Psychoneuroimmunology. Part II: Mind-body interventions

Psychoneuroimmunology and the pediatric surgeon

The mind-body connection is receiving increasing scrutiny in a large number of clinical settings, although research has lagged in the pediatric specialties. Psychoneuroimmunology (PNI) is a novel interdisciplinary scientific field that examines the relationship of the mind to the patient's neurologic, endocrine, and immune systems by examining critical parameters such as the effects of mental stress on wound healing and infection rates. Techniques that modify a patient's emotional and mental responses to illness and surgery have positive effects on their physiology resulting in improved recoveries and higher patient satisfaction rates. In the appropriate clinical settings, an awareness of PNI can enhance outcomes for pediatric surgical patients.

The role of psychoneuroimmunology in personalized and systems medicine

Psychoneuroimmunology (PNI) may provide the scientific basis for personalized and systems medicine. The exploration of the extensive interactions among psychological and behavioral factors, the nervous system, the immune system, and the endocrine system may help understand the mechanisms underlying health, wellness, and diseases. PNI theories based on systems biology methodologies may contribute to the identification of patient patterns for establishing psychological and physiological profiles for personalized medicine. A biopsychosocial model will help elucidate the systemic interrelationships between psychosocial and bio-physiological factors for the development of systems medicine. Many evidences have supported the close relationships between stress, depression, inflammation, and disorders including obesity, cardiovascular disease, diabetes, arthritis, skin diseases, infectious diseases, and sleep disorders. As inflammation is a critical connection among different diseases, the elucidation of the associations may contribute to the findings of systemic therapeutic targets. With the understanding of the translational implications of PNI, integrative interventions in multiple dimensions can be applied to modulate stress responses and promote healthier behaviors. These interventions include combination drug therapies, diets, nutritional supplements, meditation, and other behavioral and mind-body strategies.

Translation of psychoneuroimmunology into personalized medicine: a systems biology perspective

With its multidimensional features and systems biology approaches, developments in psychoneuroimmunology may provide the basis for the translation of scientific discoveries into personalized and systems medicine. To achieve this goal, several key issues need to be emphasized and resolved. These key issues include the identification of biomarkers for accurate diagnosis and treatment, the understanding of the systems interactions and networks, and the systemic profiling of patient subgroups. Recognition of systemic biomarkers may provide insight into the complex multidirectional interactions among psychological and behavioral factors, the nervous system and the immune system. Systems biology studies of complex mechanisms such as inflammation at various levels may enable the discovery of common targets for different diseases from depression to cancer. Such elucidation would enable the classification of patient patterns and subgroups for personalized interventions. Understanding of these key issues would contribute to the establishment of systems models and the development of integrative prevention and treatment strategies in multiple dimensions.