title: [Neuroendocrine immunology: new pathogenetic aspects and clinical application].
abstract: After two decades of enormous improvements in anti-inflammatory therapy with biologics long-standing disease sequelae in chronic inflammatory diseases (CID) can be recognized, such as fatigue, anorexia/malnutrition, cachectic obesity, insulin resistance, dyslipidemia, changes of steroid hormone axes (e. g. loss of androgens), increased sympathetic nervous tone/decreased parasympathetic nervous tone, inflammation-related anemia and osteopenia. This article demonstrates for the first time in the German language a new theory to explain the pathophysiology of these disease sequelae. It includes concepts from evolutionary medicine and neuroendocrine regulation of energy allocation. The core statement is: the networks of energy regulation and energy allocation have been evolutionarily positively selected for transient inflammatory episodes (not for CIDs due to the negative selection pressure) but long-standing use of these adaptive programs for CID support systemic disease sequelae. These considerations might help to deviate focus from pure anti-inflammatory treatment to adequate diagnosis and therapy of systemic disease sequelae.
authors.affiliation: Labor für Experimentelle Rheumatologie und Neuroendokrinoimmunologie, Klinik und Poliklinik für Innere Medizin I, Universitätsklinikum Regensburg, Deutschland. rainer.straub@klinik.uni-regensburg.de
authors.forename: R H
authors.initials: RH
authors.lastname: Straub
mesh_terms: D000486:Allergy and Immunology / Q000639:trends*; D020274:Autoimmune Diseases of the Nervous System / Q000235:genetics* / Q000276:immunology*; D004700:Endocrine System Diseases / Q000235:genetics* / Q000276:immunology*; D006801:Humans; D008957:Models, Genetic; D009452:Neuroendocrinology / Q000639:trends*