Ambulatory Medicine

Neural Modulation of Immunity presents the proceedings of an international symposium held in Brussels in the fall of 1983. Fifteen papers, each followed by a record of the discussion by participants in the conference, address aspects of CNS control and input into the immune response. The opening chapter by Cohn on the essential elements of the immune response offers a philosophical overview of the broad framework of the vertebrate immune system, stressing the independence of the antigen-dependent branch and the dependence of the antigen-independent branch on neural input. The routes of CNS communication are delineated as: (1) direct innervation of the spleen, lymph nodes, thymus, and marrow, and (2) endocrine feedback regulation involving soluble mediators; this sets the stage for the papers that follow. Three papers on psychological state effects on immune responsiveness examine the links between such conditions as depression, bereavement, and conditioning, and immunity as tested by studies ranging from in vitro Iymphocyte activity to mortality in laboratory animals. The next section contains six papers on the anatomical and chemical relationships between the CNS and the immune system. Hemispheric laterality and lesion studies, among other variables, are examined for their impact on immune function. The section uses excellent micrographs and contains a good discussion on the role of neurochemicals in immunity. The last six papers examine such topics as neuroendocrine-immune system feedback circuits and the immunoregulatory activity of marrow-derived factors. The volume closes with a discussion that addresses problems and the future direction of the field. As a collection of works on a new field of considerable promise, Neural Modulation of Immunity offers original work of good quality to those studying the mechanism and role of regulatory communication between the CNS and the immune system. The authors and participants are among the leading investigators in this area, and their treatment of current progress is excellent.