neuroendocrine modulation

“Defianda me Dios de mi! ” God save me from myself (Spanish Proverb)

“Man dies from the wound in his soul” (BALZAC)

What’s really going on in the human body? How do we prove all this?

In the late fifties and early sixties everything seemed so clear and certain that many deaths could be prevented with vaccines and antibiotics. However, after the eighties, death from infectious diseases in the USA, which is one of the most technologically advanced countries in the world, rose to the 5th rank and rose to 58%. Even gene technology, the latest invention of the age, could not result in an effective treatment for any disease.

“When I was a kid, I thought nature was magic. Later I learned that everything can be expressed with mathematical formulas. This has been my biggest disappointment. When you take the magic out of science, you’re left alone with technology. But I still want to believe that there is magic that twists the DNA helixes.”

The first published book in the field of psychoneuroimmunology was published by Robert Ader in 1975. Robert Ader and Nicolas Cohen repeated the classic Pavlov experiments on rats and showed that the immune response changed in relation to behavior. These researchers injected rats with cyclophosphamide after happy events (fresh water), then tried to create an antigenic reaction by injecting sheep erythrocytes and found that fresh water, which was used together with cyclophosphamide in the past, could suppress the immune system alone. It seemed that something formed in the rats’ brain was generating this response. However, classical immunology was based on many dogmas that were proven in test tubes outside the human body.

It should be said that no matter how detailed we work on the parts, we will never be able to understand the whole. This leads us to the first question, can we really believe data from any isolated system? Or how much can we trust cadavers, from which a large part of our anatomical knowledge is obtained, in this context? For example, the information that the cranial bones do not move is an anatomical information valid only for cadavers. Did you know that the movements of the cranial bones can be measured and are of vital importance? At first glance, the immune system and nervous system do not seem very similar. However, in both systems, they are related to the situation of the organism against the external environment. Both have roles of resistance and adaptation.

In addition, both systems have memory. Nerve cells not only communicate with the solid organs of the immune system, but also interact with the nervous system in Peyer’s patches and bone marrow, thanks to the freely circulating immune system cells. Endorphins and neurotransmitters, which are the communicative molecules of the nervous system, hormones of the endocrine system, cytokines of the immune system are from the peptides group of chemical substances. These peptides act as intermediates between these systems.

After all, these systems are extensions of the same network system. If we consider how interconnected the ecological systems on the planet are for natural life, perhaps we can change our view of human biological systems. One day we will stop seeing the disease as an invasion medical science as war, because as we triumph over the old ones, the new diseases that we encounter will replace the doctrine of war.

it will rot. In addition, autoimmune diseases in which the body is damaged by its own immune system are increasing. In this case, when we see the enemy, we will understand that it is us. This is the case with all degenerative diseases.

Quantum theory reveals that all elements contain energy fluctuations (vibrations). Is the quantum current detected between seas absent between cells? What is the use of microtubules, which are resistant to the frequencies of UV light, between cells? Fritz Popp argues that the cell communication system is dependent on a continuous light, such as a laser. Danah Zohar’s work, Quantum Model of Consciousness, was supported by the work of Herbert Frolich. Brian Josephson’s idea, as a result of his research on psychoneuroimmunology, is that a quantum computer, supported by the brain, operates in the body.

BASIC CONCEPTS

The Immune System has to resist countless foreign antigens in almost every part of the body. For this reason, the ability of immune system cells to travel between blood, lymph and tissues and to settle in areas exposed to antigen is called HOMING. This feature is very valuable for the immune response. Immune responses protect the individual against infection, autoimmune diseases and cancer. The normal immune system has the ability to recognize and eliminate tumor cells that differ from normal before the tumor develops, this is called Immune Control (ImmunoControl). The mechanisms that protect the individual from potentially dangerous agents and are present in the organism before encountering most agents are called NATURAL Immunity.

Natural Immunity:
Physical Barriers (skin mucous membranes)
Phagocytosis (macrophages neutrophils eosinophils)
Natural Killer Cells (NKC)
Acute Phase Proteins and
It consists of the Complement System.

SPECIFIC Immunity is the system that enables the development of a unique response when faced with a foreign antigen and creates a stronger response when the same antigen is encountered again.

Specific Immunity:
· Lymphocytes
Antibodies produced by Plasma Cells
Composed of lymphokines released from lymphocytes

Specific immunity is of two types.
1- Humoral Immunity: with B lymphocytes and antibodies (extracellular)
2- Cellular Immunity: Developed by T lymphocytes (intracellular)

Macrophages engulf the antigen they find and break it down into peptides. They bind to MHC (Major Histocompatibility Complexes) and transport them to the cell surface. T lymphocytes
each has specific receptor molecules on its surface that can recognize only one MHC. These are called T Cell Receptors. The mammalian immune system is capable of recognizing 9 out of 10 different antigens.
is thought to be. This is called LYMPHOCYTE REPERTOIRE. All of the lymphocytes derived from a lymphocyte are called a LYMPHOCYTE CLONE. All cells in a clone have the same antigen-recognizing receptors. T cells that are activated by recognizing the specific antigen presented with MHC Class 2 on the macrophage surface divide and secrete lymphokines.

Cells that secrete lymphokines are called T helper (Th). With the secretion of lymphokines:
1- Macrophages become active and digest the antigen in them
2- B lymphocytes become plasma cells and begin to secrete antibodies
3- Cytotoxic T lymphocytes enter the form that will kill cells showing Tc antigen characteristics.

After antigenic stimulation, all normal immune responses are self-limiting. Many mechanisms play a role in this stage. One of these mechanisms is NEUROENDOCrine MODULATION. To give examples of this modulation;

There is sympathetic innervation in lymphocytes and the blood vessels of most lymphoid organs: There are receptors for many hormones, neurotransmitters and neuropeptides on lymphocytes. Lymphocytes can make their own adrenocorticotropic hormones by responding to corticotropin-releasing factor, which in turn leads to corticosteroid
leads to its construction. Under stress, the in vitro mitogen response of lymphocytes is impaired and the healing of infections is delayed. A person is immune competent when the immune system can perform its functions in the body. In cases where the immune functions are not sufficient, there is an immune-compromised situation.

CAUSES AND EFFECTS OF STRESS

In recent years, many studies have been conducted to measure the effects of stress on society. For example, in a study conducted on internal medicine patients, it was revealed that the symptoms of the patients were mostly related to stress.
out. 36% of them complained that they did not take good care of themselves, 26% of them about their mood, 25% of them about their emotions, 25% of them working overtime, and 24% of them having a mental breakdown.

Stress is the initiator or main cause of many diseases. Stress is an organism’s response to an unexpected situation. For example, someone standing next to a snake urgently needs to escape. This is the organism’s fight-or-flight response. Stress can cause our behavior to be in the form of haste or laziness. Weak stimuli provide insensitivity at rest, minimizing unnecessary attacks.

Stress is an unhealthy aspect of modern life. The mind isn’t always focused on the real source of stress, it’s filled with a lot of unrealizable images. For example, fears about the future, catastrophic thoughts, habitual anxieties. These are not yet true stressors.

It is difficult for the body to distinguish between what is a real stressor and what is just an imagined stressor. If it receives a message on the way to take action in a stressful way, it will be activated in that direction. For example, when a person perceives a stick as a snake, the body reacts according to this perception. When the person perceives the snake as a stick, he makes a dangerous mistake.

Stress reduction is a relaxation response to reduce the harmful effects of unrealistic stressors. This answer can be done in many different ways . For example, when sitting on a chair. This is aimed at deep physical and conditional relaxation and focusing on a clear object with the mind. The state of the body in this state is called rest insensitivity.

Although it is known that stress has negative effects on the immune system, it is not easy to prove this objectively. Interaction of nervous system, endocrine system and immune system is very important in the execution of homeostatic mechanisms. A person’s mood or the way he responds to stress can change that person’s fight against infectious diseases or cancer, as well as affect the course of autoimmune diseases. It has been shown in the study of Cohen et al. that stress is associated with infectious diseases. In this study, volunteers were administered one of 5 different cold viruses or placebo, and it was observed that both respiratory tract infections and clinical colds increased with psychological stress. In another study, it was reported that stress adversely affected the antibody response to the hepatitis B vaccine.

It is known that stress is a risk factor for diseases caused by various infectious agents, especially human herpes viruses, and has an effect that increases the severity of the disease. In a study conducted with medical students, it was shown that there was a relatively low level of stress with the immunological tests performed on the blood samples taken from the examination period, which lasted for 3 days, and a significant decrease in NK activity during the examination period was compared with the results of similar tests 1 month ago, which was considered basic (Kiecot-Glaser 1984, p. 1987) During these studies, it was found that the levels of interferon gamma measured during the exam period were significantly lower than the levels of the samples in the control groups (Glaser, Rice1987). In studies conducted on a group of people whose natural killer cell activity was consistently low, it was observed that the best determining factors for this group were age and the degree of daily stress (Levy, Herberman 1989).

As a result of a 6-month study examining the changes made by daily stresses on the immune system, it was observed that daily stresses caused an increase in Ts, and the Th/Ts ratio decreased, and it was reported that the expectation of stress was associated with a decrease in the number of Th (Kemeny Cohen, 1989). In a study conducted with homosexual men, they were first told that they were HIV + and the measurement was made, and then it was explained that this was not correct and the measurement was made. In these measurements, it was found that the proliferative response of lymphocytes to phytohemagglutin doubled within a week after the real situation was told (Antoni, Schneiderman 1991).

It has been reported that marital problems can cause both physical and psychological disorders, as well as disorders in immune parameters. In a study comparing women who were divorced less than a year ago with appropriate control groups, it was found that marital problems go along with depression and immunocompetence deficiency (Kiecolt-Glser, Fisher 1987).

In a similar study conducted in men, similar results were obtained, but it was observed that these disorders were relatively mild on the side who wanted and initiated the divorce (Kiecolt-Glaser 1988). In a study conducted by Mayne et al. were measured and blood samples were taken for immune changes: women found elevated blood pressure and a slight decrease in lymphocyte proliferation indicating a decrease in cellular immune system functions. (Mayne 1997).

It has been reported that cellular immunity is impaired in stereotypes with primary depressive illness (Kronfol, Silva 1983). While there are publications stating that depression is associated with low Th count and more frequent herpes recurrence (Kemeny Cohen 1989), there are also studies suggesting that there is no significant difference in immune function between depressed and non-depressed patients (Darko, Gillin 1991).

Norman Cousins, in 1979, put forward the idea that personality traits, behavior patterns, ways of coping with events and emotional state may affect the course of diseases with some known or predicted disorders in immune functions. Cousins ​​reported that remission was achieved with psychological intervention in ankylosing spondylitis. The effects of coping with stress and ways of coping with stress on immune system changes are being studied more and more. These studies are especially carried out on university students, the elderly, cancer patients, people with HIV virus, those with chronic rheumatic diseases and voluntary control groups.

In this context, especially hypnosis, relaxation, exercise, classical conditioning, assertiveness and cognitive studies were summarized by Glasers (Kiecolt-Glaser 1992). It is very difficult to plan and carry out these studies and it is not always easy to evaluate the results objectively.

It has been published that the use of psychotherapy, psychological counseling services and participation in support groups positively affect the prognosis of cancer patients. Such methods have been reported to prolong survival in patients with metastatic breast cali (Spiegel, Bloom 1989) and malignant malanoma (Fawzy, Hyun 1993). After all these explanations, the thought that stress alone will definitely cause diseases by making changes in immune functions should be removed: Stress and unhappiness can push people to some risky behaviors and lifestyles.

Such people may be more prone to alcohol and drug use, their sleep and nutrition levels are often disrupted, and they may become less active. It should not be forgotten that all of these are factors that negatively affect the general health as well as the immune system. As the ways of coping with stress are better understood and applied, it is expected that many pathological conditions that are thought to be directly or indirectly related to the immune system will be positively affected.

Physiological Benefits of Stress Reduction:

A significant decrease in oxygen consumption and metabolic rate, even below the level of sleep. This is a sign of great economy and efficiency.

Decrease in minute ventilation and respiration rate

Decrease in heart rate and blood pressure,

A greater reduction in serum cholesterol than can be achieved with diet alone,

A marked increase in skin resistance (low skin resistance is an indicator of stress response)

Decreased blood lactate level, which is a sign of anaerobic metabolism, which is high in stressful situations,

Increase in (alpha) and (tetra) waves detected in resting state in EEG, ensuring coordination of EEG waves

Decreased frequency of epileptic seizures

Detection of high serotonin production seen during recovery from depression,

Decreased catecholamine metabolite levels,

Decrease in TSH and T3 levels,

Improvement of reflexes and response time,

Increased sensitivity of hearing and other senses,

· Strengthening of immune function. In chronic stress, the immune system is suppressed or excessively activated, which leads to the emergence of autoimmune and inflammatory diseases.

Melatonin levels increase

Calcium loss and reduced risk of osteoporosis (possibly due to decreased cortisol levels)

Some of the Diseases for which Stress Reduction is Beneficial:

o Heart diseases,

o Cancers,

o Chronic Pain,

that Asthma,

o Diabetes,

o Spastic Colon,

Psychological Benefits of Stress Reduction:

Decrease in anxiety,

Decreased depression (through induction of increased serotonin levels)

More optimism,

More self-awareness and self-actualization,

Developing coping skills,

non-situational sense of happiness,

Decreased tendency to alcohol with prescription or non-prescription drugs,

Increase in the quality of sleep (more restful sleep, decrease in insomnia, less need for sleep over time)

Decrease in aggression and criminal tendencies,

Increase in IQ, increase in learning capacity, development of personality and intellectuality,

Ensuring more efficiency and productivity in business life,

· Positives in terms of management,

Increasing concentration ability and memory,

Reducing the tendency to unwanted personality problems and personality disorders

PSYCHONEUROIMMUNOLOGY:

In this term, the psycho mind represents the neuro nervous system and immunology represents the immune system. In simple words, we create powerful effects on the immune and nervous systems with our thoughts and emotions. Nerves are like telephone wires. Neurotransmitters work like a mail system. This is related to the immune response for two reasons. The nervous system provides the transmission of each element, and the white blood cells send messages back to the nervous system. Therefore, this communication is two-way. The feedback mechanism of this system in the brain is in the lobe of the limbic system.

So it has a lot to do with emotions. More than 60 neurotransmitter receptors have been identified on white blood cells. Such receptors have also been detected in areas of the body such as the gut. This situation reveals how stress, anxiety and depression can cause events such as immune suppression and bowel spasm. In addition, it has been determined that drugs such as sedatives with psychoactive properties have effects on immune cell functions. Because these cells also have the same receptors. It can even be said that the blood-brain barrier becomes more permeable under stress. Although the number of white blood cells is affected under stress, the main effect occurs in functions. This effect is caused not only by emotional factors but also by factors related to lifestyle. The table below shows which factors affect Natural Killer Cells, which are very important in Cellular Immunity.

Table 1: Effects on Lifestyle and NKCell Activity

BEHAVIOR

Increase in NKcell Activity

Exercise

47%

Stress Management

45%

Adequate Sleep

44%

Balanced diet

37%

No Smoking

%27

Having Breakfast

21%

Regular and Convenient Working Hours

17%

avoiding alcohol

0%

It is a well-known situation based on many sources that unhealthy lifestyles are facilitated by stress. Appropriate stress management, meditation, psychological interviews, positive attitudes and habits are powerful immune stimulants. They reduce the immunosuppressive effect or reduce the effects of some hormones such as adrenocorticoid hormones caused by stress. The concept that the mind affects body resistance is not a new concept in Public Health. “There is no reason to panic. Fear is low and does a lot of harm. Being cheerful increases resistance and prevents complications.” Meta-analyses reveal that increased antibody titrations and interleukin2 receptors in lymphocytes are affected by stress. The strong link between the relapse of herpes viruses and stress is well known.

PERSONAL STRUCTURE AND DISEASE:

Our personality structure is a factor that affects our physical health for a lifetime. Ancient medical teachings also support this view; “There is no disease, there is a patient” Hippocrates Personality traits of people affect the appearance of the disease. The person is usually aware of most of the positive and negative personality traits in himself. For this reason, it should be possible to review the personality traits objectively and to discuss the illness. The person should be encouraged to try himself, develop his personality, and be free from fatal feelings such as self-blame. Although personality is one of the most important factors, other factors that are effective are factors such as environment, lifestyle, genetic predisposition. In Eyenstock’s research, three of the four personality types identified by the researcher were related to some diseases. These;

Type 1: people who are hopeless, do not accept help, suppress their emotions. Cancer is common among them.

Type 2: People who are prone to anxiety, aggressive, ambitious, expressing their emotions in inappropriate ways. Heart diseases are common in these people.

Type 4: People who are in tune with themselves and other people. They communicate well, are optimistic, sensitive, and try to remain calm under stress.

In a study in which personality types were followed for 10 years, the relationships between causes of death and personality types are shown in the table below.

Table: Relationships Between 2 Personality Types and Causes of Death

Personality Type

Dear)

Causes of death

Survivors (n)

Survivors %

Ca

CHD

Other

Type 1

901

347

61

155

338

38

Type 2

818

36

208

221

353

43

Type 3

570

8

21

80

346

81

Type 4

946

3

9

39

895

95

In another study, 490 people with predisposition to cancer and heart disease were taught ways to cope with stress. In this study, the groups were randomly formed and the control group was not taught ways of coping with stress. While the mortality rate was 76% in the control group, it was 20% in the study group. Deaths due to CHD in the study group were 6 times higher than in the control group.

Table: The Effect of Coping with Stress Training on Deaths in 3 Types 1 and 2 Personalities: (17 could not be heard from)

Groups

Number

Ca Deaths

Incidence of Ca

CHD Deaths

Incidence of CHD

Other Deaths

Control

234

111

129

36

45

33

Study

239

18

75

10

29

20

In this study, a 7-year follow-up was made and 17 patients could not be reached. The most important result of this research was that it revealed that personality patterns are quite flexible, no matter how unchanging they seem. Behavioral patterns and habits that have become habits are unlearned. The only positive aspect of illness and stress is that they are a very important motivator for structural changes when wisely directed.

Eysenck’s 13-year follow-up work is as follows. In this study, people prone to Ca and CHD were trained in self-compassion, relaxation techniques, improving communication skills, group support, and finding new ways to cope with stressful situations. 192 people with an average age of 50 were followed for 13 years. The results are indicated in the table below:

Table 4: Follow-up in Chronic Patients with and Without Training
Results

Medicine

number

Type 1

one hundred

Ca deaths

Ca incidence

Other deaths

the living

Control

50

16

21

15

19

Study

50

0

13

5

45

Type 2

92

CHD Deaths

CHD incidence

Other Deaths

the living

Control

46

16

20

13

17

Study

46

3

11th

6

37

According to another personality classification, the risk attributed to CHD was found to be 4.7 in the personality type defined as type D personality. Type D personality consists of two main components:

1-High rate of negative affect (anxiety, nervousness, worry)

2- Tendency to suppress their emotions

In this type of classification, type A people are impetuous, friendly, adaptable, and have a greater propensity for heart disease. Type B is people who have the opposite of these features. Type C are people with a predisposition to cancer. These are cold and angry people who are resistant to expressing their pessimistic and difficult to adapt feelings.

THERAPEUTIC EFFECT OF Laughing:

· It reduces stress,
Reduces pain, increases resistance to pain,
· Strengthens immunity,
Increases blood and lymph flow,
Increases oxygenation,
Lowers blood pressure,
· It moves the muscles.

EFFECT OF MELATONIN:

One of the mediators that has attracted attention recently is melatonin. The antitumor effects of melatonin are under investigation. Melatonin is also antiproliferative. It regulates intranuclear gene transfer by suppressing it. It inhibits the release and activity of growth factors. Melatonin is stimulated endogenously. In addition to many beneficial effects at physiological limits, it has been found to have very negative effects in humans at high pharmacological doses. One of these adverse effects is immunosuppression.

When we take a look at the situations that stimulate melatonin, we see that these are the lifestyle effects used in supportive treatment programs. Low melatonin levels are also often seen in conditions such as extreme fatigue caused by workplace conditions.

Figure: 1 Factors Affecting Melatonin Release:

IMPROVING SITUATIONS

INHIBITING SITUATIONS

Meditation

sunlight

Lights near sunset

calorie restriction

Exercise

Diet rich in Ca, Mg, B6

diet rich in tryptophan

Eggs, milk, seafood (seaweed), spirulina

Stress

Caffeine, beta-blocker, alcohol or sedative intake before bedtime

electromagnetic radiation

Night shift and fatigue

Excessive calorie intake

inactivity

SOCIAL FACTORS AND HEALTH:

In preventive health programs, the importance of people’s social integration and relationships in catching the disease has been revealed and the importance of known lifestyle factors has been emphasized. There are studies supporting that job dissatisfaction and unhappiness at work in the etiology of CHD are stronger than generally accepted risk factors. Some factors such as being married, having a large circle of friends, being a church member, participating in group activities are factors that have a protective effect on health. In addition, marginality predisposes to many diseases. Social support, which is a savior in a person’s life, is questioned with the following question: “Do you have a relative who provides emotional support to you? So is there someone you can talk to about your problems and help you with your difficult decisions?” The social structure of people is much more important than their medical background. This is a more powerful and central factor in their health than any other therapeutic potential. This is why support groups are so helpful.

IMMUNE SYSTEM IN DEPRESSION:

The interaction between the neural immune and psychological systems follows routes that include the immune system, hypothalamic pituitary and adrenal axis, and the autonomic nervous system. When the body encounters a pathogen, the immune system acts as a sensor organ. Communication between the immune system and the brain is provided by cytokines. Cytokines are peptides that provide a wide variety of biological activities. They also govern the immune response. During immunostimulation, cytokines such as interleukins and interferons are produced in the periphery and in the brain, and are transferred to specific receptors with neural neuroendocrine and behavioral functions, where they can act.
they move.

Hypothalamo-pituitary adrenal axis HPA causes hormonal responses as well as physiological responses such as fever, meanwhile cytokines in brain tissue can cause behavioral changes.
It can explain cases such as depressive mode, anorexia, weight loss, insomnia or different sleep patterns, weakness and regression of motor activity, indifference to the physical and social environment, and impaired consciousness in people with physical illness. These behavioral symptoms during acute illness are called ‘illness behaviour’. In the case of immune activation accompanying chronic diseases, illness behavior may develop in a depressive episode.

Depression is a common and devastating medical condition. The prevalence of major depressive episodes in physically ill individuals ranges from 5% to over 40%. This state of prevalence is due to the fact that depression is often not diagnosed or treated. Medical processes related to depression can be processes that directly cause the activation of the immune system, not only some losses due to pain, weakness, physical illness. It has been experimentally shown that the causes of viral infections, especially in the respiratory system, are neurophysiological disorders such as depressive mode or other depressive symptoms. Similar findings; shown for chronic herpes infections, CMV, EBV, gastroenteritis, Borna Disease Virus and HIV infections.

Cytokines secreted due to chronic activation of the immune system cause many non-infective conditions. The incidence of depression was found to be high in such patients. Studies have shown that depression causes dysregulation of the immune system. This supports that the depression accompanying the disease occurs as a result of immune activation.

The Role of Cytokines in Accompanying Depression: The psychological effects of cytokines have been understood because of the psychological and neuroendocrine symptoms that occur when exogenous cytokines are administered to patients with cancer or hepatitis C. Exogenous administration of cytokines such as interferon alpha, interleukin 2 or Tumor Necrosis Factor (TNF) created masked depression. The symptoms of this depression began following cytokine administration and
became evident after cytokine therapy.

In another experimental study, the first response was signs of infection in people injected with low-dose purified lipopolysaccharide (LPS). These people did not develop the disease, Heart Rate and blood pressure remained normal, but fever increased, and blood levels of cytokines and cortisol increased. In the following period, anxiety and depressive mood were detected in these individuals, and verbal and nonverbal memory functions were observed to be impaired.

Animal studies have also demonstrated the behavioral effects of cytokines. These effects are conditions such as anorexia, weight loss, sleepiness, psychomotor retardation, weakness, fatigue, hypertrophy of lymph nodes, and cognitive disorders. These are thought to be related to IL-1 and TNF.

The Role of Antidepressants: Comorbid depression is treated with antidepressants. For this purpose, tricyclic antidepressants and selective serotonin reuptake inhibitors can be recommended. of antidepressants
Many immunomodulatory effects have been demonstrated. At the end of long-term treatment, effects such as suppression of immune function and cytokine secretion or no effect on cytokine levels can be observed. Illness behavior and neuroendocrine effects induced by LPS in experimental animals were reduced by using imipramine and fluxetine.

In a double-blind study performed on patients with malignant melanoma during interferon treatment, less than 1/3 of the patients in the group given paroxetine 2 weeks before the treatment developed depression and did not abandon the treatment. However, most patients in the placebo group had major depression and had to be discontinued 3 weeks early due to the toxic effects of interferon.

Summary:
· Cytokines; are non-antigen proteins that are released from cells that come into contact with antigens and act intracellularly,
During the disease, the immune system works as a sensitive organ, it communicates with the brain and stimulates the release of cytokines,
There is a relationship between high cytokine levels and psychological disorders such as depression,
Experimental immune activation caused depressive mode and other psychological disorders,
Antidepressants can be used in the treatment and prevention of depression accompanying diseases due to their possible immunomodulatory effects,
Depressive symptoms in sick people may be the result of immune activation and cytokine secretion rather than the discomfort and deficiencies caused by the disease.

Non-infective Conditions Associated with Cytokine Secretion and Immune System Activation
• Autoimmune diseases: MS, RA, SLE, Allergy

• Stroke

• Trauma

• Alzheimer’s HSt

• Other Neurodegenerative Diseases

• Cancer

Depressive Symptoms Caused by Administration of Cytokines to Cancer or Hepatitis Patients:
• Depressive Mode

• dysphoria

• Anhedonia (Decreased capacity for pleasure)

• Hopelessness,

• Moderate or extreme fatigue,

• Anorexia or weight loss,

• Hypersomnia,

• Psychomotor Retardation,

• Decreased Concentration,

• Confusion

Diseases Associated with Depressive Syndromes Responding to Antidepressants:
• MS,

• Stroke,

• Alzheimer’s Disease.

• Cancer,

• AIDS,

• Interferon Use (Hepatitis C or MS)

Recent studies on depression have revealed that major depression is not only a risk factor for the development of coronary artery diseases, but also a factor affecting the mortality of patients with MI.

HOLISTIC MEDICINE:

Holistic Medicine, known as Mind-Body Medicine or Mind-Body Medicine, requires collaborative work in many subjects. These fields include psychologists, immunologists, psychiatrists, oncologists, behavioral scientists, and cardiologists. Mind body medicine is a promising field for Health Promotion. This is because the cost is relatively low and the side effects are generally good.
In this respect, it would be a good attitude to reconsider the traditional methods in clinical medicine and create a new opening. Hippocrates, the father of Western Medicine, said that “man can only be understood as a whole”. After many definitions and centuries passed, WHO is about to catch up with the same definition. The definition of “a dynamic harmony of one’s body, mind, spirit and social and cultural interactions in the environment” is the latest definition of health by WHO. “The body is the shadow of the soul”

This simple sentence contains many meanings involving holistic thinking. An analogy used to explain the holistic relationship is that of vehicle and driver. The driver influences the route the vehicle takes, whether the vehicle reaches and maintains sufficient engine power, and even whether or not accidents occur. Careful drivers take good care of their vehicles, have fewer accidents and at least need a mechanic.

The other analogy is that of the orchestra and its conductor. If the communication between the orchestra and the conductor is good, there is harmony. If it is otherwise, it will sound distorted. The human body has an amazing healing tendency. This vital force prepares life with great intelligence, supervision and coordination. Einstein explained this intelligence possessed by nature as follows. “Whoever is seriously engaged in the pursuit of science knows that there is a spirit in the laws of nature. When a person comes face to face with this power over his humble and humble power, he attributes a loaded meaning to religious feelings. Religion is a different area in which one is quite inexperienced.” “Miracles do not contradict nature, they already exist in nature, which we know as contradiction”

Holistic Medicine Techniques:
East Indian Openwork,
· Acupuncture,
· Biofeedback,
Chinese Herbal Medicine,
· Exercise,
· Herbalism,
· Homeopathy,
· Hypnosis,
· Massage,
· Musculoskeletal System Manipulations,
· Meditation Rites,
· Psychotherapy
· Reflexology,
· Relaxation,
· Tai Chi
· Therapeutic touch,
Yoga

RECOMMENDATIONS FOR PUBLIC HEALTH:

· Research on holistic and alternative medicine techniques should be given importance.
· Research on psychoneuroimmunology should be given importance.
· Adequate information on medical practices other than Modern Medicine should be added to the Medical Education Curriculum.
· Stress Reduction and Relaxation Techniques should be included in Health Promotion Programs
The deficiencies in education and practice on the diagnosis and treatment of depression should be tried to be eliminated.

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