 'structured stress' can, through their effect on a child's socioculture, become synergistic with the development of immune cognition, triggering the persistence of an atopic Th2 phenotype, a necessary precursor to asthma and other immune disease. Reversal of the rising tide of asthma and related chronic diseases in the US thus seems unlikely without a 21st Century version of the earlier Great Urban Reforms which ended the scourge of infectious diseases

Community Lynching and the US Asthma Epidemic

We explore the implications of IR Cohen's work on immune cognition for understanding rising rates of asthma morbidity and mortality in the US. Immune cognition is inherently linked with central nervous system cognition, and with the cognitive function of the embedding sociocultural networks by which individuals are acculturated and through which they work with others to meet challenges of threat and opportunity. Externally-imposed patterns of 'structured stress' can, through their effect on a child's socioculture, become synergistic with the development of immune cognition, triggering the persistence of an atopic Th2 phenotype, a necessary precursor to asthma and other immune diseases. Structured stress in the US particularly includes the cross sectional and longitudinal effects of a systematic destruction of minority urban communities occurring since the end of World War II which we characterize as community lynching. Reversal of the rising tide of asthma and related chronic diseases in the US thus seems unlikely without a 21st Century version of the earlier Great Urban Reforms which ended the scourge of infectious diseases, in particular an end to the de-facto ethnic cleansing of minority neighborhoo