The brain-immune cells axis controls tissue specific immunopathology.

Abstract

During viral infections, cell death can be induced as a direct result of cytopathic virus replication in various cell types and tissues or as an immune response of the host to the infectious agent. This leads to an infiltration of inflammatory cells, causing subsequent tissue damage. The balance between effective elimination of the pathogen and prevention of fatal tissue damage is decisive for life. The host has developed various mechanisms to inhibit excessive immune responses.

Glucocorticoids (GCs) are well known to inhibit the immune response. GCs are synthesized after activation of the hypothalamic–pituitary–adrenal (HPA) axis by various viral infections and systemic inflammation. Neurons in the hypothalamus express the corticotropin-releasing hormone (CRH). CRH in turn induces a signaling cascade, which ends with an activation and release of GCs in the adrenal cortex.1 GCs can act as suppressors or inducers of the immune system by binding to the glucocorticoid receptor (GR) (Fig. 1). The HPA axis is activated in response to various viral infections or systemic inflammation, and is required to restore homeostasis by limiting inflammation and tissue damage. The underlying mechanisms remained unclear so far.