NEUROENDOCRINE-IMMUNE INTERACTIONS IN AUTOIMMUNE DISEASES: A CROSS-SPECIALTY PERSPECTIVE

Abstract

Autoimmune diseases are becoming known to reflect highly complicated relations between neuro endocrine- immune systems but the clinical research is very fragmented among specialties.  This paper uses a mixed-methods experimental design to examine these interactions through a combination of biomarker measurements to include patient-derived qualitative perspectives.  A group of autoimmune patients was selected in rheumatology and endocrinology departments.  Quantitative data incorporated serum cytokines (IL-6, TNF-alpha), cortisol and ACTH concentrations and others as indicators of autonomic functioning-ie, the heart rate variability.  Findings showed that there were statistically significant reciprocals between increased pro-inflammatory cytokines and diminished autonomic performance, and imbalanced cortisol regulation, which indicates HPA axis dysfunction.  The above biomarkers passed the test of multivariate regression as predictive of severity of symptoms in the various types of diseases.  Parallel to them, qualitative interviews were conducted to investigate patient experiences of flares of their symptoms, aspects perceived as triggering stress, and emotional load.  Thematic analysis identified a number of recurrent themes of psychological stress followed by physiological aggravation indicating a duplicating neuroimmune feedback system.  The cross-specialty management systems that take into account the molecular and experiential aspects of disease were outlined by the combination of quantitative and qualitative information.  These outcomes demonstrate the importance of cross-discipline collaboration when it comes to the improvement of patient-centred care, patient monitoring, and diagnostic accuracy in autoimmunity.