| Contents | 5 |
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| Preface | 12 |
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| Acknowledgments | 14 |
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| Contributors | 15 |
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| 1 Bidirectional Communication Between the Brain and the Immune System | 21 |
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| 1.1 Introduction | 21 |
| 1.2 Nervous System Communication to the Immune System | 23 |
| 1.3 Neuroendocrine Hormone Influence on the Immune System | 25 |
| 1.4 Actions of Hypothalamic-Releasing Hormones | 28 |
| 1.5 Immune System Communication with the Nervous System Hormones | 29 |
| 1.6 Cytokine Influences on the Nervous System | 30 |
| 1.7 Neuroendocrine Hormone Release by Cells of the Immune System | 32 |
| 1.8 Neurotransmitter Release by Cells of the Immune System | 33 |
| 1.9 Bidirectional Communication and Sleep | 34 |
| 1.10 Summary and Conclusions | 35 |
| References | 36 |
| 2 Neuroimmunological Correlates of Circadian Rhythmicity in Oral Biology and Medicine | 44 |
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| 2.1 Introduction | 44 |
| 2.2 Allostatic Response and Allostatic Intervention: Relevance to Oral Biology and Medicine | 46 |
| 2.3 Mucositis: A Case of Allostatic Load | 53 |
| 2.4 Directions for the Future | 66 |
| References | 70 |
| 3 Circadian Organization of the Immune Response | 76 |
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| 3.1 The Circadian Clock Is One of the Most Indispensable Biological Functions | 76 |
| 3.2 The Immune System Shows Circadian Organization | 78 |
| 3.3 Sickness Behavior Includes Changes in Circadian Rhythms | 81 |
| 3.4 The Rat Adjuvant Arthritis Is an Experimental Model of Rheumatoid Arthritis | 83 |
| 3.5 Adjuvant Arthritis Disrupts Normal Chronobiological Organization | 85 |
| 3.6 Melatonin as a Circadian Immunoregulatory Signal in Adjuvant Arthritis | 89 |
| References | 93 |
| 4 The Biological Clock in Inflammation and Sleep Switch Alterations | 103 |
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| 4.1 Introduction | 103 |
| 4.2 Interactions Between the Biological Clock and the Sleep Switch | 103 |
| 4.3 Effects of Inflammatory Molecules on the SCN and Sleep Switch Structures | 106 |
| 4.4 Intracellular Inflammatory Regulators | 108 |
| 4.5 Concluding Remarks | 110 |
| References | 110 |
| 5 Vasoactive Intestinal Polypeptide and Prolactin Cytokines: Role in Sleep and Some Immune Aspects | 113 |
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| 5.1 Introduction | 113 |
| 5.2 Vasoactive Intestinal Polypeptide (VIP) | 114 |
| 5.3 VIP: Brain Distribution | 115 |
| 5.4 VIP and Sleep Regulation | 115 |
| 5.5 How VIP Induces REMS: A Hypothesis | 118 |
| 5.6 VIP Clinical Implications | 118 |
| 5.7 Prolactin (PRL) | 119 |
| 5.8 PRL Molecular Aspects | 119 |
| 5.9 PRL and Sleep Regulation | 121 |
| 5.10 Relationship Between PRL and Stress | 123 |
| 5.11. Stress and REMS: Role of PRL | 124 |
| 5.12. PRL Expression and REMS | 125 |
| 5.13. PRL Clinical Implications | 125 |
| References | 126 |
| 6 Immune Signaling to Brain: Mechanisms and Potential Pathways Influencing Sleep | 134 |
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| 6.1 Introduction | 134 |
| 6.2 Mechanisms of Immune Signaling to the Brain | 134 |
| 6.3 Neurocircuitry Mediating Sleep and Waking States | 139 |
| Sleep Neurocircuitry? 6.4 What Are the Links Between Immune Brain Interfaces and | 139 |
| 6.5 Conclusions and Perspectives | 142 |
| References | 144 |
| 7 Aging, Sleep, and Immunity | 147 |
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| 7.1 Introduction | 147 |
| 7.2 Altered Sleep and Concomitant Alterations in Immune Function | 147 |
| 7.3 Cytokines and Sleep | 149 |
| 7.4 Relationship of Infection to Altered Sleep Behavior | 152 |
| 7.5 Stress, Hormonal Change, Cytokines, and Sleep Behavior | 154 |
| 7.6 Age-Related Changes in Sleep and Relation to Altered Immunity | 157 |
| 7.7 Summary and Conclusions | 162 |
| References | 163 |
| 8 Cytokines and Sleep: Neuro-Immune Interactions and Regulations | 168 |
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| 8.1 Introduction | 168 |
| 8.2. Effect of Sleep on Immune System | 168 |
| 8.3 Effect of Modulation of Immune System on Sleep | 169 |
| 8.4 Conclusion | 174 |
| References | 174 |
| 9 Selective REM Sleep Deprivation and Its Impact on the Immune Response | 180 |
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| 9.1 Introduction | 180 |
| 9.2 Human Studies | 181 |
| 9.3 Animal Studies | 182 |
| References | 185 |
| 10 Sleep and Immune Correlates: Translational Research in Clinical Populations | 189 |
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| 10.1 The Rationale for Studying Sleep and Immunity in Clinical Populations | 189 |
| 10.2 Sleep and Immunity in Primary Insomnia | 190 |
| 10.3 Sleep and Immunity in Depression and Substance Dependence | 194 |
| 10.4 Sleep and Cytokines in Rheumatoid Arthritis | 199 |
| 10.5 Future Directions | 201 |
| References | 201 |
| 11 The Stress of Inadequate Sleep and Immune Consequences | 206 |
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| 11.1 Introduction | 206 |
| 11.2 Inadequate Sleep and Disease | 208 |
| 11.3 Immune Function in Sleep Disorders | 209 |
| 11.4 Hospitalized Patients | 210 |
| 11.5 Chronic Inflammatory Diseases and Sleep | 211 |
| 11.4 Concluding Remarks | 213 |
| References | 213 |
| 12 Neuroimmunology of Pregnancy-Related Sleep Disturbances | 218 |
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| 12.1 Introduction | 218 |
| 12.2 Pregnancy and Alterations in Sleep | 218 |
| 12.3 Understanding Sleep in Pregnancy via Animal Models | 223 |
| 12.4 Factors That May Contribute to Disrupted Sleep During Pregnancy | 223 |
| 12.5 Where Does Sleep Fit In? The Cytokine and Hormone Changes Associated with Sleep Deprivation/ Sleep Disorders | 227 |
| 12.6 Pregnancy Complications | 229 |
| 12.7 Summary | 231 |
| References | 231 |
| 13 Changes in Sleep and Behavior Following Experimental Immune Stimulation Using Bacterial Endotoxin in Humans | 237 |
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| 13.1 | 237 |
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