Integrated evolutionary, immunological, and neuroendocrine framework for the pathogenesis of chronic disabling inflammatory diseases
Abstract
The pathogenesis of chronic disabling inflammatory diseases (CDIDs) is poorly understood. Current concepts that focus on abnormalities of the immune system are, in our view, incomplete. Here we propose that chronic disruption of homeostasis through abnormal neuronal and endocrine host re‐ sponses to transient inflammatory reactions contributes to the appearance of CDIDs. Coordinated reactions of the supersystems (immune, nervous, endocrine, and reproductive) that maintain homeostasis have been evolutionarily conserved to respond to and eliminate foreign agents over a period of days to a few weeks. If the responses of these supersystems fail to return to normal after elimination of the pathogen, a continuous aggressive immune response is created; this situation can trigger development of CDIDs. Maladaptation of the supersystems during CDIDs has not been evolution‐ arily conserved but is nevertheless still prevalent be‐ cause a large proportion of these diseases tend to appear after the reproductive phase. We propose that this integrated systems hypothesis may permit better identification of a patient at risk or in the early stages of developing a CDID such as rheumatoid arthritis and enable more coordinated intervention than is presently attempted.—Straub, R. H., Besedovsky, H. O. Inte‐ grated evolutionary, immunological, and neuroendo‐ crine framework for the pathogenesis of chronic dis‐ abling inflammatory diseases. FASEB J. 17, 2176‐2183 (2003)
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Inflammation-driven energy expenditure programs were positively selected for acute but not chronic systemic inflammation, and chronic use of these programs is highly unfavorable.
“(iii) evolutionary medicine explains that these inflammation-driven energy expenditure programs were positively selected for acute but not chronic systemic inflammation, and chronic use of these programs is highly unfavorable [7].”
From Interaction of the endocrine system with inflammation: a function of energy and volume regulation (2014) · cites this paper as [7]
Genes responsible for energy regulation have been positively selected under conditions without chronic inflammation.
“It has been hypothesized that genes responsible for energy regulation have been positively selected under conditions without chronic inflammation [8, 10].”
From Evolutionary medicine and chronic inflammatory state—known and new concepts in pathophysiology (2012) · cites this paper as [8]
Sickness behavior represents an element of an adaptive program that has been positively selected for transient immune and inflammatory reactions to limit energy utilization for activities such as foraging and courtship behavior.
“To explain these seemingly disparate observations, it can be proposed that sickness behavior represents an element of an adaptive program that has been positively selected for transient immune and inflammatory reactions to limit energy utilization for such activities as foraging and courtship behavior [8, 26, 27].”
From Evolutionary medicine and chronic inflammatory state—known and new concepts in pathophysiology (2012) · cites this paper as [8]
Genes relevant to the etiology of today's chronic inflammatory diseases have been positively selected for their effects on normal host defense as well as the host response to serious, albeit non-life-threatening, inflammatory episodes in contrast to chronic inflammatory diseases.
“It has been hypothesized that the genes relevant to the etiology of today’s chronic inflammatory diseases have been positively selected for their effects on normal host defense as well as the host response to serious, albeit non-life-threatening, inflammatory episodes in contrast to chronic inflammatory diseases (Table 2) [8].”
From Evolutionary medicine and chronic inflammatory state—known and new concepts in pathophysiology (2012) · cites this paper as [8]
No positively selected programs exist for aging and chronic inflammatory diseases.
“Since no positively selected programs exist for aging [44] and chronic inflammatory diseases [8, 45]”
From Evolutionary medicine and chronic inflammatory state—known and new concepts in pathophysiology (2012) · cites this paper as [8]
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“org/licenses/ medium, provided the original work is proper 2014 (i) energy-rich fuel allocation is important for an activated immune system [4,5], (ii) increased activity of the water retention system accompanies energy allocation to the immune system [6], and (iii) evolutionary medicine explains that these inflammati…”
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Wolff, C., Krinner, K., Schroeder, J. A., & Straub, R. H. (2014) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2013-203885 · Cited by 19 · see citing works
Self-citationTeodorczyk-Injeyan, J. A., McGregor, M., Ruegg, R. P., & Injeyan, H. S. (2010) · Chiropractic & Manual Therapies · doi:10.1186/1746-1340-18-26 · Cited by 19 · see citing works
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The human body as an energetic hybrid? New perspectives for chronic disease treatment?
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The Selfish Immune System when the Immune System Overrides the ‘Selfish’ Brain
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Origin of Typical Disease Sequelae
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Pathogenesis and Neuroendocrine Immunology
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Neural Regulation of Pain and Inflammation
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Dhabhar, F. S. (2007)
Neuroendokrinimmunologie: Neue Aspekte zur Pathogenese und klinischen Anwendung
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Self-citationBottasso, O. A. (2022) · International Journal of Cardiology · doi:10.1016/j.ijcard.2022.01.012
Masi, A. T., & Aldag, J. C. (2007) · Elsevier eBooks · doi:10.1016/b978-012373947-6.00459-1
(2015) · Elsevier eBooks · doi:10.1016/b978-0-12-803321-0.09996-1
Straub, R. H. (2015) · Elsevier eBooks · doi:10.1016/b978-0-12-803321-0.00003-3
Self-citation
- Authors
- Straub, R. H., & Besedovsky, H. O.
- Affiliations
- University Hospital Regensburg (DE)
- Philipps University of Marburg (DE)
- Venue
- The FASEB Journal
- Publisher
- Wiley
- Published
- 2003-12
- Volume
- 17
- Issue
- 15
- Pages
- 2176-2183
- ISSN
- 0892-6638 (ISSN-L)
- 1530-6860
- OpenAlex
- W2095195181
- Cited by
- 85
- References
- 74
- Citations by year
- 2026: 1 · 2024: 1 · 2022: 3 · 2021: 2 · 2020: 3 · 2019: 4 · 2018: 2 · 2017: 2 · 2016: 3 · 2015: 9 · 2014: 5 · 2013: 4 · 2012: 4
- FWCI
- 1.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The FASEB Journal (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Deutsche Forschungsgemeinschaft
- Volkswagen Foundation
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Keywords
- pathogenesis, neuroendocrine-immune interaction, homeostasis disruption, rheumatoid arthritis, reproductive stage, host defense
- MeSH terms
- Adaptation, Physiological, Chronic Disease, Biological Evolution, Homeostasis, Humans, Immune System, Immune Tolerance, Inflammation, Nervous System, Neurosecretory Systems, Reproduction, Models, Immunological
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