Dr David McGrath

Spine Physician

MB BS (Hons) FAFOM, RACP, FAFMM
Master of Pain Medicine

Neurology-Immunology Interaction

Bottom Line: Immunological stress leads to an increase in neuroendocrine hormone activity. Neurological stress, may lead to an altered immunological response.

A. Neurological stress to Immunology (white cell) Function through pituitary hormones
B. Immunology to Neural Function, through hypothalamus and cytokines

Input/Output	Neutrophil Regulation	Hypothalamus
Neuroendocrine (from hypothalamus activity)	Growth Hormone(+) Prolactin(+) beta-Endorphin (-) Cortisol (-) Adrenaline (-)
Immuno/Cytokines (from white cell activity)		IL-1 (+) IL-6(+) TNF-alpha (+)

1.GH primes oxidative burst of neutrophils (via prolactin receptors). GH mediates growth of neutrophils,macrophages
2. Prolactin similar actions to GH
3. Cortisol, impairs phagocytic and cytotoxic activity of neutrophils/macrophages
4. Opiods and Adrenaline inhibit Oxidative Burst of phagocytes
5. IL-1,IL-6,TNF-alpha all mediate the febrile response, and activate energy mobilisation, with lipid and glycogen breakdown. Multiple hormone release.

(to be continued)