Kuliah Psikoneuroimunologi
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PSIKONEUROIMUNOLOGI
dr. H. Agung Putra, MSi, Med
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STRESS ???
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STRESS ???
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TRADITIONAL VIEW Still held my many scientists
The illness appears when the immune system (considered to be autonomous!) has broken down Most physicians treat the body: the organ or the function
Most psychotherapists follow the cognitive-behavior paradigm treat the mind as something separated from the body
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OLD VIEWS ARE BECOMING LESS LEGITIMATE
Mood Mind Emotions Behavior Brainwaves
Directly affect our health and longevity
we need to accept the integration of body - mind therapies because it’s becoming very clear thatthe body and mind are in a powerful connection!
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DEFINITION OF PSYCHONEUROIMUNOLOGY
Studies the relationships between psychologic states and the immune response.(Mosbys Medical Dictionary, 8th edition. © 2009, Elsevier)
The study of the effects of the mental and neurological status on theimmune system.(McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.)
The study of the interactions between psychological factors, the centralnervous system, and immune function as modulated by theneuroendocrine system.(Dorlands Medical Dictionary for Health Consumers. © 2007 by Saunders, an imprint of Elsevier, Inc. All rightsreserved.)
The study of the integrated interactions of the immunologic, neurologicand psychologic systems and their effects on health.(Jonas: Mosbys Dictionary of Complementary and Alternative Medicine. 2005, Elsevier
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Psychoneuroimmunology (PNI)= scientific discipline - multidisciplinary field - rapidly expanding Role – to elucidate the complex processes that underlie health
Psychoneuroimmunology Google search 349 000 results in 0,37 sec Pubmed 1261 articles
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PSIKONEUROIMUNOLOGI (PNI)
Cabang ilmu kedokteran yang mengkaji interaksi antara :
1. Stress psikologis 2. Sistem saraf endokrin Modulasi sistem 3. Sistem imun
Perubahan respons imun Manifestasi berbagai penyakit yang diperantarai oleh
sistem imun Berkembang 2 dekade lalu----- kontribusi kepada ilmu
kedokteran.
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PRILAKU---OTAK --- SISTIM
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APA YANG TERJADI DENGAN SISTEM TUBUH ???
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TUJUAN RESPON STRES Menjaga keseimbangan tubuh yang
dikenal sebagai homeostatis Peran stres psikologis dalam patobiologi
beberapa penyakit.
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STRESOR PSIKOLOGIS
Otak (sistem limbik)Hipothalamus: “ Stress perception” Hipofisis: Hormon ACTH
Sistem endokrin: “Stress responses”
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Stresor psikologis akut maupun kronis dapat :Menekan sistem imunitas seluler Meningkatkan imunitas humora.
Menerangkan kekambuhan atau bertambah beratnya beberapa penyakit kulit seperti dermatitis atopik, psoriasis, urtikaria, sistemik lupus eritematosus sistemik, herpes simpleks
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JALUR KOMUNIKASI Komunikasi antara sistem saraf pusat
(SSP) dengan jaringan limfoid primer dan sekunder Secara anatomis:------ serat saraf simpatis
yang menginervasi jaringan limfoid (KGB regional-kelenjar thymus)
Melalui mediator neurotransmiter dan neuropeptid.
Sel limfoid mempunyai reseptor terhadap berbagai hormon dan neurotransmiter yang dilepaskan oleh sel saraf dan kelenjar endokrin.
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STRES PSIKOLOGIS—STRES PERSEPSI
Pelepasan hormon stres :1. Glukokortikoid2. Katekolamin
Respons imun
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JALUR I : SUMBU HYPOTHALAMUS-PITUITARY-ADRENAL (HPA)
Hipothalamus -----sintesis corticotropin-releasing hormone (CRH)
Hipofise anterior (pituitary)-----pelepasan adenocorticotropine hormone (ACTH)
Korteks adrenal------- stimulasi pelepasan kortikosteroid (Kortikosteroid : hormon penekan menekan sistem imun)
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STRESS PHYSICAL– PSYCHOLOGICAL--ENVIRONMENTAL.
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SUMBU SIMPATIKO-ADRENAL MEDULARIS (SAM) stresor psikologis----rangsang sistem
adrenergik di SSP, serat saraf pascasinaptik simpatis dan medula adrenal ----lepaskan katekolamin.
Katekolamin-----pengaruhi keseimbangan sel Th1/Th2,Pengalihan ke sel Th2
Imunitas humoral lebih dominan.
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SUMBU CRH-SEL MAST CRH yang dilepas hipotalamus
mempengaruhi sel mast melalui reseptor CRHR1 di permukaan sel mast---- degranulasi sel mast dengan pelepasan histamin dan mediator peradangan lainnya.
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JALUR LAIN
Melalui neuropeptid yaitu substance P dan neuropeptid Y berefek langsung terhadap sel imun.
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Feedback mechanism
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