Das gestresste Immunsystem und Autoimmunität

Zusammenfassung

Über einen möglichen Zusammenhang zwischen psychologischem Stress, Immunsystem und Autoimmunität wird schon lange debattiert. Erkenntnisse aus der Grundlagen- und epidemiologischen Forschung, die das Verständnis für diesen komplexen Zusammenhang erhöhen werden in dieser kurzen Übersicht zusammengestellt. Zunächst werden bekannte anatomisch-physiologische Grundlagen für einen Zusammenhang zwischen psychologischem Stress und Immunsystem dargestellt. Es wird beschrieben, dass die Interaktion zwischen Gehirn über autonomes Nervensystem und Hormonsystem bis zur Immunzelle mit entsprechenden Rezeptoren für Neurotransmitter und Hormone mittlerweile bis auf die molekulare Ebene gut beschrieben ist. Im Rahmen der akuten Stressreaktion treten charakteristische Veränderungen im Immunsystem auf, die ebenfalls gut dokumentiert sind. In einem zweiten Teil wird dann beschrieben welche Veränderungen im Rahmen einer chronischen Stressbelastung am Immunsystem auftreten können und zuletzt wird diskutiert inwiefern diese Veränderungen auch für pathophysiologische Zustände des Immunsystems, z. B. im Rahmen von Autoimmunerkrankungen, relevant sein könnten. Zusammenfassend führt akuter Stress, im Sinne der optimalen Vorbereitung einer fight&flight Situation, zu einer Steigerung der Immunfunktion v. a. der humoralen Immunität, wohingegen die Auswirkungen von chronischem Stress weniger klar definiert sind und es eher zu einer Immundysregulation mit verminderter basaler Immunfunktion, v. a. der zytotoxischen Funktion aber einer gesteigerten Reaktion nach Aktivierung, v. a. im angeborenen Immunschenkel kommt. Epidemiologische Daten belegen gut, dass chronischer Stress zu einer erhöhten Suzeptibilität für Autoimmunerkrankungen führt. Erste klinische Anwendungen, wie beispielsweise die gezielte neuronale Stimulation des N. vagus sind in Erprobung, für einen breiteren klinischen Einsatz sollten aber die biologischen Netzwerkstrukturen noch besser verstanden werden, um die besten Angriffspunkte zu finden.

Abstract

A possible Interaction between psychological stress, immune system and autoimmunity has been discussed for a long time. This short review provides evidence from basic and epidemiological research that contributes to a better understanding of these complex interactions. Firstly, known anatomical physiological basic conditions for the interaction between psychological stress and immune system are presented. It will be discussed whether the interaction between the brain, via the autonomic nervous system and the endocrine system, to the individual immune cell bearing the receptors for neurotransmitters and hormones is well characterised down to the molecular level. In the context of an acute stress response, characteristic changes within the immune system are noted, which are also well documented. In a second part, alterations in the immune system are described that may result from chronic stress exposure. Finally, it will be discussed in what way these alterations are also relevant for the development of pathophysiological immune conditions, such as autoimmunity. In conclusion, acute stress supports immune function, especially humoral immunity, to optimally prepare the fight or flight reaction. On the other hand, the effect of chronic stress is less well defined and chronic stress rather leads to Immunodysregulation with decreased basal immune function, especially cytotoxic function, but enhanced responses upon activation, especially of the innate branch. Epidemiological data provides solid evidence that chronic stress exposure leads to increased susceptibility for autoimmune diseases. First clinical applications, e. g. targeted neuronal vagal nerve stimulation, are currently under investigation, However, broader clinical use would require greater understanding of the underlying biological networks, in order to identify the best targets for intervention.

Schlüsselwörter

Stress - Psychoneuroimmunologie - Autoimmunität - Immunsystem

Key words

psychological stress - Psychoneuroimmunology - Autoimmunity - immune system

Publication History

Article published online:
29 March 2021

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