Clinical psychoneuroimmunology (KPNI from the Dutch Klinische Psychoneuro-Immunologie)
A translational medical discipline that examines interconnected body systems and their relationship with psychological, social and ecological aspects of the patient’s life.
The next step in medicine
Imagine noticing a ceiling leak in your house. You place a bucket underneath and forget about it. Some time later, the drywall has cracked and peeled away, mold covers the site, and the leak continues to worsen.
Current medical care takes a similar approach to treating patients. The main focus is on alleviating symptoms, and little attention is paid to the underlying causes of the disease. It’s a system that favors drug prescription and surgical intervention over healthy habits and prevention.
KPNI is a new translational medical discipline that brings the focus back to people. It examines the patient from a more humanistic perspective, and seeks out the origin of the disease. This approach gives patients a leading role in their wellbeing, and promotes a healthy lifestyle.
KPNI is much more than just setting a bucket under the leak, or even patching up the damaged drywall. It’s tracking down and repairing the source to prevent the leak from coming back.
A multidisciplinary approach
KPNI explores the interactions between the neurological, endocrine, immune and metabolic systems. It examines the patient’s broader psychological, social and ecological context to paint a more complete picture of their health.
KPNI practitioners recognize health as a consequence of the past, not just the present. Not only do they treat visible symptoms, they also carry out a thorough evaluation of the patient’s lifestyle and history. This involves the analysis of biomarkers as well as physiological parameters, diet, physical activity, psycho-emotional context, personal and medical history, and social, economic and ecological environment.
This discipline is based on the understanding that unbalanced energy distribution drives chronic pathologies. It takes into account that the majority of ailments of this type have a low-grade inflammatory or autoimmune basis that can be modulated with nutritional, emotional and lifestyle changes.
Some of the diseases that are targets for KPNI are cancer, cardiovascular pathologies, frailty syndrome, type 2 diabetes, autoimmune diseases, depression, schizophrenia, and chronic inflammation.
The 5 metamodels
There are 7 components in health that help determine our state of well-being. These are the physiological, emotional, cognitive, social, sexual, ecological and transgenerational aspects of our lives.
Low-grade inflammation is associated with most, if not all, chronic non-communicable diseases. Low-grade inflammation is produced by different pathways activated by specific groups of risk factors, called associated molecular patterns (AMP).
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History of KPNI
Dr Hans Selye publishes a study that describes, for the first time, the physiological response to stress.Selye Hans. A Syndrome Produced by Diverse Nocuous Agents. Nature. 1936 July 4;138:32.
Dr. Robert Ader and Dr. Cohen demonstrate how immune responses can be modified by classical conditioning. They coined the term “psychoneuroimmunology”.Ader R., & Cohen N. Behaviourally conditioned immunosuppression. Psychosomatic Medicine, 1975. 37(4), 333–340.
Dr. David Felten and colleagues discover a network of nerves that leads to blood vessels and cells of the immune system, providing the 1st indication of how neurological and immune systems connect.John M. Williams, David L. Felten. Sympathetic innervation of murine thymus and spleen: a comparative histofluorescence study. Anat Rec 1981; 199: 531-42.
Dr. Candance Pert and her team find neurotransmitter and neuropeptide receptors on the cell walls of both the immune system and the brain.
J. E. Blalock discovers a bidirectional circuit linking the immune system with the endocrine system.
Pert CB, Ruff MR, Weber RJ, Herkenham M. Neuropeptides and their receptors: a psychosomatic network. J Immunol 1985 Aug;135(2 Suppl):820s-826s.
J.E. Blalock, E.M. Smith. A complete regulatory loop between the immune and neuroendocrine systems. Fed. Proc., 44 (1985), pp. 108-111.