Psychoneuroimmunology in Rheumatic Diseases

Studies on interactions between central nervous systemCentral nervous system (CNS), immune system and endocrine system as well as the influence of these interactions on mental health became a basis of psychoneuroimmunology (PNI). The neurological and psychiatric symptoms in the course of autoimmune inflammatory rheumatic diseases (AIRDs) such as rheumatoid arthritisRheumatoid arthritis, systemic lupus erythematosusSystemic lupus erythematosus, primary Sjögren’s syndromeSjögren’s syndrome or antiphospholipid syndromeAntiphospholipid syndrome are known and intensively studied. However, the pathogenesis of these symptoms/disturbances and connections between CNS changes and mental state changes of patients with diseases listed above are still not fully explained. Hormonal disbalance, activity of the cytokine network especially proinflammatory cytokines, breaking autotolerance with autoantibodies production and persistent immune cells stimulation as well as probability of crossing the blood brain barrierBlood-brain barrier in AIRDs in a general way can explain these connections. This chapter presents the most common phenomena that can be defined as PNI in autoimmune inflammatory rheumatic diseases.