Prostaglandins in the sickness syndrome

63woman-698962_960_720When you’re sick you also feel awful: no appetite, weak, sleepy, feverish, achy, and so on. This is called, appropriately so, the sickness syndrome.

Saper, Romanovsky & Scammell (2012) wrote a beautiful review of the neural circuits underlying this collection of symptoms. In a nutshell, the immune system releases cytokines to fight the inflammation, which in turn stimulate the release of prostaglandins. Prostaglandins bind to various areas in the brain to produce the sickness syndrome symptoms. Below are outlined 4 simplified circuits which the non-specialists can skip entirely.

  1. in median preoptic nucleus which will lead to a cascade involving dorsomedial hypothalamus, rostral meduallary raphe and finally the spinal cord to produce fever by activating the brown adipose tissue.
  2. in preoptic area which will lead to the inhibition of the brain’s analgesic system involving the descending projections of the periaqueductal grey to spinal cord, thus promoting achiness.
  3. in the meninges that results in adenosine release which binds in nucleus accumbens and ventrolateral preoptic nucleus which will result, downstream, in inhibiting the arousal system to produce sleepiness.
  4. in arcuate nucleus to inhibit several hypothalamic nuclei involved in promoting feeding, thereby producing anorexia.

The sickness syndrome and the role prostaglandins play in it has tremendous adaptive role, as it promotes rest and recuperation. So don’t blame them too much. And if you’re really done feeling sick, take some non-steroid anti-inflammatory drugs, like aspirin, who very effectively inhibit the prostaglandins’ synthesis. That’s why NSAIDs work.

Reference: Saper CB, Romanovsky AA & Scammell TE (26 Jul 2012). Neural Circuitry Engaged by Prostaglandins during the Sickness Syndrome. Nature Neuroscience, 15(8):1088-95. doi: 10.1038/nn.3159. Article | FREE PDF

by Neuronicus, 21 December 2015

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