192 Concluding remarks The interdisciplinary

approach of PNI has led to an integrative view of the immune system and the nervous system. Meanwhile, it is commonly accepted that not only does the CNS influence the immune reaction, but also that the immune system, particularly via its hormones- the AMD3100 clinical trial cytokines – acts on brain function and behavior. There is ample evidence for the contribution of cytokines in psychiatric symptoms, syndromes, and disorders, and the involvement of the immune system fits to other commonly accepted Inhibitors,research,lifescience,medical etiopathological concepts like the neuro-developmental hypothesis of schizophrenia. Genetic research gives further evidence for the possible involvement Inhibitors,research,lifescience,medical of the cytokine system especially in schizophrenia. However, the exact mechanisms of (inter) action must be elucidated in further investigations. Immunopsychiatrists may learn from somatic disorders like the systemic lupus erythematosus (SLE), an inflammatory disease affecting many organ systems including the CNS. The CNS affection in SLE encompasses a wide spectrum of neurological and psychiatric features including dementia, anxiety, depression,

and psychosis,193 and the causative role of cytokines, predominantly TNF-α, for the neuropsychiatrie symptoms of SLE was proposed.134 Another Inhibitors,research,lifescience,medical aspect for future research derives from first therapy approaches in psychiatric disorders based on immunological considerations. The report of the therapeutic efficacy of a COX-2 inhibitor in schizophrenia194 has particularly demonstrated the importance of immunological research in psychiatric disorders. Thus, the new paradigm of brain-immune interaction appears Inhibitors,research,lifescience,medical to evoke new research and treatment strategies. Selected abbreviations

and acronyms BBB blood-brain barrier COX cyclooxygenase-2 CS conditioned stimulus CSF colony-stimulating factor CVO circumventricular organ Inhibitors,research,lifescience,medical HPA hypothalamus-pituitary-adrenal (axis) 5-HT serotonin (5-hydroxytryptamine) ICV intracerebroventricular IDO indoleamine-2,3-dioxygenase IFN interferon IL interleukin LPS lipopolysaccharide LT lymphotoxin MD major depression PNI psychoneuroimmunology either TGFβ transforming growth factor beta Th T helper (cell) TNF-α tumor necrosis factor alpha
AIthough cognitive decline and deficits in social competence are the hallmarks of progressive neurodegeneration, behavioral abnormalities are common and important characteristics of dementia. Alzheimer’s disease (AD) is the principal cause of dementia in the elderly,1 therefore the following review closely relates to this disorder. It. affects almost 15 million people worldwide.1 A wide range of behavioral disturbances afflict the majority of patients with dementia. Behavioral disturbances, such as verbal or physical aggression, urinary incontinence, and excessive wandering, are a major source of caregiver burden and an important contributor to the decision to admit AD patients to institutionalized long-term care.