• Psychoneuroimmunology: a Brief overview of recent literature
  • Fatemeh Hassani,1,*
    1. Post graduate Department of Midwifery, Faculty of Medicine, Kerman Branch, Islamic Azad University, Kerman, Iran


  • Introduction: Around 200 AD, Galen noted a higher prevalence of breast cancer in melancholic women. Since the mid-1970s, an interdisciplinary field known as Psychoneuroimmunology (PNI) has emerged. PNI investigates the intricate interactions between the brain, behavior, immune, and endocrine systems. Neurons can release and respond to pro-inflammatory cytokines, while immune cells can release and receive neurotransmitters. This highlights the interconnectedness of the nervous and endocrine systems, which share signals to produce integrated behaviors. While many aspects of PNI interactions remain complex and unexplored, PNI essentially describes the relationship between psychological and physiological health. Mental illness can influence biological health, and physiological diseases can be accompanied by specific behaviors like irritability. This overview aims to provide a clear and concise introduction to PNI knowledge, assisting healthcare workers in developing effective treatment protocols.
  • Methods: After providing keywords from MESH vocabulary thesaurus, preparation an overview study started from search in Pubmed, Google scholar and Elsevier databases. A total of 1135 studies was found which reduces to 183 after limit time in recent studies 2018-2024. According to title and abstracts 14 eligible studies included this overview.
  • Results: As a psychological condition, stress can significantly impact the immune system. When a mammal experiences stress, the HPA axis starts to secrete of glucocorticoids, which bind to receptors on immune cells like monocytes and macrophages. This initially decreases pro-inflammatory cytokines, but prolonged stress can lead to glucocorticoid resistance and sustained inflammation. Psychological stress can also change gene expression by increasing levels of adrenaline, noradrenaline, and cortisol. Over time, high levels of serum cortisol, known as hypercortisolemia, can reduce the lymphatic tissue of the spleen and thymus so that the body's immunity becomes poor. In essence, stress can suppress immunity, increase inflammation, and contribute to disease symptoms. A significant portion of nervous system growth and development depends on elements like iron. Stress and psychological pressure can decrease iron absorption and homeostasis in the body, leading to iron deficiency, which can disrupt nervous system function. In pregnant women, iron deficiency following stress can impair the child's neurological development, affecting memory and maternal bonding and interaction. Additionally, early-life stress can cause physiological changes in the structure of the hippocampus, synapses, and cerebral cortex, leading to reduced learning abilities. Patients with depression are often at higher risk for diseases such as rheumatoid arthritis, cardiovascular disease, and autoimmune diseases. A baseline diagnosis of depression is often associated with elevated levels of pro-inflammatory cytokines and C-reactive protein (CRP), which can contribute to disease by increasing inflammation. Combining antidepressant treatments with common treatments for rheumatoid arthritis patients can sometimes result in improved therapeutic effectiveness. The role of inflammation in causing disease is undeniable, and the underlying cause of inflammation is often recognized as a contributing factor to psychiatric diseases. Evidence suggests that aspirin, an anti-inflammatory drug, can modify some depressive-like behaviors. Environmental factors like isolation and social rejection can be associated with the expression of genes related to inflammation markers. Conversely, social support can lead to decreased inflammation factors such as CRP, interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). Oxytocin, released following social support, directly affects immune cells, reduces inflammation, and promotes wound healing.
  • Conclusion: As demonstrated by the principles of Psychoneuroimmunology (PNI), physiological and psychological health are interconnected. Environmental factors like social support and stress management can significantly influence the biological outcomes of treatments. Therefore, it is essential to consider the psychological, emotional, and mental health of patients to achieve more effective disease management.
  • Keywords: Psychoneuroimmunology, Psychophysiology, Psychoimmunology, affect, health