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Erschienen in: Clinical Autonomic Research 1/2016

01.02.2016 | Review Article

Autonomic dysfunction, immune regulation, and multiple sclerosis

verfasst von: Juan Manuel Racosta, Kurt Kimpinski

Erschienen in: Clinical Autonomic Research | Ausgabe 1/2016

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Abstract

Objective

To review existing evidence regarding interactions between the autonomic nervous system and the immune system functions in multiple sclerosis.

Methods

We reviewed the literature regarding new insights linking autonomic dysfunction to immune deregulation in multiple sclerosis, with particular focus on the specific influence of sympathetic and parasympathetic dysfunction on inflammatory and neurodegenerative processes.

Results

Autonomic dysfunction is common in multiple sclerosis, representing a significant cause of disability. Several connections between pathologic immune pathways and the autonomic nervous system function were found.

Conclusions

Autonomic dysfunction may enhance inflammatory and neurodegenerative pathways that are of major importance in multiple sclerosis. Autonomic dysfunction can present with highly variable manifestations. Sympathetic and parasympathetic dysfunction displays different patterns in multiple sclerosis, with specific impact on inflammation and neurodegeneration.
Literatur
1.
2.
Zurück zum Zitat Lucchinetti C, Bruck W, Parisi J, Scheithauer B, Rodriguez M, Lassmann H (2000) Heterogeneity of multiple sclerosis lesions: implications for the pathogenesis of demyelination. Ann Neurol 47:707–717. doi:10.1002/1531-8249 CrossRefPubMed Lucchinetti C, Bruck W, Parisi J, Scheithauer B, Rodriguez M, Lassmann H (2000) Heterogeneity of multiple sclerosis lesions: implications for the pathogenesis of demyelination. Ann Neurol 47:707–717. doi:10.​1002/​1531-8249 CrossRefPubMed
3.
Zurück zum Zitat Racosta JM, Sposato L, Morrow SA, Cipriano L, Kimpiski K, Kremenchutzky M (2015) Cardiovascular autonomic dysfunction in multiple sclerosis: a meta-analysis. Mult Scler Relat Disord. doi:10.1016/j.msard.2015.02.002 Racosta JM, Sposato L, Morrow SA, Cipriano L, Kimpiski K, Kremenchutzky M (2015) Cardiovascular autonomic dysfunction in multiple sclerosis: a meta-analysis. Mult Scler Relat Disord. doi:10.​1016/​j.​msard.​2015.​02.​002
5.
Zurück zum Zitat Elenkov IJ, Wilder RL, Chrousos GP, Vizi ES (2000) The sympathetic nerve—an integrative interface between two supersystems: the brain and the immune system. Pharmacol Rev 52:595–638. doi:10.1159/000156469 PubMed Elenkov IJ, Wilder RL, Chrousos GP, Vizi ES (2000) The sympathetic nerve—an integrative interface between two supersystems: the brain and the immune system. Pharmacol Rev 52:595–638. doi:10.​1159/​000156469 PubMed
8.
Zurück zum Zitat Hasko G, Elenkov IJ, Kvetan V, Vizi ES (1995) Differential effect of selective block of alpha 2-adrenoreceptors on plasma levels of tumour necrosis factor-alpha, interleukin-6 and corticosterone induced by bacterial lipopolysaccharide in mice. J Endocrinol 144:457–462. doi:10.1677/joe.0.1440457 CrossRefPubMed Hasko G, Elenkov IJ, Kvetan V, Vizi ES (1995) Differential effect of selective block of alpha 2-adrenoreceptors on plasma levels of tumour necrosis factor-alpha, interleukin-6 and corticosterone induced by bacterial lipopolysaccharide in mice. J Endocrinol 144:457–462. doi:10.​1677/​joe.​0.​1440457 CrossRefPubMed
9.
Zurück zum Zitat Zoukos Y, Thomaides TN, Kidd D, Cuzner ML, Thompson A (2003) Expression of beta 2 adrenoreceptors on peripheral blood mononuclear cells in patients with primary and secondary progressive multiple sclerosis: a longitudinal six month study. J Neurol Neurosurg Psychiatry 74:197–202. doi:10.1136/jnnp.74.2.197 PubMedCentralCrossRefPubMed Zoukos Y, Thomaides TN, Kidd D, Cuzner ML, Thompson A (2003) Expression of beta 2 adrenoreceptors on peripheral blood mononuclear cells in patients with primary and secondary progressive multiple sclerosis: a longitudinal six month study. J Neurol Neurosurg Psychiatry 74:197–202. doi:10.​1136/​jnnp.​74.​2.​197 PubMedCentralCrossRefPubMed
10.
Zurück zum Zitat Zoukos Y, Kidd D, Woodroofe MN, Kendall BE, Thompson AJ, Cuzner ML (1994) Increased expression of high affinity IL-2 receptors and beta-adrenoceptors on peripheral blood mononuclear cells is associated with clinical and MRI activity in multiple sclerosis. Brain J Neurol 117:307–315. doi:10.1136/jnnp.74.2.197 CrossRef Zoukos Y, Kidd D, Woodroofe MN, Kendall BE, Thompson AJ, Cuzner ML (1994) Increased expression of high affinity IL-2 receptors and beta-adrenoceptors on peripheral blood mononuclear cells is associated with clinical and MRI activity in multiple sclerosis. Brain J Neurol 117:307–315. doi:10.​1136/​jnnp.​74.​2.​197 CrossRef
11.
Zurück zum Zitat Karaszewski JW, Reder AT, Anlar B, Kim WC, Arnason BG (1991) Increased lymphocyte beta-adrenergic receptor density in progressive multiple sclerosis is specific for the CD8+, CD28− suppressor cell. Ann Neurol 30:42–47. doi:10.1002/ana.410300109 CrossRefPubMed Karaszewski JW, Reder AT, Anlar B, Kim WC, Arnason BG (1991) Increased lymphocyte beta-adrenergic receptor density in progressive multiple sclerosis is specific for the CD8+, CD28− suppressor cell. Ann Neurol 30:42–47. doi:10.​1002/​ana.​410300109 CrossRefPubMed
12.
Zurück zum Zitat Zaffaroni M, Marino F, Bombelli R, Rasini E, Monti M, Ferrari M, Ghezzi A, Comi G, Lecchini S, Cosentino M (2008) Therapy with interferon-beta modulates endogenous catecholamines in lymphocytes of patients with multiple sclerosis. Exp Neurol 214:315–321. doi:10.1016/j.expneurol.2008.08.015 CrossRefPubMed Zaffaroni M, Marino F, Bombelli R, Rasini E, Monti M, Ferrari M, Ghezzi A, Comi G, Lecchini S, Cosentino M (2008) Therapy with interferon-beta modulates endogenous catecholamines in lymphocytes of patients with multiple sclerosis. Exp Neurol 214:315–321. doi:10.​1016/​j.​expneurol.​2008.​08.​015 CrossRefPubMed
16.
Zurück zum Zitat Khoury SJ, Healy BC, Kivisakk P, Viglietta V, Egorova S, Guttmann CR, Wedgwood JF, Hafler DA, Weiner HL, Buckle G, Cook S, Reddy S (2010) A randomized controlled double-masked trial of albuterol add-on therapy in patients with multiple sclerosis. Arch Neurol 67:1055–1061. doi:10.1001/archneurol.2010.222 PubMedCentralCrossRefPubMed Khoury SJ, Healy BC, Kivisakk P, Viglietta V, Egorova S, Guttmann CR, Wedgwood JF, Hafler DA, Weiner HL, Buckle G, Cook S, Reddy S (2010) A randomized controlled double-masked trial of albuterol add-on therapy in patients with multiple sclerosis. Arch Neurol 67:1055–1061. doi:10.​1001/​archneurol.​2010.​222 PubMedCentralCrossRefPubMed
20.
Zurück zum Zitat Seravalle G, Mancia G, Grassi G (2014) Role of the sympathetic nervous system in hypertension and hypertension-related cardiovascular disease. High Blood Press Cardiovasc Prev Off J Ital Soc Hypertens 21:89–105. doi:10.1007/s40292-014-0056-1 CrossRef Seravalle G, Mancia G, Grassi G (2014) Role of the sympathetic nervous system in hypertension and hypertension-related cardiovascular disease. High Blood Press Cardiovasc Prev Off J Ital Soc Hypertens 21:89–105. doi:10.​1007/​s40292-014-0056-1 CrossRef
25.
26.
Zurück zum Zitat Veldhoen M, Hirota K, Westendorf AM, Buer J, Dumoutier L, Renauld JC, Stockinger B (2008) The aryl hydrocarbon receptor links TH17-cell-mediated autoimmunity to environmental toxins. Nature 453:106–109. doi:10.1038/nature06881 CrossRefPubMed Veldhoen M, Hirota K, Westendorf AM, Buer J, Dumoutier L, Renauld JC, Stockinger B (2008) The aryl hydrocarbon receptor links TH17-cell-mediated autoimmunity to environmental toxins. Nature 453:106–109. doi:10.​1038/​nature06881 CrossRefPubMed
31.
33.
Zurück zum Zitat Vijayaraghavan S, Karami A, Aeinehband S, Behbahani H, Grandien A, Nilsson B, Ekdahl KN, Lindblom RPF, Piehl F, Darreh-Shori T (2013) Regulated extracellular choline acetyltransferase activity—the plausible missing link of the distant action of acetylcholine in the cholinergic anti-Inflammatory pathway. PLoS ONE 8:65936. doi:10.1371/journal.pone.0065936 CrossRef Vijayaraghavan S, Karami A, Aeinehband S, Behbahani H, Grandien A, Nilsson B, Ekdahl KN, Lindblom RPF, Piehl F, Darreh-Shori T (2013) Regulated extracellular choline acetyltransferase activity—the plausible missing link of the distant action of acetylcholine in the cholinergic anti-Inflammatory pathway. PLoS ONE 8:65936. doi:10.​1371/​journal.​pone.​0065936 CrossRef
37.
Zurück zum Zitat Huitinga I, De Groot CJ, Van der Valk P, Kamphorst W, Tilders FJ, Swaab DF (2001) Hypothalamic lesions in multiple sclerosis. J J Neuropathol Exp Neurol 60:1208–1218CrossRefPubMed Huitinga I, De Groot CJ, Van der Valk P, Kamphorst W, Tilders FJ, Swaab DF (2001) Hypothalamic lesions in multiple sclerosis. J J Neuropathol Exp Neurol 60:1208–1218CrossRefPubMed
39.
Zurück zum Zitat Melief J, de Wit SJ, van Eden CG, Teunissen C, Hamann J, Uitdehaag BM, Huitinga I (2013) HPA axis activity in multiple sclerosis correlates with disease severity, lesion type and gene expression in normal-appearing white matter. Acta Neuropathol 126:237–249. doi:10.1007/s00401-013-1140-7 CrossRefPubMed Melief J, de Wit SJ, van Eden CG, Teunissen C, Hamann J, Uitdehaag BM, Huitinga I (2013) HPA axis activity in multiple sclerosis correlates with disease severity, lesion type and gene expression in normal-appearing white matter. Acta Neuropathol 126:237–249. doi:10.​1007/​s00401-013-1140-7 CrossRefPubMed
41.
43.
Zurück zum Zitat Hanken K, Manousi A, Klein J, Kastrup A, Eling P, Hildebrandt H (2015) On the relation between self-reported cognitive fatigue and the posterior hypothalamic-brainstem network. Eur J Neurol. doi:10.1111/ene.12815 PubMed Hanken K, Manousi A, Klein J, Kastrup A, Eling P, Hildebrandt H (2015) On the relation between self-reported cognitive fatigue and the posterior hypothalamic-brainstem network. Eur J Neurol. doi:10.​1111/​ene.​12815 PubMed
44.
Metadaten
Titel
Autonomic dysfunction, immune regulation, and multiple sclerosis
verfasst von
Juan Manuel Racosta
Kurt Kimpinski
Publikationsdatum
01.02.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Autonomic Research / Ausgabe 1/2016
Print ISSN: 0959-9851
Elektronische ISSN: 1619-1560
DOI
https://doi.org/10.1007/s10286-015-0325-7

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