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P S Y CH OI M M U NOL O GY

©1999 ROMESH SENEWIRATNE

The immune system of humans has eluded a holistic scientific understanding for several reasons, including the reductionism of the medical discipline of “immunology”, which is largely focused on drug treatments, and the complexity of the subject. Many pieces of a fascinating puzzle have emerged in recent years, however, that promise to transform human health by a more complete understanding of the principles of psychoimmunology, the vital but largely ignored aspect of immunology that is the subject of this paper. This is because using the mind to heal immune related diseases is cheap, indeed free, and also risk-free. Not so the numerous dangerous drugs that are prescribed to treat diseases characterised by malfunction of the immune system, including cancers (malignant tumours, lymphomas and leukaemias), autoimmune diseases (such as rheumatoid arthritis and ulcerative colitis) and immune hyper-reactivity as occurs in asthma and eczema of an allergic aetiology. Central to the question of psychoimmunology in humans is the pineal organ in the core of the brain, for reasons that will be elaborated on in the following pages.

Psychoimmunology refers to the scientific study and knowledge of the relationship between the mind and the immune system. This relationship is complex and includes both effects of the mind on the immune system and those of the immune system on the mind. The effects of the mind on the immune system have been recognised scientifically for over 2000 years, these including both adverse effects of despair on the ability to withstand the plague following diagnosis of the infection, and the famous “placebo effect” which refers to the tendency of faith in a cure to produce a cure. Both phenomena were described by

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physicians in Greece around 2500 years ago. Whilst the fact that the mind can influence the immune system in ways that can promote either sickness or health is not in dispute, the exact psychoimmunological connections and the areas of the brain involved in the activation and direction of immune activity have not been clearly documented. An exploration and deciphering of these psychoimmunological mechanisms and connections could enable specific strategies to be developed to balance and redirect the immune system using psychological techniques such as autosuggestion and suggestions by therapists in the course of medical consultations and counselling. These could include general psychological advice regarding communication, social relationships, family relationships, activities, and attitudes and more specific advice regarding music, creative activity and the specific development of areas of lack or deficit, both mentally and physically. General suggestions regarding communication include advice regarding eye contact during speech, and the development of listening as well as speaking skills. Family relationship advice necessarily depends on the individual problems faced by families, but is assisted by an understanding of parent-child and sibling relationships, as well as common communication difficulties faced by partners. Social advice includes advice about the making and growth of sincere friendships with other people as well as domestic and wild animals. Friendship generally has predictable effects on psychological wellbeing, and psychological wellbeing has a direct influence on physiology, including that of the immune system.

Psychoimmunological problems can be broadly differentiated into conditions characterised by immune deficiency, such as infections and cancers, and conditions characterised by excessive or misdirected immune reactions, as occurs in allergies and autoimmune diseases respectively. Immunological problems can also be caused by a range of ingested and inhaled toxins, as well as toxins that are injected subcutaneously, intramuscularly and intravenously. Experiential factors which damage the immune system through sight and hearing can be described as “audiovisual immune toxins”, and these can be added to the total toxin load that people in the modern world are subjected to.

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IMMUNE SYSTEM TOXINS

Many different substances can cause damage to the immune system and these may be referred to as “immune system toxins”. These include inhaled, ingested and injected chemicals including pharmaceutical drugs and immunisations (vaccinations) as well as so-called “street drugs” such as amphetamines and heroin. The act of self-injection into veins also places the injecter at risk of toxic reactions to additives, with which the drug is “cut” (diluted) and from the water used to dissolve the drug in. Infections, including HIV and hepatitis B can also be introduced via self-injection and other intravenous injections. These include intravenous injections of blood and blood products. Intramuscular injections of blood products have also been known to cause HIV infections, hepatitis B and C infections and AIDS.

Immune suppression can also be caused by environmental toxins including chemicals which are inhaled or absorbed through the skin and various forms of harmful radiation, the best recognised of which is ionizing radiation such as gamma-radiation from radioactive materials. It is of note that Marie and Pierre Curie, the discoverers of radioactivity, both died from the results of immunosuppression, a direct result of the years they were exposed to ionizing radiation in the experiments they conducted. The two French scientists died of leukaemia, and this form of cancer is a long-recognised consequence of exposure to hyper-normal levels of gamma radiation. It is true, however, that we have evolved in a sea of normal background radiation, the result of solar radiation and naturally occurring radioactive materials in concentrations found in various rocks that form the Earth’s crust.

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Over the past 200 years, however, and in the past 50 years in particular, the amount of radiation and chemical pollution produced by mankind’s increased industrialisation has increased exponentially. This has been the result of man-made electricity and its many resultant technologies and industries. Whilst technology dependent on electricity has resulted in many marvellous human creations, it is worth considering the possible damage to our immune system and other harmful effects that can result from a mindless expansion of industrialisation.

Industrialisation has also brought new psychological experiences of a profoundly emotion-oriented nature in the form of television, video and recorded sound. These experiences have direct physiological effects, and by examining the connections of the visual and auditory systems it is possible to reasonably speculate as to what these effects are likely to be. It is possible also, by deductive reasoning, to hypothesise scientifically about which audiovisual experiences are likely to be harmful and which to be beneficial. These beneficial or harmful effects could involve the respiratory system, the cardiovascular system, the endocrine system, the gastrointestinal system, the excretory system, the reproductive system, the nervous system and the immune system. Television programs and the physical immobility of watching television can adversely affect all these physiological systems. Likewise videos. The reasons for this claim are that, firstly, television watching profoundly affects the brain, and the brain affects all these other systems, and secondly, television watching is a very unnatural activity for a person to engage in, and physiologically unnatural activities have a tendency to cause physiological harm. This affects different physiological systems, and lack of active use leads, as a general principle, to loss of function.

Medical information conveyed via television can also damage health, including the induction of groundless fears about the risk or existence of illness, and the induction of mistaken ideas about treatment. Purported cures of various sorts abound, usually involving the ingestion of tablets or capsules. These include “vitamins”, “minerals” and “dietary

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supplements”, which are often marketed as “natural”, although their appearance contradicts this. They come in the form of pills and capsules, which are clearly artificial.

THE IMMUNE SYSTEM AND THE BRAIN

The mechanisms by which the brain can influence the immune system are complex and these involve chemical, hormonal and other physiological changes which occur at different times. These include hormones from the pituitary gland and pineal organ, as well as hormones and regulatory factors secreted by the hypothalamus. Specifically, adrenocorticotrophic hormone from the anterior lobe of the pituitary gland and melatonin from the pineal organ have been demonstrated to affect immune activity by clearly elucidated mechanisms. Other mechanisms, including the activities of tumour necrosing factor from the hypothalamus, and autonomic nervous system influences on the thymus, lymph nodes and other parts of the immune system are also involved, according to more recent immunological research, and others such as the influence of the thyroid gland can be theoretically inferred.

The role of the brain in regulating and influencing immune responses can be expected to be complex and to involve several areas of the brain. In recent years some of these areas have been identified with greater certainty. By examining the known anatomical and physiological connections between different areas of the brain, it is possible to scientifically hypothesise about specific mechanisms that may play a part in immune related activity of the brain, and from the careful

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analysis of clinical medicine others can be hypothesised. Such a model will be presented in the following pages.

The areas of the brain directly connected with the hypothalamus include the limbic system and thalamus. The limbic system, in which the neurotransmitter dopamine is active, is involved in “emotional tone” and emotional reactions, as well as memory. The thalamus, which is directly connected to the limbic system and hypothalamus and positioned adjacent to the pineal organ, is involved in sensory responses and integration of sensory information from the eyes, ears and other sense organs, including the complex somatic senses of soft touch, temperature, pressure, pain, vibration and proprioception (position sense). These sensory modalities are carried by distinct nerve pathways to the brain and around it, and all are able to elicit emotional reactions. These emotional reactions involve electrical and chemical activity in the limbic system. The direct connection between the limbic system, thalamus and hypothalamus provide a direct means by which visually and auditorily perceived experiences can directly influence the hormonal and immune systems, as well as other physiological systems in the body.

Adrenocorticotrophic hormone (ACTH) is one of several important hormones secreted by the pituitary gland, and not the only pituitary hormone to affect the immune system. This hormone, which regulates secretion of cortisol by the adrenal glands, is itself stimulated by regulatory hormones from the hypothalamus, to which the pituitary is attached. These hormones include corticotrophin releasing hormone (CRH). CRH and cortisol levels exhibit diurnal variation, meaning that different amounts are produced at different times of the day and night. The same is the case for melatonin from the pineal and other hormones to greater or lesser degrees.

Depending on time of day, and in response to various triggers, including stress, ACTH stimulates the release of the steroid hormone cortisol

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(hydrocortisone) from the cortex of the adrenal glands. Cortisol is a natural anti-inflammatory agent and decreases activity of the immune system generally. It is for this reason that cortisones (synthetic forms and variations of cortisol) are widely prescribed for a range of medical illnesses and diseases characterised by excessive immune system activity. These include asthma, eczema, and other allergic conditions as well as autoimmune diseases such as Crohn’s disease, ulcerative colitis, rheumatoid arthritis, systemic lupus erythematosus (SLE), Sjogren’s syndrome, idiopathic thrombocytopenic purpura (ITP) and others. In Hashimoto’s thyroiditis, juvenile onset diabetes mellitus (“Type I”) and many other conditions which are also thought to have an auto-immune origin, cortisone by tablet or injection have not been of benefit and are likely to worsen the overall condition of the sufferer.

By examining the known adverse effects of cortisone it is possible to elucidate some of the physiological actions of cortisol and infer about others regarding the immune system in its natural state. Cortisone is recognised to cause the following: weight gain, particularly with obesity of the trunk and face (Cushing’s syndrome), demineralisation of bones (osteoporosis), susceptibility to infections by bacteria, viruses and funghi, and erosion and ulceration of the oesophagus, stomach and gastrointestinal tract. These side-effects hint at the diverse range of functions that this molecule is likely to have in the natural state.

Cortisol is a carbon-ring based molecule derived, like all steroid hormones, from the ubiquitous steroid precursor cholesterol, in the following chain of chemical reactions:

Cholesterol Progesterone 21-deoxy cortisol Cortisol (hydrocortisone)

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Cholesterol has been the subject of a campaign of fear-mongering in recent years, based on the association between high cholesterol levels and the development of heart disease and brain disease. Specifically, high serum cholesterol levels have been linked to the development of atherosclerosis, popularly translated as “hardening of the arteries”. This problem affects people in Australia and other self-designated “first world” countries much more than in poorer nations, the reasons for which can be clearly identified.

The most obvious difference in the populations who enjoy different levels of freedom from heart disease can be seen in dietary differences between these populations, particularly in the consumption of animal versus plant foods. In Australia, a typical example of a country with a very high incidence of heart disease, the British tradition of a high meat and dairy diet has been maintained by much of the population, combined with a North American tendency to eat excess amounts of “fast foods”, “junk foods” and confectionaries.

The role that meat production has played in the colonial history of Australia has been traditionally protected by governments at State and Federal level. Likewise the role of the dairy industry. Yet it is common knowledge that people suffering from high LDL cholesterol levels can greatly reduce these levels and the risk of heart disease, stroke and atherosclerosis by eating a diet rich in fruits, vegetables and cereals, depending on fish and legumes for protein rather than meat and dairy products. Milk is an essential for all young mammals, but human breast milk is undoubtedly the most healthy food that human babies and infants can be given. Breast feeding also confers added immunological benefit, since breast milk transmits protective maternal antibodies against infective organisms from mother to child. Later in life milk remains a good source of protein, calcium and other minerals, as well as various vitamins, and so are various milk products. They can be useful inclusions in a balanced diet throughout life. There are, however,

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problems with too many dairy products, and some dairy products are more beneficial than others. There are also some medical indications for restricting or ceasing the intake of dairy products. A high serum cholesterol is a good reason to restrict consumption of meat as well as dairy products.

Mental (psychological) factors have a direct influence on both cholesterol levels and the development of atherosclerosis. Atherosclerosis in turn leads to ischaemic heart disease (including angina and myocardial infarction), cerebrovascular disease (including cerebral infarction and multi-infarct dementia) and peripheral vascular disease (which can cause claudication and gangrene of the extremeties, usually the toes, feet and legs). The combined financial burden that atherosclerosis brings to the Australian people amounts to several billion dollars every year, and the incidence of atherosclerosis-related problems has been predicted to increase as the “population ages”. This will hopefully turn out to be a false prediction. It is certainly avoidable.

Mental factors which can be predicted to worsen atherosclerosis include any factors that cause sustained elevation of blood pressure or blood glucose level, and mental stress has been associated independently with raise in serum cholesterol levels. Stress causes release of cortisol from the adrenals and this cortisol is manufactured, as with all steroid hormones, from cholesterol. It makes sense then, that stress could directly result in the manufacture of more cholesterol by the body, since most of the cholesterol in the body is not absorbed from the diet; it is synthesised in the liver from acetate molecules. The liver adds cholesterol to the blood when necessary and also removes it from the blood, excreting it via the bile into the intestines. Smaller amounts of cholesterol are also excreted through the skin (Harper, 1963).

Stimulation of the adrenal cortex to produce cortisol from cholesterol occurs from the brain via the sympathetic nervous system, the activation and “fight or flight” branch of the autonomic nervous system.

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Sympathetic stimulation, which occurs at times of anxiety, excitement and anger has the physiological effect of raising blood pressure and increasing the heart rate. Blood pressure rises partly because of increased contractility of the heart and constriction of smooth muscle in arteries throughout the body. These physiological changes can be predicted to trigger episodes of anginal chest pain in people whose coronary arteries are partially occluded. Strenuous physical activity can also cause lack of adequate blood flow to affected areas of heart muscle (termed ischaemia) and trigger episodes of angina, which is usually felt as a dull, heavy feeling in the chest, which may radiate to the neck and shoulders (the left shoulder in particular, due to the position and neural connections of the heart).

The chest pain of angina is not always severe, however serious disease of the heart is to be assumed by its occurrence, and it is essential that the pain be resolved, by immediate rest and the use of sublingual nitrates. Effective medications are available for the control of angina, however use of these medications does not cure worsening blood vessel blockage, the underlying cause of most angina and ischaemic heart disease. For the progressive unblocking of already partially occluded blood vessels, much more needs to be done than drug treatment alone. Attitudinal and other psychological changes as well as dietary changes are also usually necessary. Environmental changes, eliminating triggers for acute blood pressure rises and persistent blood sugar rises are also advisable, and regular walking and other physical activity aimed towards improved overall cardio-respiratory fitness is essential. Music can be used as a safe tranquilliser for the chronically anxious or acutely angry, and as an energiser for the depressed. Adopting a more contemplative and less hurried lifestyle is helpful for those who are stressed regarding the availability of “time”, and this can also help with communication between the person concerned and the people they care about or come into contact with. It is difficult to communicate well when one is in a hurry. At the same time good communication and the growth of friendship assists psychological and physical health in profound ways, improving depression, anxiety, addictions, psychosis and other psychological problems with direct influences on health of the brain and

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body. These include effects on the cardiovascular, gastrointestinal and respiratory systems as well as the immune system.

IMMUNE CELLS AND CELLULAR IMMUNOLOGY

The immune system is directly involved in the unblocking of partially occluded arteries, since it is immune system cells that rid the body of diseased cells and toxic debris within blood vessels. This involves an immune reaction, where white cells (leucocytes) are attracted to inflamed and diseased cells and tissues by the release of chemical messengers termed cytokines from these cells and tissues. The white blood cells which are attracted to these diseased areas include lymphocytes, neutrophils and monocytes, which perform different roles in the various types of immune reaction which occur in the body.

Most of the leucocytes in the blood stream are lymphocytes, which are of two main types, termed “T-lymphocytes” and “B-lymphocytes”. B-lymphocytes transform, when activated in the tissues, into “plasma cells” which produce immune protein molecules termed “antibodies” or “immunoglobulins”. These bind to toxic particles, or particles identified as toxic (antigens) forming “antigen-antibody complexes”. Antigen-antibody complexes are consumed (phagocytosed) by other larger immune cells including neutrophils and macrophages. The latter are large phagocytic cells which transform from monocytes in the blood. This transformation occurs under the influence of different cytokines, which also trigger the transformation of B-lymphocytes into “plasma cells”. This change from B-lymphocytes to plasma cells occurs in various tissue sites where the antibody produced by a particular B-lymphocyte/plasma cell is needed, and plasma cells are not actually found in significant numbers in the blood plasma in normal states of health.

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T-lymphoctes are so named because they are prepared for immune activity in the thymus (behind the sternum of the chest). These cells differentiate in two main types of cell, “helper T-cells” and “killer T-cells”. The helper T-cells secrete cyokines, immune chemicals which act as messengers to other immune cells. They also have other activities. Killer T-cells directly kill invading pathogenic organisms and irretrievably damaged cells.

It is worth noting that these names and the descriptive terms used to describe the immune activity of the body are, perhaps unfortunately, heavily imbued traditionally with military and police-style references and theoretical models, and have been since the development of modern medical science. This terminology itself may have negative effects of the immune systems of the world’s population, but it is difficult to avoid due to common medical and scientific conventions and consensus.

An example of this can be seen in the immunologist Sir Gustav Nossal’s Boyer Lecture of 1978, printed by the Australian Broadcasting Commission as a paperback titled Nature’s Defences: New Frontiers in Vaccine Research. In it, antibodies are described in the following manner:

“The antibody molecule is a kind of magic bullet shot by the soldier, the lymphocyte, into the blood stream. It has the capacity to seek out the enemy, the microbe, and to foil its attempts to gain a foothold in the tissues. As soon as an adequate number of antibody molecules has been formed, the infection is usually thrown off. More importantly, as long as a few molecules of antibody remain in the blood and tissue fluids, a renewed invasion by the same microbe can never succeed.

“These antibodies, or guided missiles as I have called them, are quite specific. They are designed to lock onto the hostile antigen that provoked their formation…” (p.21)

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Professor Nossal, who studied medicine at the University of Sydney, is one of Australia’s most decorated scientists, and became director of the Walter and Eliza Hall Institute of Medical Research in 1965. He remains associated with this Melbourne vaccine and immunology research institution today, and was knighted for his work in 1977. Gustav Nossal, who was born in Austria in 1931, worked for two years as Assistant Professor of Genetics as Stanford University in America and a year at the Pasteur Institute in Paris before becoming director of the Walter and Eliza Hall Institute associated with the University of Melbourne. He has also advised the World Health Organization on matters relating to international health and the global immunization program. Professor Nossal is a keen advocate of vaccination, and this is evident from his Boyer Lecture, when he extols the virtues and successes of vaccination against polio, small-pox and other infectious diseases.

Nevertheless, his own account of the “last case of smallpox” leaves some important questions regarding safety unanswered and raises some others about the origin of AIDS in Africa:

“By 1975, smallpox existed only in the Horn of Africa, and final success seemed near, but then in May 1977 an unexpectedly severe epidemic broke out in Somalia. Twenty-four WHO staff were recruited for the final ‘search and destroy’ mission. The team, and 50 vehicles, was assembled and airlifted to Somalia under emergency conditions. Within 18 days, a full-scale operation involving 3,500 Somalian health workers, was in progress. The team searched for smallpox cases amongst nomadic tribes in some of the most rugged terrain in the world. It was an epidemiologist’s nightmare, but within four months the task was complete. Smallpox was gone from Somalia and the world – or so we thought.

“Then came the tragic incident in Birmingham. On August 11, 1978, Mrs Janet Parker, a medical photographer from the University of Birmingham became ill. A couple of weeks later, laboratory tests confirmed that she had smallpox. Mrs Parker had not been abroad recently, and though details of what happened are still shrouded in secrecy, the source of the infection must have been from the

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University’s Department of Medical Microbiology. A leading smallpox authority, Dr Henry Bedson, blamed himself for what happened, and committed suicide. Mrs Parker herself died on September 11…” (p.16)

This event prompted Professor Nossal to urge for the disposal of all remaining samples of smallpox from private laboratories around the world, but he claimed that this is difficult to enforce, even by the United Nations and its subsidiary organisation, the World Health Organization. He says:

“Laboratory research involving smallpox is simply no longer justified. There may be some merit in preserving two or three seed lots of the virus under conditions of absolute maximum security, in case some unforeseen future emergency demands renewed smallpox research. Perhaps the drama of Birmingham will persuade the nations as no plea from WHO could do.” (p.16)

Nevertheless, he considered the smallpox eradication strategy to have been an overall success, but then, in 1978, the AIDS epidemic of Africa had only just begun. The AIDS epidemic in Africa, which has claimed millions of lives over the past 20 years, began around the same time as the World Health Organization’s smallpox and polio eradication programs in Africa, and the early experiments with hepatitis B vaccination in male homosexual populations in the cities of Los Angeles and San Francisco. These same populations were the first to develop HIV antibodies in their blood and clinical AIDS, and the epidemics began roughly simultaneously in the United States of America and Africa, in the early 1980s. The postulated viral causative agent of AIDS was named HTLV III, and changed to HIV (Human Immunodeficiency Virus) in the mid 1980s.

Epidemiologically, the explanation put forward by academics from American, British and western European Universities has not made sense from the outset. This is that HIV entered the human population

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from monkeys in central Africa, where it had been an endemic infection of simian mammals previously. Why then did it suddenly and simultaneously cause human epidemics in Africa and America, affecting completely different populations, with different environments and lifestyles? Why was and is the disease predominantly one affecting women and young children in Africa and Asia, and homosexual men in Australia and Europe? Why was the disease first called “GRID” (Gay Related Immune Deficiency) by health care workers and researchers in the USA, when, at the time, most of the people apparently contracting AIDS were not homosexual (“gay”), but were heterosexual men and women in Africa? Why did the disease, if it is, indeed, a single disease caused by a single aetiological agent, change so dramatically in its epidemiology, whilst continuing to decimate the previous targets of Commonwealth and American eugenic policies? Why is the fastest growing population of AIDS victims young black women of childbearing age in the United States, but also in New Guinea? Is it true that unlike other viruses, breast feeding confers a risk of transmission to infants rather than a protection, as is the case with other infections? Is it true that “antibodies against HIV” signify chronic infection, rather than evidence of a successful immune response, as is the case with other infections? Instead, could damage to the immune system from vaccinations be causing AIDS? Could the general collapse of the immune system characteristic of AIDS be being caused by a combination of dietary deficiency, contaminated water and air and experimental vaccines given to already immunocompromised children and adults? Could the AIDS epidemic be an outright attempt at population control through genocide, using biological warfare technologies? Why were the events in Birmingham “shrouded in secrecy”? Why have the remaining supplies of smallpox still not been destroyed, 20 years later? What is the history of American and Commonwealth biowarfare programs?

Regardless of the origin of AIDS, the epidemic has taught us many things about the immune system and the consequences of immune system collapse, and particularly the role of the T-lymphocytes in fighting cancer and infections.

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CELL SUICIDE AND AUTOIMMUNE DISEASE

In the Scientific American article titled “Cell Suicide in Health and Disease” (December, 1996), Richard Duke, David Ojcius and John Young wrote:

“T cells arise from precursors in the bone marrow. The immature cells migrate to the thymus, where, as so-called thymocytes, they become more specialized. In particular, they begin to display the receptor molecules that later enable mature T cells to detect infection. To be beneficial, T cells must be able to attach through their receptors to microbial antigens (protein markers signaling an invader’s presence). At the same time, they must be blind to substances made by the body itself, because self-reactive T cells can destroy normal tissues. Only those thymocytes that make useful receptors will mature fully and enter the bloodstream to patrol the body.”

This article is very reductionist, and focused on a phenomenon termed “apoptosis”, or “cell suicide”, the microscopic (histological) features of which were first described by Professor John Kerr of the University of Queensland medical school together with Scottish colleagues Alastair Currie and Andrew Wyllie in 1972.

The Scientific American authors write, about this discovery:

“In their report, they contended that the same type of cell death evident during development also happens in mature organisms and

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continues throughout life. They suggested that unlike necrosis, in which a cell is a passive victim, this form of death is active, requiring the cell to expand energy toward its own demise. The researcher further proposed that inappropriate initiation or inhibition of cell suicide could contribute to many diseases, including cancer.”

The article explains that apoptosis is thought to be the means by which killer T-cells destroy “invading” cells with which they bind. The authors who include the Assistant Professor of Medicine and Immunology at the University of Colorado Health Sciences Center (who is also president of CERES Pharmaceuticals in Denver), write:

“After killer cells bind to target cells, they bombard the cells with two kinds of proteins that together inflict a deadly one-two punch. One of the proteins (perforin) inserts itself into the membrane of the infected cell; there it forms a porelike structure that allows uptake of the other proteins – enzymes called granzymes. Granzymes can activate ICE-like proteases and thus induce apoptosis. But if that approach to killing fails, calcium ions that pass in through the new pores can collaborate with the granzymes to produce a necrotic death.” (p.52)

“ICE-like proteases”, according to the article, are protein cleaving enzymes which are released by lymphocytes which are triggering their own death for the sake of destroying the “toxic” cell. These molecules destroy the DNA in the nucleus of cells, causing the cell’s death. However cells identified as “toxic” by the immune system are not necessarily so. This forms the aetiological basis of autoimmune diseases. Under the subheading “A role in autoimmunity”, the article on “cell suicide” continues:

“Although normal helper T cells may be induced to commit suicide by other immune cells in HIV patients, the healthy cells are not technically dying from an autoimmune process. Autoimmunity is said to occur when the antigen receptors on immune cells recognize specific antigens on healthy cells and cause the cells bearing those particular substances to die. But true autoimmune diseases that involve apoptosis do exist.”

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Several common, and other rare diseases are thought to involve pathologically self-directed immune activity, termed “autoimmune disease”. Despite the assertion in Scientific American that true autoimmune disease involves specific antibodies produced in specific conditions, this is a reference only to antibody associated (humoral) autoimmune mechanisms. Theoretically cellular autoimmune damage could also occur, involving cytotoxic (killer) T cells and phagocytes such as neutrophils. Although neither Professor Nossal nor Professor Duke and collaborators mention psychoimmunogical factors involved in autoimmune diseases, these are theoretically predictable, intuitively expected and clinically observed. For one thing, stressful events are known to trigger and aggravate many different autoimmune diseases, and this may be the case for the entire range of autoimmune disease.

Known autoimmune diseases in which specific autoantibodies have been identified include rheumatoid arthritis, systemic lupus erythematosus (SLE), thyroiditis, juvenile-onset diabetes mellitus, idiopathic thrombocytopenic purpura (ITP), nephritis, uveitis and pneumonitis. In each of these conditions, antibodies are produced against previously healthy tissues in the body due to misdirected immune responses. In the case of rheumatoid arthritis the antibodies are directed against the synovial lining of joints; in thyroiditis, they are produced against the thyroid gland in the throat; in ‘type I’ diabetes mellitus they are against islet cells in the pancreas, whilst in ITP they damage platelets in the blood. In nephritis they attack particular cells in the kidneys, whilst in SLE they are produced against nuclear proteins of connective tissues of several type. In each disease, the symptoms and signs reflect the particular nature of the damage being done by these molecules.

To examine the possible role of the brain and mind in the development of autoimmune disease, the example of thyroiditis and the thyroid gland will be used. In the case of thyroiditis, autoantibodies binding to cells of

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the gland often cause transient stimulation of thyroxine, resulting in hyperthyroidism, characterised by an overdriven metabolism manifest as anxiety, irritability, rapid heart rate, sweating, diarrhoea, weight loss and insomnia. On examination, patients with hyperthyroidism usually have a rapid pulse rate, exaggerated deep tendon reflexes and signs of sympathetic nervous system overactivity. They may have swelling of the thyroid gland (goitre), tenderness of the gland to palpation and bulging eyes (exophthalmos). This condition is also called “Grave’s disease”. These symptoms are caused by the direct hormonal (chemical and physiological) effects of excessive thyroxine, and are reproduced by exogenously ingested thyroxine. Because hyperthyroidism causes weight loss, experimentation with thyroxine as a weight reduction drug occurred in the 1960s and 1970s. However, the toxic effects of the hormone used in this way became evident (including demineralisation of bones) and such trials were ceased.

The example of the many effects of thyroxine on the body’s metabolism and physiology gives some indication of how diverse hormonal effects can be. The same hormone, in the case of thyroxine, can influence mood and mental state, cardiovascular function, growth, gastrointestinal function, immunity and brain growth. It can cause different effects in children, adolescence and adulthood.

Thyroxine deficiency causes severe brain dysfunction in early childhood and infancy, resulting in permanent brain damage and the syndrome termed “cretinism”. This demonstrates that the hormone has important effects on the brain, at least in childhood. The symptoms of hyperthyroidism and hypothyroidism suggest that these important effects, although different in nature, persist into adult life. Hypothyroidism, which usually results from continued autoimmune damage to the thyroid (following the transient hyperthyroidism of Grave’s disease), is characterised by lethargy, fatigue, sensation of coldness, depression, dryness of the skin and constipation. On examination, the person looks “flat” and stiff, with a slowed pulse and delayed deep tendon reflexes. The condition may develop insidiously,

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and not be diagnosed as a result of slow gradual onset. The condition of hypothyroidism can also develop from toxicity to the gland from the salt lithium, which is still sometimes used as a “mood stabiliser” in the treatment of “manic depression” and “mania” due to its lethargy-inducing and emotion-dulling properties.

Stimulation of thyroxine secretion by the thyroid comes under the dual influences of the autonomic nervous system and thyroxine stimulating hormone (TSH) from the anterior lobe of the pituitary gland. Such dual stimulation of glands by the autonomic nervous system and hormonal system is seen throughout the body. In autoimmune hypothyroidism, feedback mechanisms between the thyroid and pituitary result in greatly increased secretion of TSH by the pituitary, and the reverse is the case in autoimmune hyperthyroidism, when pituitary secretion of TSH decreases.

The connection between the thyroid gland and the brain can be seen to be complex, and it includes both effects of the brain on the gland and the gland on the brain. Thyroxine affects brain function, including brain growth, and thought generally, and brain activity regulates the secretion of thyroxine by the thyroid gland through dual mechanisms involving direct neural connections (via the autonomic nervous system) and “indirect” hormonal connections (via TSH from the pituitary). The pituitary is directly connected to the hypothalamus at the base of the brain, and the hypothalamus is directly connected to the limbic system, which is involved in emotional reactions. The hypothalamus is also directly connected to the thalamus, which receives neuronal inputs from the visual and auditory systems. Thus the connections are evident for what we see and hear to affect thyroid function directly, as well as the hormonal (endocrine) system generally. The hormonal system has profound effects on the immune system and ability to remain free of infections and cancers, and to get rid of them if they do develop. The anatomical and physiological connections described above also allow scientific hypotheses to be formulated regarding the influences of what

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is seen, heard and thought about on the immune system generally, and the development of autoimmune diseases specifically.

THE PINEAL ORGAN AND THE IMMUNE SYSTEM

The pineal is a small pea-sized organ in the centre of the brain. It is situated in the midline, positioned about 3 cm above and behind the pituitary gland. The pineal, which was first described in ancient times, is highly vascular, having an intricate network of tiny blood vessels in it. These blood vessels carry the many hormones secreted by the pineal to other parts of the body, notably the neurohormone melatonin, which is thought to have direct effects on the immune system. The pineal also produces the chemical precursor of melatonin, serotonin, which is synthesised during the day from the dietary amino acid tryptophan. Melatonin is secreted mainly at night, and levels of melatonin are suppressed by light shining into the eyes at night. This physiological discovery was made in the 1960s, following the discovery of the hormone he named “melatonin” by Aaron Lerner from Yale University in the USA. This discovery was made in 1958, and was followed by an extraordinary series of scientific and medical frauds, suppressions and conspiracies. The pineal organ, melatonin, serotonin and the limbic system were in the centre of this twentieth century scandal.

Melatonin is a relatively small molecule, with a chemical structure as follows: H H H O H

CH3O

C C N C C H

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H N H H H H H

H H

The molecule is synthesised in the pineal organ from the indole amine serotonin, the chemical structure of which is:

H H H H

HO

C C N

H N H H H H

H H

Serotonin is synthesised from the amino acid tryptophan, which is absorbed from the digestive tract and carried to the pineal through the blood stream. Both serotonin and melatonin are thought to have influences on several aspects of physiology relating to the immune system. These include subsidiary mechanisms involving blood temperature regulation, mood, sleep and hormonal secretion by other endocrine glands, including the pituitary.

It was discovered in the 1970s that pineal hormones influence the levels of certain pituitary hormones, including luteinising hormone and melanocyte stimulating hormone, according to the 1980 edition of Harrison’s Principles of Internal Medicine. This textbook omits other discoveries about the pineal and melatonin which were made in the 1970s and 1960s. These include the discovery of the neurological connection between the eyes and visual system and the pineal and the postulated magneto-sensory function of the pineal of Robert Becker and others. It is through a direct neurological (nerve) connection that

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visually received light signals can affect pineal function. This in turn affects other organs and organ systems, including the immune system.

A possible mechanism by which this occurs is by the direct rise in circulating lymphocytes during nocturnal sleep noted by Professor Josephine Arendt in her 1995 book Mammalian Pineal Gland. Under the subtitle “Possible relationships of the pineal and melatonin to the immune system”, she wrote:

“Whether the pineal gland and melatonin are closely related to immune function or not is a subject of some considerable topical interest. Pinealectomy is reported to suppress various aspects of immune function and in many (but not all) studies enhances tumor growth. Thus it is a reasonable deduction that the pineal does indeed influence the immune system.”

A diagram on the same page shows a graph demonstrating a rise in the number of circulating lymphocytes in human studies during nocturnal sleep, corresponding with a rise in plasma melatonin levels. Professor Arendt does not, however, believe that a causal relationship is established by these findings, although she accepts as proven that depression and stress adversely affect the immune system in humans. Under the subtitle “Circadian rhythms” she writes:

“There is very little information to date on entrainment of rhythms in the immune system to the light-dark cycle or other potential zeitgebers. Given the important effects of bright light on winter depression in humans, and the relationship between depression, stress and immune response, such information would be of considerable interest.”

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MELATONIN AND THE PINEAL

It is known that artificially manufactured melatonin (or that from animal pineals), when ingested, causes drowsiness and sleep. It is also being trialled for “seasonal affective disorder” and other “mental illnesses”. Synthetic and “natural” melatonin preparations (as capsules and tablets) are also currently being promoted for “jet lag”, the prevention of ageing, and as a treatment for cancer.

Melatonin is produced in the pineal organs of almost all known vertebrates, the earliest evidence of pineal organs in vertebrates having been found in the fossils of fish from over 300 million years ago. In some amphibians and reptiles the pineal acts as a directly light sensitive (photosensitive) third eye, and in birds the organ serves as an organ of navigation, sensing variations in ambient magnetic field strength and direction. It is thought to fulfil a similar function in cetaceans such as whales and dolphins, assisting them in navigating the oceans at depths where visible light is scarce and navigationally unhelpful.

The human pineal organ produces several chemicals other than melatonin, and it is likely that the organ also has functions other than hormone production, hence description of the pineal as the “pineal organ” rather than the “pineal gland”. Two interesting non-glandular functions that have been postulated for the pineal include magnetic sensitivity and a role a biological clock. Both functions have relevance to psychoimmunology.

A world authority on biomagnetism is the American scientist Robert Becker. In his 1990 book Crosscurrents, he wrote of the pineal:

“It has been only during the past decade that scientists have discovered how important this structure is. The pineal produces a veritable pharmacopoeia of active chemical substances. Some regulate

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the operations of all other glands in the body (including the pituitary, the former “master gland”); others are major neurohormones (such as melatonin, serotonin, and dopamine), which regulate the level of operations of the brain itself.

“The pineal is the “clock” that the mechanists postulated was the source of biological cycles. The cyclic pattern of sleep-wakefulness is dependent upon the level of melatonin secretion by the pineal. It was first determined that a part of the output of the retina was diverted to the pineal, where it was sensed as the day-night cycle, and melatonin secretion was adjusted accordingly. More recently, it has been shown that the pineal is also sensitive to the daily cyclic pattern in the Earth’s magnetic field. Melatonin secretion in human subjects may be changed at will by exposure to steady magnetic fields of the same strength as the geomagnetic field. Apparently, nature determined that biological cycle activity was too important to be left to one environmental signal alone.” (pp.76-77)

The Earth’s geomagnetic field is the natural magnetic field produced by magnetic elements and compounds in the Earth’s crust and metallic core. This is a dynamic, changing, oscillating force, which interacts with the earth’s atmosphere, oceans and waterways. It interacts also with the magnetosphere of the sun, moon and the planets of our solar system, and throughout the past millenia creatures on the planet have evolved with various types of sensory organ to detect and analyse this physical force which surrounds us day and night.

The role of the pineal as a “biological” clock can be further explored in view of the immune system’s well recognised cyclical properties. As well as lymphocytes, other white blood cells demonstrate different levels of activity at different times of the day and night. Rhythms varying according to 24 hour (approximately) periodicity are termed diurnal rhythms, and many immune-related rhythms are diurnal in nature, including the secretion of cortisol by the adrenals, melatonin from the pineal and lymphocyte levels in the blood stream. The concept of a

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biological clock could mean a relatively insensitive piece of equipment that senses monthly and seasonal cycles, which is how the pineal was long regarded, after it was conclusively proved that the vestigial theory of the organ held no merit. On the other hand, given the sensitive nature of our visual and auditory perceptive abilities and sensibilities, it is possible that the pineal is a very sensitive and delicate sense organ involved in perception of time, mentally, as well as responding to crude “light-dark cycles”. It is also possible that the magnetic sensitivity of the pineal can have greater sensitivity than it tends to develop in our map-oriented society. By this it is meant that in a traditionally nomadic existence, geomagnetic navigation could play a more significant role than in societies whose residents tend to navigate by maps, street signs and visible landmarks.

GLOBAL IMMUNOSUPPRESSION

If one looks worldwide, however, it becomes evident that the nomadic peoples of the Earth are being attacked by much more than disturbance to their navigational systems. A profound, but easily treatable cause of immunosuppression is malnutrition and starvation. In what has been termed the “Third World”, starvation and inadequate nourishment remain major sources of illness and death, especially amongst the very young and very old. The use of the phrase “Third World” is a recognition that a sharp division exists between the standard of living between the colonising and colonised nations around the globe. In the poorer nations

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the standard of healthcare and causes of illness and death are very different from that in the richer nations. Added to this is the problem of perpetual warfare, which brings on the populations that experience it, famine and pestilence of various sorts. This pestilence includes chemical and biological warfare agents as well as unintentional infections from unhygenic living conditions.

Looking specifically at immune suppression and deficiency, Acquired Immune Deficiency Syndrome (AIDS) is blamed for a world wide epidemic of previously rare infections and cancers, mainly in Africa, but also elsewhere in the “Third World”. It is true, however, that the same populations who are developing AIDS are also being injected with experimental vaccines in less than hygenic circumstances. It is true also that the infants who are being targetted with these vaccines are also suffering from a general immune depression, the result of environmental toxins and poor nutrition, as well as tainted drinking water.

In industrialised countries atmospheric pollution and the numerous polymers which are pumped into the air, contribute to a different pattern of immune-related disease. Here, we suffer from an increasing incidence of cancer generally, as well as autoimmune diseases, which are crippling the population at younger and younger ages. Drug treatments for the numerous chronic immune related diseases abound, but cures are few and charlatanism has reached new depths in the late 1990s, as a population desperate for cures look outside the medical profession and find numerous “alternative practitioners” peddling their wares.

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A PSYCHOIMMUNOLOGICAL APPROACH

William Clark, in his 1995 book At War Within quotes the Athenian General Thucydides who wrote, following the devastating effects of the plague in Athens in 430 B.C.:

“The most terrible thing of all was the despair into which people fell when they realized that they had caught the plague; for they would immediately adopt an attitude of utter hopelessness, and, by giving in this way, would lose their powers of resistance.” (p.5)

Professor Clark, who according to the back cover of the paperback is “an internationally recognized authority on cellular immune responses” and “has taught immunology at the University of California, Los Angeles for the past twenty-five years”, devotes a chapter of his detailed book to “the dialogue between the brain and the immune system”. In it he writes:

“The idea that psychological and psychosocial states can influence human health has clearly been with us for a long time, maybe as long as human consciousness itself. It can be found in the literature and traditions of virtually every culture…it is by no means unique to Western science or medicine. On the other hand, studies in the past hundred years or so have begun to explore these experiences a little more closely, helping us interpret them in terms of whet we have learned during that period about how our bodies – and to some extent our minds – function. These studies were the basis for creation of the field of psychosomatic medicine; the first professional journal dedicated to this subject appeared in 1939.”

“Psycho-somatic” can be literally translated as “pertaining to the mind-body connection or relationship”, and it could reasonably be argued that knowledge of this area should be a central aspect of medical science, teaching and clinical practice. This is because the first contact that a physician usually has with a patient occurs when their minds meet for

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the first time. This meeting of minds, and the words uttered by the physician, even if they are few, can have a profound effect on the patient’s mind as well as his or her body. The power of this meeting of minds to heal or create illness is difficult to overstate, and it is important that physicians realise that they wield such power and use it wisely, and in the best interests of the people who come to them for advice and healing.

Medical practitioners are trained to “take histories”, “examine patients”, “order investigations” and “formulate differential diagnoses”. At each stage of this time-honoured tradition, ideas can be acquired by the patient regarding what might be wrong and how serious the problem is or if it exists at all. Such fears can be ameliorated or worsened by the “final diagnosis” and “prognosis”. In the case of a pronouncement of an incurable fatal disease this prediction regarding outcome (despite treatment or without it), which is what “prognosis” means, can become a death sentence. It is important, then, for physicians and surgeons to avoid giving unnecessarily pessimistic prognoses, and also to avoid implanting suggestions of disease in the minds of others (and themselves) during the taking of a history, during the physical examination or through investigations that are requested.

A good physical examination and careful history taking can often make blood tests and other invasive investigations unnecessary, and be reassuring to a person who is unnecessarily worried about their health. These are also essential aspects of clinical medicine that are necessary to maintain if genuine illness and disease are to be detected and properly treated. For the proper treatment of any medical condition, the aim should always be a complete cure. Ideas that “we will never be able to cure this or that” have no place in modern progressive medicine. This is not to say that currently incurable diseases do not exist, or that doctors have the right to keep the unpleasant truth from patients, and should incorrectly reassure them without full investigation for serious illness. The latter is every patient’s right and every doctor’s responsibility.

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The following principles, the author has found to be useful in approaching psychological problems generally, and it is hoped that these will benefit psychoimmunological and psychophysiological dysfunction:

1. Recognising imagined fears and negative preconceptions and questioning

these.

2. Encouraging an improved attitude to the self, others and the world.

3. Encouraging the development of mental balance, tranquility and

harmony.

4. Encouraging creative self-expression artistically and musically.

5. Encouraging music appreciation and enjoyment.

6. Improving communication and verbal skills.

7. Improving eye contact.

8. Encouraging a cooperative rather than competitive attitude towards others.

9. Encouraging ongoing multidirectional learning.

10. Encouraging the formation and growth of genuine, supportive

friendships

11. Encouraging mutual respect.

12. Encouraging realistic optimism.

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REFERENCES

1. Arendt, Josephine. The Mammalian Pineal Gland. Chapman-Hall:

London, printed by Cambridge University Press (1995)

2. Clark, William. At War Within. Oxford University Press: NY, Oxford

(1995)

3. Duke, R., Ojcius, D., Young, J. Cell Suicide in Health and Disease. In Scientific American, December, 1996

4. Harper, H. Review of Physiological Chemistry. Lange: California (1965)

5. Isselbacher, Kurt. (et al: eds) Harrison’s Principles of Internal Medicine.

McGraw-Hill: USA, UK, NZ, Australia, Canada, Japan, S. Africa (1980)

6. Nossal, G. Nature’s Defences. Australian Broadcasting Commission:

Sydney (1978)

ABOUT THE AUTHOR:

Dr Romesh Senewiratne has worked for several years in general medical practice, and since 1995 has been involved in original integrative research work in the neurosciences, psychology, physiology and psychosomatic medicine. He has also worked as a musician, photographer, poet and artist.

Contact Romesh by writing to:

149 Bambra Road

Caulfield

32

Melbourne

Victoria

Australia 3162

Phone 03 9505 3697

Mobile: (0412) 922 698

e-mail: drromesh@optusnet.com.au