Effects of Acute Stress or Centrally Injected Interleukin-1beta on Neuropeptide Expression in the Immune System

Acute stress stimulates the expression and release of corticotropin-releasing hormone (CRH) and arginine vasopressin (AVP) from the hypothalamus, and the pro-opiomelanocortin products beta-endorphin and ACTH from the anterior pituitary. These neuropeptides are also expressed in immune tissues, and it has been proposed that they may modulate immune responses to stress through paracrine mechanisms. We subjected rats to restraint stress or central injection of interleukin (IL)-1beta to determine whether these acute stimuli can alter the expression of neuropeptides in the spleen and thymus. Restraint stress significantly increased the contents of all these neuropeptides in thymic, but not splenic, extracts. A single icv injection of IL-1beta increased contents of CRH, AVP, ACTH and beta-endorphin in the spleens of both sham-operated and adrenalectomised (ADX) rats. IL-1beta increased thymic contents of CRH and ACTH in sham-operated rats but these increases were not observed in ADX rats. These results suggest that the effects of IL-1beta on neuropeptide expression in the spleen are independent of glucocorticoids, whereas IL-1beta stimulation of neuropeptide expression in the thymus is dependent on circulating glucocorticoids. There were significant correlations between increases in CRH, ACTH and beta-endorphin in the spleen, and between CRH and ACTH in the thymus, consistent with the suggestion that IL-1beta-induced increases in ACTH and beta-endorphin may be mediated through CRH. These results provide evidence that stressors can directly influence neuropeptide expression in immune tissues. Thus stress may influence immune functions through paracrine mechanisms involving locally synthesised neuropeptides as well as through activation of the hypothalamo-pituitary-adrenal axis.     

Book reviews

SINGER, J. L. (Ed.). The Child's World of Make-Believe. New York: Academic Press. 1973. PP. 294. £5.75.

CRUE, B. L. (Ed.). Pain Research and Treatment. New York: Academic Press. 1975. Pp. 417. £12.50.

BEILIN, H. Studies in the Cognitive Basis of Language Development. New York: Academic Press. 1975. Pp. 420. £11.25.

ROLLS, E. T. The Brain and Reward. Oxford: Pergamon Press. 1975. Pp. 115. £3.00.

GAZZANIGA, M. S. and BLAKEMORE, C. Handbook of Psychobiology. New York and London: Academic Press. 1975. Pp. 639. £15.15.

KULLER, R. (Ed.). Architectural Psychology. Stroudsberg: Dowden, Hutchinson and Ross. 1973. Pp. 450. S.Kr. 69.

CANTER, D. and LEE, T. (Eds). Psychology and the Built Environment. London: Architectural Press. 1974. Pp. 213. £7.50.

CLARE, A. Psychiatry in Dissent. Controversial Issues in Thought and Practice. London: Tavistock Publications. 1976. Pp. xvii +438. £7.50 (hardback); £4.00 (paperback).

RACHMAN, S. J. and PHILIPS, C. Psychology and Medicine. London: Temple Smith. 1975. PP. 223. £3.75.

VURPILLOT, ELIANE. The Visual World of the Child. London: George Allen & Unwin Ltd. 1976. Pp. 372. £9.50.

FALMAGNE, R. J. (Ed.). Reasoning: Representation and Process. London and New York: Wiley. 1975. Pp. 275. £10.15.

FANT, G. and TATHAM, M. A. (Eds). Auditory Analysis and Pevception of Speech. London: Academic Press. 1975. Pp. 564. £12.00.     

A review of teen-tot programs: comprehensive clinical care for young parents and their children

Comprehensive clinical programs for teenage mothers and their children, also known as teen-tot programs, have been a promising intervention to improve outcomes of teenage childbearing and parenting. However, much remains unknown regarding the efficacy of such programs. We reviewed four published evaluations of programs that provided medical care, counseling, contraception, guidance for parenting, and assistance with staying in school. The evaluations reported moderate success in preventing repeat pregnancies, helping teen mothers continue their education, and improving teen and infant health over 6 to 18 months. However, the evaluations had limitations that may have reduced or accentuated observed effectiveness. Teen-tot programs will continue to face the challenges of sustaining adequate long-term interventions and evaluations, and reducing the high attrition rate among program participants. It is concluded that increased support and funding for teen-tot programs and more complete evaluations are warranted.     

Regulation of Peripheral Catecholamine Responses to Acute Stress in Young Adult and Aged F-344 Rats

Young adult (3-month-old) and aged (24-month-old) Fischer-344 male rats received i.v. infusions of 3H-labeled norepinephrine (NE) and epinephrine (EPI) to examine the effects of aging on the neuronal uptake of NE and sympathoadrenal release of NE and EPI. Spillovers of NE and EPI into plasma and their clearance from the circulation were estimated from plasma concentrations of endogenous and 3H-labeled NE and EPI. The efficiency of neuronal uptake was assessed from changes in plasma clearance of NE and concentrations of its intraneuronal metabolite, dihydroxyphenylglycol (DHPG), during immobilization stress or neuronal uptake blockade with desipramine. Stress-induced increases in plasma NE and higher plasma NE concentrations in aged compared to young adult rats were due to both decreases in NE clearance and increases in NE spillover. EPI spillover and clearance were reduced in aged compared to young adult rats, so that plasma EPI levels did not differ between groups. Young adult and aged rats had similar desipramine-induced decreases in NE clearance, whereas desipramine-sensitive decreases and stress-induced increases in plasma DHPG were larger in aged rats. This indicates that neuronal uptake is intact and that increased NE spillover at rest and during stress in aged rats reflects increased NE release from sympathetic nerves. The results show that aging is associated with divergent decreases in EPI release from the adrenal medulla and increases in NE release from sympathetic nerves. Increased plasma concentrations of NE in aged compared to young adult rats also result from decreased circulatory clearance of NE, but this does not reflect any age-related impairment of NE reuptake.     

Commentary on "Sedation before ventilator withdrawal

In any important article in the field of clinical ethics, the focus should not be on the specific case example, but rather on the issues it presents for thought and discussion. Barbara Springer Edwards and Winston M. Ueno achieve this end admirably. They present a terminally ill patient who requested termination of ventilator support, despite the overwhelming odds that he would die as a result. The authors ask whether or not the physician acted appropriately in accommodating the patient's wish and in sedating him to decrease suffering in his last moments. They present compelling arguments that sedation was warranted in this case. They also note correctly that competent patients have the right to refuse treatment. However, in addition to the question of sedation, this case raises other important issues, specifically those related to pain management and depression in the terminally ill....     

Can we measure out a life in coffee spoons?

Public policy decisions in medicine and other fields necessitate careful weighing of choices and consequences. Cost-benefit analyses have been offered as one way to facilitate such decisions. In "Quantifying the value of human life," L. Eugene Arnold asserts that mathematical models such as his offer greater clarity in making public policy decisions than is possible with the "intuitive" or "emotional" approach. In our opinion, problems associated with this quantitative analysis demonstrate a need for caution in applying such mathematical models to public policy decisions....