Future Directions for Psychoneuroimmunology Research
Marvin Stein Mount Sinai School of Medicine
Andrew H. Miller Emory University School of Medicine
The notion that psychosocial factors may influence disorders attributable to the immune system is a widely held popular belief. Woody Allen, for example, in the movie Manhattan said, "I can't express anger. That's one of the problems I have; I grow a tumor instead." Public interest has even extended to the belief that stress can affect pet birds and cause significant changes in the immune system. Is the interaction among brain, behavior, and the immune system "for the birds," or is there a body of scientific facts that indicates that this is a promising area for future research? Over the past decade we have witnessed an explosive growth in neurobiological and immunobiological research. The investigation of the relationship among the brain, behavior, and the immune system has undergone a parallel period of rapid expansion with compelling evidence for central nervous system (CNS) and behavioral interactions with the immune system. It is not clear at this time, however, if these interactions have clinical relevance.
The evolution of the research in our laboratory over a period of more than 40 years has included as a central consideration, the investigation of brain, behavior, and the immune system. Some examples of this research are presented as a means of considering some of the issues that may be involved in determining future directions for psychoneuroimmunology research.
In the mid- 1950s, the research in our laboratory was primarily concerned with the investigation of the psychophysiology of bronchial asthma. A wide range of mechanisms appear to be involved in bronchial asthma, and psychosocial factors may play a role by modifying the immunologic processes that may be relevant in some cases. There are many experimental studies demonstrating the effect of psychosocial processes on immunologic responses, and these have been reviewed in detail elsewhere ( Stein & Miller, 1993). The processes that might