When is an illness classified as neuroimmune?

[Andy]

Are all illnesses that involve the immune and neurological systems labelled as neuroimmune? Are there any that aren't? And if so, why not? I've tried investigating this myself and the information that I can find is vague and unsatisfying, so I'm hoping that the S4ME hive mind can help out here.

 

[Jonathan Edwards]

There is no agreed category of 'neuroimmune disease'. A pathological process that involves an immune response and nervous tissue can be called neuro-immune uncontroversially in that there is no additional implication. Calling something a neuro-immune disease is a bigger deal because it implies you know what is going on. Nobody would complain if you called multiple sclerosis a neuroimmune disease because we know enough to say that, similarly autoantibody-based encephalitis. But whether Parkinson's is neuroimmune, or Alzheimer's few would want to decide. And equally lupus is not called a 'neuro-immune disease' because it involves a much more general immune malfunction, even if it includes encephalitis. Similarly for Wegener's, rheumatoid, Churg-Strauss syndrome, scleroderma. all of which can have neurological involvement.

 

[Jonathan Edwards]

In the context of ME/CFS I think the label neuro-immune disease may turn out to be reasonable but at the moment it is likely to cause confusion. Diabetes involves immune and nervous systems but the nervous involvement is not 'neuro-immune'. ME/CFS might be similar. There might be some general problem that affects both systems. In contrast there might be an effect of immune activity on nerves - as suggested in our Qeios model. Until we have some evidence I think using the neuro-immune term may put people off track.

There is the additional problem that 'ME' was considered a neuroimmune conditions on the grounds that it was thought that an abnormal immune response gave rise to encephalitis. The got muddled in with the ICC definition of ME/CFS. As clean a break as possible with that confusion would help.

 

[Kiristar]

There is no agreed category of 'neuroimmune disease'. A pathological process that involves an immune response and nervous tissue can be called neuro-immune uncontroversially in that there is no additional implication. Calling something a neuro-immune disease is a bigger deal because it implies you know what is going on. Nobody would complain if you called multiple sclerosis a neuroimmune disease because we know enough to say that, similarly autoantibody-based encephalitis. But whether Parkinson's is neuroimmune, or Alzheimer's few would want to decide. And equally lupus is not called a 'neuro-immune disease' because it involves a much more general immune malfunction, even if it includes encephalitis. Similarly for Wegener's, rheumatoid, Churg-Strauss syndrome, scleroderma. all of which can have neurological involvement.

In the absence of such a category, do you think once decode is out that ME/CFS will be reclassified as a straight immune disease? Or would it warrant the creation of the neuro-immune category label?

As a lay person I confess I find it quite helpful as a term to preemptively head off the "all in your head" conceptualisation, but yes my use is really more referring to the foremost symptomology.

 

[Jonathan Edwards]

In the absence of such a category, do you think once decode is out that ME/CFS will be reclassified as a straight immune disease? Or would it warrant the creation of the neuro-immune category label?

As a lay person I confess I find it quite helpful as a term to preemptively head off the "all in your head" conceptualisation, but yes my use is really more referring to the foremost symptomology.

Categories like this do not mean anything in medicine. They crop up in diagnostic coding systems, but that has nothing to do with the reality of science or practice.

I don't think categories like these head anything off either. ME/CFS could just be the idea of having a neuro-immune disease called ME. As indicated on another thread I think 'all in the head' has to be unpicked because people manipulate the term to mean different things.

 

[Creekside]

Elsewhere someone claimed that ME involved neuroinflammation, so I pointed out that there wasn't clear evidence of inflammation, so the difference between neuroimmune and neuroinflammatory was important.

 

[MrMagoo]

It’s a side issue but I feel like the “wellness industry” has hijacked “inflammation” recently.
Lay people keep mentioning to me about reducing inflammation in the body, or ME being “inflammation” and I don’t think they’re referencing the activity of Cytokines or T or B cells or immune response or CRP levels, I think it’s to do with sugar/stress/gluten whatever the food baddie is these days plus stress/no exercise.
It seems to be the latest fad.

 

[Yann04]

It’s a side issue but I feel like the “wellness industry” has hijacked “inflammation” recently.
Lay people keep mentioning to me about reducing inflammation in the body, or ME being “inflammation” and I don’t think they’re referencing the activity of Cytokines or T or B cells or immune response or CRP levels, I think it’s to do with sugar/stress/gluten whatever the food baddie is these days plus stress/no exercise.
It seems to be the latest fad.

Very much.

I find it funny when a product advertises itself both as “anti inflammatory” and as “boosting the immune system”…