Forschungsverbund Neuroimmunologie und Schmerz (Neuroimpa) im Forschungsnetz Muskuloskelettale Erkrankungen

Research consortium Neuroimmunology and pain in the research network musculoskeletal diseases

Zusammenfassung

Hintergrund

Der Forschungsverbund Neuroimmunologie und Schmerz (Neuroimpa) untersucht die Bedeutung der Beziehungen zwischen dem Immunsystem und dem Nervensystem bei muskuloskeletalen Erkrankungen für die Entstehung von Schmerzen und für den Verlauf von Frakturheilung und Arthritiden.

Methodik

Das Methodenspektrum umfasst Untersuchungen an Einzelzellen, In-vivo-Modelle von Arthritis und Frakturheilung, bildgebende Verfahren zum Studium von Gehirnfunktionen an Tier und Mensch sowie die Analyse von Patientendaten.

Ergebnisse

Proinflammatorische Zytokine tragen über neuronale Zytokinrezeptoren signifikant zur Entstehung von Gelenkschmerzen bei. Immunzellen sezernieren Opioidpeptide, die über Opioidrezeptoren peripherer Nozizeptoren hypoalgetisch wirken. Die Knochenneubildung nach Fraktur wird durch das Nervensystem signifikant unterstützt. Das sympathische Nervensystem fördert die Entwicklung immunologisch induzierter Arthritiden. Die Studien zeigen ein bedeutsames analgetisches Potenzial der Neutralisierung von proinflammatorischen Zytokinen und von selektiv peripher wirkenden Opioiden. Ferner zeigen sie, dass die Modulation neuronaler Mechanismen muskuloskeletale Krankheitsverläufe günstig beeinflussen kann.

Diskussion

Eingriffe in die Interaktionen zwischen dem Immunsystem und dem Nervensystem bergen ein großes therapeutisches Potenzial für die Behandlung von muskuloskeletalen Erkrankungen und Schmerzen.

Abstract

Background

The research consortium Neuroimmunology and Pain (Neuroimpa) explores the importance of the relationships between the immune system and the nervous system in musculoskeletal diseases for the generation of pain and for the course of fracture healing and arthritis.

Material and methods

The spectrum of methods includes analyses at the single cell level, in vivo models of arthritis and fracture healing, imaging studies on brain function in animals and humans and analysis of data from patients.

Results

Proinflammatory cytokines significantly contribute to the generation of joint pain through neuronal cytokine receptors. Immune cells release opioid peptides which activate opioid receptors at peripheral nociceptors and thereby evoke hypoalgesia. The formation of new bone after fractures is significantly supported by the nervous system. The sympathetic nervous system promotes the development of immune-mediated arthritis. The studies show a significant analgesic potential of the neutralization of proinflammatory cytokines and of opioids which selectively inhibit peripheral neurons. Furthermore, they show that the modulation of neuronal mechanisms can beneficially influence the course of musculoskeletal diseases.

Discussion

Interventions in the interactions between the immune system and the nervous system hold a great therapeutic potential for the treatment of musculoskeletal diseases and pain.

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Correspondence to Prof. Dr. H.-G. Schaible.

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Interessenkonflikt

H.-G. Schaible, H.-D. Chang, S. Grässel, H. Haibel, A. Hess, T. Kamradt, A. Radbruch, G. Schett, C. Stein und R.H. Straub geben an, dass kein Interessenkonflikt besteht.

Alle beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethik-Kommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor.

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Schaible, HG., Chang, HD., Grässel, S. et al. Forschungsverbund Neuroimmunologie und Schmerz (Neuroimpa) im Forschungsnetz Muskuloskelettale Erkrankungen. Z Rheumatol 77, 24–30 (2018). https://doi.org/10.1007/s00393-018-0459-9

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Schlüsselwörter

  • Immunsystem
  • Nervensystem
  • Muskuloskelettale Erkrankungen
  • Opioide
  • Proinflammatorische Zytokine

Keywords

  • Immune system
  • Nervous system
  • Musculoskeletal diseases
  • Opioids
  • Proinflammatory cytokines