‫ﻫﺬﺍ ﺍﳌﻘﺎﻝ ﻣﺎﺧﻮﺫ ﻋﻦ ﳎﻠﺔ ﺍﻟﻌﻠﻮﻡ ﺍﻟﱵ ﺗﺼﺪﺭ ﻋﻦ ﻣﺆﺳﺴﺔ ﺍﻟﻜﻮﻳﺖ ﻟﻠﺘﻘﺪﻡ ﺍﻟﻌﻠﻤﻲ‬

‫‪1999‬‬ ‫ﻓﱪﺍﻳﺮ ‪ -‬ﻣﺎﺭﺱ‬ ‫ﺍﻟﻌﺪﺩ‬

‫ﻋﺪﻧﺎﻥ ﺍﳊﻤﻮﻱ‬ ‫ﻣﺮﺍﺟﻌﺔ‪:‬‬ ‫ﺗﺮﲨﺔ‪ :‬ﻫﺎﱐ ﺭﺯﻕ‬

‫ﺍﻟﺘﺂﺜﺭ ﻓﻲ ﺍﻟﻤﺭﺽ ﺒﻴﻥ ﺍﻟﻌﻘل ﻭﺍﻟﺠﺴﺩ‬

‫)*(‬

‫ﻳﺘﺒﺎﺩﻝ ﺍﻟﺪﻣﺎﻍ ﻭﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﺇﺷﺎﺭﺍﺕ‬

‫ﻣﺴﺘﻤﺮﺓ‪ ،‬ﻭﻏﺎﻟﺒﺎ ﻋﱪ ﺍﳌﺴﺎﻟﻚ ﻧﻔﺴﻬﺎ‪ .‬ﻭﻗﺪ ﻳﻔﺴﺮ‬

‫ﺫﻟﻚ ﻛﻴﻒ ﺗﺆﺛﺮ ﺍﳊﺎﻟﺔ ﺍﻟﻌﻘﻠﻴﺔ ﰲ ﺍﻟﺼﺤﺔ‪.‬‬

‫>‪ .M .E‬ﺳﺘﺮﻧﱪﮒ< ـ >‪ .W .Ph‬ﮔﻮﻟﺪ<‬

‫ﻳﻌﻮﺩ ﺗﺎﺭﻳﺦ ﺍﻻﻋﺘﻘﺎﺩ ﺑﺄﻥ ﻟﻠﻌﻘﻞ ﺩﻭﺭﺍ ﻣﻬﻤﺎ ﰲ ﺍﻻﻋﺘﻼﻝ ﺍﳉﺴﺪﻱ ﺇﱃ ﺍﻷﻳﺎﻡ ﺍﻷﻭﱃ ﻟﻠﻄﺐ‪ .‬ﻓﻤﻦ‬
‫ﻋﻬﺪ ﺍﻹﻏﺮﻳﻖ ﻭﺣﱴ ﺑﺪﺍﻳﺔ ﺍﻟﻘﺮﻥ ﺍﻟﻌﺸﺮﻳﻦ‪ ،‬ﻛﺎﻥ ﻛﻞ ﻣﻦ ﺍﻟﻄﺒﻴﺐ ﻭﺍﳌﺮﻳﺾ ﻳﻘﺒﻞ ﻋﻤﻮﻣﺎ ﺑﺄﻥ ﺑﻮﺳﻊ‬
‫ﺍﻟﻌﻘﻞ ﺃﻥ ﻳﺆﺛﺮ ﰲ ﺳﲑﻭﺭﺓ ﺍﳌﺮﺽ‪ ،‬ﻭﺑﺪﺍ ﻃﺒﻴﻌﻴﺎ ﺗﻄﺒﻴﻖ ﻫﺬﺍ ﺍﳌﻔﻬﻮﻡ ﰲ ﺍﳌﻌﺎﳉﺔ ﺍﻟﻄﺒﻴﺔ ﻟﻠﻤﺮﺽ‪ .‬ﻭﻟﻜﻦ‬
‫ﳋﻤَﺠﻴﺔ‬
‫ﺑﻌﺪ ﺍﻛﺘﺸﺎﻑ ﺍﳌﻀﺎﺩﺍﺕ ﺍﳊﻴﻮﻳﺔ ﺷﺎﻉ ﺍﻓﺘﺮﺍﺽ ﺟﺪﻳﺪ ﻣﻔﺎﺩﻩ ﺃﻥ ﻣﻌﺎﳉﺔ ﺍﻷﻣﺮﺍﺽ ﺍ ﹶ‬
‫)ﺍﻟﻌﺪﻭﺍﺋﻴﺔ( ﺃﻭ ﺍﻻﻟﺘﻬﺎﺑﻴﺔ ﲢﺘﺎﺝ ﻓﻘﻂ ﺇﱃ ﺍﻟﺘﺨﻠﺺ ﻣﻦ ﺍﻟﻜﺎﺋﻦ ﺍﳊﻲ ﺃﻭ ﺍﻟﻌﺎﻣﻞ ﺍﻟﻐﺮﻳﺐ ﺍﻟﺬﻱ ﺍﺳﺘﺜﺎﺭ‬
‫ﺍﻻﻋﺘﻼﻝ‪ .‬ﻭﰲ ﺍﻧﺪﻓﺎﻋﻬﻢ ﻻﻛﺘﺸﺎﻑ ﻣﻀﺎﺩﺍﺕ ﺣﻴﻮﻳﺔ ﻭﻋﻘﺎﻗﲑ ﺟﺪﻳﺪﺓ ﺗﺸﻔﻲ ﺃﲬﺎﺟ‪‬ﺎ ﻭﺃﻣﺮﺍﺿﺎ ﻣﻌﻴﻨﺔ‪،‬‬
‫ﻓﺈﻥ ﺍﻟﺒﺎﺣﺜﲔ ﺍﻟﻄﺒﻴﲔ ﲡﺎﻫﻠﻮﺍ ﺇﱃ ﺣﺪ ﺑﻌﻴﺪ ﺣﻘﻴﻘﺔ ﺃﻥ ﺑﻮﺳﻊ ﺍﺳﺘﺠﺎﺑﺔ ﺍﳉﺴﻢ ﻧﻔﺴﻪ ﺃﻥ ﺗﺆﺛﺮ ﰲ‬
‫ﺍﻻﺳﺘﻌﺪﺍﺩ ﻟﻠﻤﺮﺽ ﻭﰲ ﺳﲑﻭﺭﺗﻪ‪.‬‬
 ‫ﳝﻜﻦ ﺗﻐﻴﲑ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﳌﻨﺎﻋﻴﺔ‬
‫ﻋﻠﻰ ﺍﳌﺴﺘﻮﻯ ﺍﳋﻠﻮﻱ ﺑﻮﺳﺎﻃﺔ‬
‫ﻫﺮﻣﻮﻧﺎﺕ ﺍﻟﻜﺮﺏ‪.‬‬

‫ﻭﻣﻦ ﺳﺨﺮﻳﺔ ﺍﻟﻘﺪﺭ ﺃﻥ ﺍﻷﲝﺎﺙ ﰲ ﻧﻄﺎﻕ ﺍﻷﻣﺮﺍﺽ ﺍﳋﻤﺠﻴﺔ ﻭﺍﻻﻟﺘﻬﺎﺑﻴﺔ ﻗﺪ ﺩﻓﻌﺖ‪ ،‬ﰲ ﺑﺪﺍﻳﺔ‬
‫ﺍﻷﻣﺮ‪ ،‬ﻃﺐ ﺍﻟﻘﺮﻥ ﺍﻟﻌﺸﺮﻳﻦ ﺇﱃ ﺭﻓﺾ ﻓﻜﺮﺓ ﺃﻥ ﺍﻟﻌﻘﻞ ﻳﺆﺛﺮ ﰲ ﺍﻻﻋﺘﻼﻝ ﺍﳉﺴﺪﻱ‪ .‬ﻭﺗﻌﻮﺩ ﺍﻵﻥ‬
‫ﺍﻷﲝﺎﺙ ﺍﳉﺎﺭﻳﺔ ﰲ ﺍﻟﻨﻄﺎﻕ ﻧﻔﺴﻪ ‪ -‬ﲟﺎ ﰲ ﺫﻟﻚ ﺍﻷﲝﺎﺙ ﺍﻟﱵ ﻳﻘﻮﻡ ﻬﺑﺎ ﳐﺘﱪﻧﺎ ﻭﺍﳌﺨﺘﱪ ﺍﳌﺘﻌﺎﻭﻥ ﻣﻌﻨﺎ‬
‫ﰲ ﻣﻌﺎﻫﺪ ﺍﻟﺼﺤﺔ ﺍﻟﻮﻃﻨﻴﺔ ‪ -‬ﻟﺘﺜﺒﺖ ﻋﻜﺲ ﺫﻟﻚ‪ .‬ﻭﻟﻘﺪ ﺃﺗﺎﺣﺖ ﻟﻨﺎ ﺍﻟﻮﺳﺎﺋﻞ ﺍﳉﺰﻳﺌﻴﺔ ﻭﺍﻟﺪﻭﺍﺋﻴﺔ‬
‫ﻑ ﺷﺒﻜﺔ ﻣﻌﻘﺪﺓ ﺗﻮﺟﺪ ﺑﲔ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﻭﺍﻟﺪﻣﺎﻍ ﻭﺗﺘﻴﺢ ﳍﻤﺎ ﺗﺒﺎﺩﻝ ﺍﻹﺷﺎﺭﺍﺕ ﻋﻠﻰ ﳓﻮ ﻣﺴﺘﻤﺮ‬
‫ﺗﻌ ّﺮ َ‬
‫ﻭﺳﺮﻳﻊ‪ .‬ﻓﻜﻴﻤﻴﺎﺋﻴﺎﺕ ﻣﻌﻴﻨﺔ ﻳﻨﺘﺠﻬﺎ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﺗﻌﻤﻞ ﻛﺈﺷﺎﺭﺍﺕ ﰲ ﺍﻟﺪﻣﺎﻍ‪ ،‬ﻓﻴﻘﻮﻡ ﻫﺬﺍ ﺑﺪﻭﺭﻩ‬
‫ﺑﺈﺭﺳﺎﻝ ﺇﺷﺎﺭﺍﺕ ﺗﻘﻴﺪ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ‪ .‬ﻛﻤﺎ ﺃﻥ ﻫﺬﻩ ﺍﻹﺷﺎﺭﺍﺕ ﺍﻟﻜﻴﻤﻴﺎﺋﻴﺔ ﻧﻔﺴﻬﺎ ﺗﺆﺛﺮ ﰲ ﺍﻟﺴﻠﻮﻙ‬
‫ﲡﺎﻩ ﺍﻟ ﹶﻜﺮْﺏ ‪ stress‬ﻭﰲ ﺍﻻﺳﺘﺠﺎﺑﺔ ﻟﻪ‪ .‬ﻭﻳﻌﻤﻞ ﺗﻌﻄﻞ ﺷﺒﻜﺔ ﺍﻻﺗﺼﺎﻝ ﻫﺬﻩ )ﺳﻮﺍﺀ ﻛﺎﻥ ﻫﺬﺍ ﺍﻟﺘﻌﻄﻞ‬
‫ﻣﻮﺭﻭﺛﺎ ﺃﻭ ﺑﻮﺳﺎﻃﺔ ﺍﻟﻌﻘﺎﻗﲑ ﺃﻭ ﺍﳌﻮﺍﺩ ﺍﻟﺴﺎﻣﺔ ﺃﻭ ﺍﳉﺮﺍﺣﺔ( ﻋﻠﻰ ﺗﻔﺎﻗﻢ ﺍﻷﻣﺮﺍﺽ ﺍﻟﱵ ﻳﺼﻮﻥ ﺍﻟﺪﻣﺎﻍ‬
‫ﻭﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﺍﳉﺴ َﻢ ﻣﻦ ﺍﻹﺻﺎﺑﺔ ﻬﺑﺎ‪ ،‬ﺳﻮﺍﺀ ﻛﺎﻧﺖ ﻫﺬﻩ ﺍﻷﻣﺮﺍﺽ ﲬﺠﻴﺔ ﺃﻭ ﺍﻟﺘﻬﺎﺑﻴﺔ ﺃﻭ ﻣﻨﺎﻋﻴﺔ‬
‫ﺫﺍﺗﻴﺔ ﺃﻭ ﺃﻱ ﺍﺿﻄﺮﺍﺏ ﻟﻪ ﻋﻼﻗﺔ ﺑﺎﳌﺰﺍﺝ‪.‬‬

‫ﻭﻳﺮﺟﺢ ﺃﻥ ﻳﻜﻮﻥ ﺍﻻﻧﻌﻜﺎﺱ ﺍﻟﺴﺮﻳﺮﻱ ﳍﺬﻩ ﺍﻻﻛﺘﺸﺎﻓﺎﺕ ﺑﻌﻴﺪ ﺍﻷﺛﺮ‪ .‬ﺇ‪‬ﺎ َﺗﻌ‪‬ﺪ ﺑﺘﻮﺳﻴﻊ ﻃﻴﻒ‬
‫ﺍﳌﻌﺎﳉﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﳌﺘﺎﺣﺔ ﻟﻼﺿﻄﺮﺍﺑﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ‪ ،‬ﺣﻴﺚ ﺍﺗﻀﺢ ﺃﻥ ﺍﻟﻌﻘﺎﻗﲑ )ﺍﻟﱵ ﻛﺎﻥ ﻳﻌﺮﻑ ﺃ‪‬ﺎ‬
‫ﺗﻌﻤﻞ ﺑﺼﻮﺭﺓ ﺃﺳﺎﺳﻴﺔ ﻋﻠﻰ ﺍﳉﻬﺎﺯ ﺍﻟﻌﺼﱯ( ﻓﻌّﺎﻟﺔ ﺃﻳﻀﺎ ﰲ ﻣﻌﺎﳉﺔ ﺃﻣﺮﺍﺽ ﻣﻨﺎﻋﻴﺔ ﻣﻌﻴﻨﺔ‪ ،‬ﻭﺍﻟﻌﻜﺲ‬
‫ﺑﺎﻟﻌﻜﺲ‪ .‬ﻛﻤﺎ ﺃ‪‬ﺎ ﺗﺴﺎﻋﺪ ﻋﻠﻰ ﺇﻗﺎﻣﺔ ﺍﻟﺪﻟﻴﻞ ﻋﻠﻰ ﺻﺤﺔ ﺍﻻﻋﺘﻘﺎﺩ ﺍﻟﺸﻌﱯ ـ ﺍﻟﺬﻱ ﻣﺎﺯﺍﻝ ﻣﺴﺘﺒﻌﺪﺍ‬
‫ﻣﻦ ﻗﺒﻞ ﺑﻌﺾ ﺍﻟﺪﻭﺍﺋﺮ ﺍﻟﻄﺒﻴﺔ ـ ﻭﺍﻟﻘﺎﺋﻞ ﺑﺄﻥ ﰲ ﻭﺳﻊ ﺣﺎﻟﺘﻨﺎ ﺍﻟﻌﻘﻠﻴﺔ ﺃﻥ ﺗﺆﺛﺮ ﰲ ﻣﺪﻯ ﻣﻘﺎﻭﻣﺘﻨﺎ‬
‫ﻟﻸﻣﺮﺍﺽ ﺍﳋﻤﺠﻴﺔ ﺃﻭ ﺍﻻﻟﺘﻬﺎﺑﻴﺔ ﺃﻭ ﰲ ﻣﺪﻯ ﺷﻔﺎﺋﻨﺎ ﻣﻨﻬﺎ‪.‬‬
 ‫ﺘﺸﺭﻴﺢ ﺠﻬﺎﺯﻱ ﺍﻟﻜﺭﺏ ﻭﺍﻟﻤﻨﺎﻋﺔ‬
‫ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﻟﻜﺮﺑﻴﺔ‬

‫ﻍ ﺑﺎﻷﻋﻀﺎﺀ ﻭﺑﺎﻟﻨﺴﺞ ﻛﺎﻓﺔ‪ .‬ﻭﺗﻌﻤﻞ ﻣﻮﺍﻗﻒ ﺍﻟﺘﺤﺪﻱ ﺃﻭ ﺍﻟﺘﻬﺪﻳﺪ ﻋﻠﻰ‬

‫ﺏ ﺍﻟﺪﻣﺎ ﹶ‬
‫ﺗﺼﻞ ﺍﻷﻋﺼﺎ ُ‬
‫ﺍﺳﺘﺜﺎﺭﺓ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﻟﻜﺮﺑﻴﺔ ﻟﻠﺪﻣﺎﻍ‪ ،‬ﺍﻟﱵ ﺗﻌﻤﻞ ﺑﺪﻭﺭﻫﺎ ﻋﻠﻰ ﺇﻃﻼﻕ ﻫﺮﻣﻮﻥ ﻳﻨﺒﻪ ﺗﻴﻘﻈﺎ ﻓﻴﺰﻳﻮﻟﻮﺟﻴﺎ‬
‫ﻭﻳﻨﻈﻢ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ‪ .‬ﻭﺍﳌﻜﻮﻧﺎﺕ ﺍﳌﻔﺘﺎﺣﻴﺔ ﻟﻼﺳﺘﺠﺎﺑﺔ ﺍﻟﻜﺮﺑﻴﺔ ﻫﻲ‪ :‬ﺍﻟﻮﻃﺎﺀ ﻭﺍﳌﻮﺿﻊ ﺍﻷﺯﺭﻕ ﰲ‬
‫ﺍﻟﺪﻣﺎﻍ ﻭﺍﻟﻐﺪﺓ ﺍﻟﻨﺨﺎﻣﻴﺔ ﻭﺍﳉﻤﻠﺔ ﺍﻟﻌﺼﺒﻴﺔ ﺍﻟﻮﺩﻳﺔ ﻭﻏﺪﺓ ﺍﻟﻜﻈﺮ‪.‬‬

‫ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﳌﻨﺎﻋﻴﺔ‬

‫ﻳﻌﻤﻞ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﻛﺸﺒﻜﺔ ﻻﻣﺮﻛﺰﻳﺔ‪ ،‬ﻳﺴﺘﺠﻴﺐ ﺁﻟﻴﺎ ﻷﻱ ﺷﻲﺀ ﻳﻐﺰﻭ ﺍﳉﺴﻢ ﺃﻭ ﻳﻌﻄﻠﻪ‪ .‬ﻭﺇﻥ‬
‫ﺧﻼﻳﺎ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ‪ ،‬ﺍﻟﱵ ﺗﺘﻮﻟﺪ ﰲ ﻧﻘﻲ ﺍﻟﻌﻈﻢ ﻭﺍﻟﻌﻘﺪ ﺍﻟﻠﻤﻔﻴﺔ ﻭﺍﻟﻄﺤﺎﻝ ﻭﺍﻟﺘﻮﺗﺔ‪ ،‬ﺗﺴﺘﻌﻤﻞ‬
‫ﺑﺮﻭﺗﻴﻨﺎﺕ ﺻﻐﲑﺓ ﻣﻦ ﺃﺟﻞ ﺍﺗﺼﺎﻝ ﺑﻌﻀﻬﺎ ﺑﺒﻌﺾ‪ .‬ﻭﺑﻮﺳﻊ ﻫﺬﻩ ﺍﳌﺮﺍﺳﻴﻞ ﺍﻟﻜﻴﻤﻴﺎﺋﻴﺔ ﺃﻳﻀﺎ ﺃﻥ ﺗﺒﻌﺚ‬
‫ﺇﺷﺎﺭﺍﺕ ﺇﱃ ﺍﻟﺪﻣﺎﻍ ﻋﱪ ﺍﻟﺪﻡ ﺃﻭ ﺍﳌﺴﺎﻟﻚ ﺍﻟﻌﺼﺒﻴﺔ‪ ،‬ﻛﺎﻟﻌﺼﺐ ﺍﳌﺒﻬﻢ ﻭﺍﻟﺴﺒﻴﻞ ﺍﳌﻔﺮﺩ‪.‬‬
‫ﻭﺗُ ﹶﻔ ‪‬ﻌّﻞ ﺍﳊﺎﻻﺕ ﺍﳌﻨﺬﺭﺓ ﺑﺎﳋﻄﺮ ﻧﻈﺎﻡ ﺍﺳﺘﺠﺎﺑﺔ ﺍﻟﺪﻣﺎﻍ ﻟﻠﻜﺮﺏ‪ .‬ﻭﻳﺴﺘﺠﻴﺐ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﺗﻠﻘﺎﺋﻴﺎ‬
‫ﻭﻟﻠﺠﺰﻳﺌﺎﺕ ﺍﻟﻐﺮﻳﺒﺔ‪ .‬ﻭﻳﻌﺘﱪ ﺟﻬﺎﺯﺍ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﳌﺸﺎﺭ ﺇﻟﻴﻬﻤﺎ ﻭﺳﻴﻠﱵ ﺍﳉﺴﻢ‬ ‫) ‪(1‬‬
‫ﻟﻠ ُﻤ ْﻤﺮﹺﺿﺎﺕ‬
‫ﺍﻟﺮﺋﻴﺴﻴﺘﲔ ﻟﻠﺤﻔﺎﻅ ﻋﻠﻰ ﺣﺎﻟﺔ ﺍﺳﺘﻘﺮﺍﺭﻩ ﺍﻟﺪﺍﺧﻠﻲ‪ ،‬ﺃﻭ ﻣﺎ ﻳﻌﺮﻑ ﺑﺎﻻﺳﺘﺘﺒﺎﺏ ‪ .homeostasis‬ﻫﺬﺍ‬
‫ﻭﺇﻥ ﻧﺴﺒﺔ ﻣﻬﻤﺔ ﻣﻦ ﺍﳌﺎﻛﻴﻨﺔ ﺍﳋﻠﻮﻳﺔ ﺍﻟﺒﺸﺮﻳﺔ ﻣﻜﺮﺳﺔ ﻟﺼﻴﺎﻧﺔ ﻫﺬﺍ ﺍﻻﺳﺘﺘﺒﺎﺏ‪.‬‬

‫ﻓﻌﻨﺪﻣﺎ ﻳﻀﻄﺮﺏ ﺍﻻﺳﺘﺘﺒﺎﺏ ﺃﻭ ﻳُﻬﺪﺩ‪ ،‬ﻓﺈﻥ ﳎﻤﻮﻋﺔ ﻣﻦ ﺍﻻﺳﺘﺠﺎﺑﺎﺕ ﺍﳉﺰﻳﺌﻴﺔ ﻭﺍﳋﻠﻮﻳﺔ‬

‫ﻭﺍﻟﺴﻠﻮﻛﻴﺔ ﺗُﺴﺘﺜﺎﺭ‪ .‬ﻭﲢﺎﻭﻝ ﻫﺬﻩ ﺍﻻﺳﺘﺠﺎﺑﺎﺕ ﺇﺑﻄﺎﻝ ﻓﻌﻞ ﺍﻟﻘﻮﻯ ﺍﳌﺴﺒﺒﺔ ﻟﻼﺿﻄﺮﺍﺏ ﺑﻐﻴﺔ ﺍﻟﻌﻮﺩﺓ‬
‫ﺇﱃ ﺣﺎﻟﺔ ﺍﻻﺳﺘﻘﺮﺍﺭ‪ .‬ﻭﻗﺪ ﺗﻜﻮﻥ ﻫﺬﻩ ﺍﻻﺳﺘﺠﺎﺑﺎﺕ ﻧﻮﻋﻴﺔ ﲡﺎﻩ ﻏﺎﺯﹴ ﻏﺮﻳﺐ ﺑﻌﻴﻨﻪ ﺃﻭ ﻛﺮﺏ ﻣﻌﲔ ﺃﻭ‬
‫ﺃ‪‬ﺎ ﺗﻜﻮﻥ ﻋﺎﻣﺔ ﻭﻻﻧﻮﻋﻴﺔ ﻋﻨﺪﻣﺎ ﻳﺘﺠﺎﻭﺯ ﺍﻟﺘﻬﺪﻳﺪ ﻟﻼﺳﺘﺘﺒﺎﺏ ﻋﺘﺒﺔ ﻣﻌﻴﻨﺔ‪ .‬ﻭﳝﻜﻦ ﳍﺬﻩ ﺍﻻﺳﺘﺠﺎﺑﺎﺕ‬
‫ﺍﻟﺘﻼﺅﻣﻴﺔ ﻧﻔﺴﻬﺎ ﺃﻥ ﺗﺘﺤﻮﻝ ﺇﱃ ُﻣ ﹾﻜﺮﹺﺑﺎﺕ ﻗﺎﺩﺭﺓ ﻋﻠﻰ ﺇﺣﺪﺍﺙ ﺍﳌﺮﺽ‪ .‬ﻭﻟﻘﺪ ﺑﺪﺃﻧﺎ ﻟﺘﻮﻧﺎ ﻓﻬﻢ ﺍﻟﻄﺮﺍﺋﻖ‬
‫ﺍﻟﻌﺪﻳﺪﺓ ﺍﻟﱵ ﻳﺘﻮﺍﻓﻖ ﻓﻴﻬﺎ ﺍﻟﺪﻣﺎﻍ ﻭﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ‪ ،‬ﻭﻛﻴﻒ ﻳﺴﺎﻋﺪﺍﻥ ﻋﻠﻰ ﺗﻨﻈﻴﻢ ﺃﻭ ﺗﻀﺎﺩ ﺗﻨﻈﻴﻢ‬
‫ﺃﺣﺪﳘﺎ ﻟﻶﺧﺮ‪ ،‬ﻭﻛﻴﻒ ﳜﺘﻼﻥ ﻭﻇﻴﻔﻴﺎ ﻓﻴﺴﺒﺒﺎﻥ ﺍﳌﺮﺽ‪.‬‬

‫ﻭﺗﺪﻋﻢ ﺍﺳﺘﺠﺎﺑﺔ ﺍﻟﻜﺮﺏ ﺍﻟﺘﻐﲑﺍﺕ ﺍﻟﻔﻴﺰﻳﻮﻟﻮﺟﻴﺔ ﻭﺍﻟﺴﻠﻮﻛﻴﺔ ﺍﻟﱵ ﺗﻌﺰﺯ ﺍﻟﺒُﻘﻴﺎ)‪ (2‬ﰲ ﺍﳊﺎﻻﺕ‬
‫ﺍﳌﻨﺬﺭﺓ ﺑﺎﳋﻄﺮ ﻭﺍﻹﺭﻫﺎﻕ‪ .‬ﻓﻤﺜﻼ‪ ،‬ﻋﻨﺪﻣﺎ ﻧﻮﺍﺟﻪ ﺣﺎﻟﺔ ﺗﻨﻄﻮﻱ ﻋﻠﻰ ﺧﻄﺮ ﻣﻬﺪّﺩ ﻟﻠﺤﻴﺎﺓ‪ ،‬ﻓﺈﻥ ﺍﺳﺘﺠﺎﺑﺔ‬
‫ﺍﻟﺪﻣﺎﻍ ﻟﻠﻜﺮﺏ ﺗﺴﺘﺜﺎﺭ ﻟﺘﻌﺰﻳﺰ ﺗﺮﻛﻴﺰ ﺍﻧﺘﺒﺎﻫﻨﺎ ﻭﺧﻮﻓﻨﺎ ﻭﺍﺳﺘﺠﺎﺑﺘﻨﺎ ﺍﻟﻐﺮﻳﺰﻳﺔ ﺍﳌﺘﻤﺜﻠﺔ ﺑﻌﺒﺎﺭﺓ »ﺍﻟﻜ ّﺮ ﺃﻭ‬
‫ﺍﻟﻔ ّﺮ«)‪ ،(3‬ﺑﺎﻟﺘﺰﺍﻣﻦ ﻣﻊ ﺗﺜﺒﻴﻂ ﺍﻟﺴﻠﻮﻛﻴﺎﺕ ﺍﳋﺎﺻﺔ ﺑﺎﻹﻃﻌﺎﻡ ﻭﺍﳉﻨﺲ ﻭﺍﻟﻨﻮﻡ‪ ،‬ﻭﺍﻟﱵ ﳝﻜﻦ ﺃﻥ ﺗﻘﻠﻞ ﻣﻦ‬
‫ﻓﺮﺹ ﺍﻟﺒُﻘﻴﺎ ﺍﳌﺒﺎﺷﺮﺓ‪ .‬ﺑﻴﺪ ﺃﻧﻪ ﻻﺑﺪ ﻣﻦ ﺗﻨﻈﻴﻢ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﻟﻜﺮﺑﻴﺔ ﻛﻲ ﻻ ﺗﺼﺒﺢ ﻣﻔﺮﻃﺔ‪ ،‬ﺃﻭ ﺩﻭﻥ ﺍﳊﺪ‬
‫ﺍﻷﻣﺜﻞ)‪ ،(4‬ﻓﺘﻈﻬﺮ ﻋﻨﺪﺋﺬ ﺍﺿﻄﺮﺍﺑﺎﺕ ﺗﺼﻴﺐ ﺍﻟﺘﻴﻘﻆ ﻭﺍﻟﺘﻔﻜﲑ ﻭﺍﳌﺸﺎﻋﺮ‪.‬‬

‫ﻳﻌﻤﻞ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﻋﻠﻰ ﺍﳊﻴﻠﻮﻟﺔ ﺩﻭﻥ ﻭﺻﻮﻝ ﺍﳌﻤﺮﺿﺎﺕ ﺍﻟﻐﺮﻳﺒﺔ ﺇﱃ ﺍﳉﺴﻢ‪ ،‬ﻭﲣﺮﻳﺐ ﻣﺎ‬
‫ﳜﺘﺮﻕ ﻣﻨﻬﺎ ﺳﻄﻮﺣﻪ ﺍﻟﻮﺍﻗﻴﺔ‪ .‬ﻭﻋﻠﻰ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﺃﻳﻀﺎ ﺗﻌﺪﻳﻞ ﺍﻟﺬﻳﻔﺎﻧﺎﺕ ‪ toxins‬ﺫﺍﺕ ﺍﳋﻄﻮﺭﺓ‬
‫ﺍﻟﻜﺎﻣﻨﺔ‪ ،‬ﻭﺗﺴﻬﻴﻞ ﺗﺼﻠﻴﺢ ﺍﻟﻨﺴﺞ ﺍﳌﺘﺄﺫﻳﺔ ﺃﻭ ﺍﳌﻬﺘﺮﺋﺔ‪ ،‬ﻭﺍﻟﺘﺨﻠﺺ ﻣﻦ ﺍﳋﻼﻳﺎ ﺍﻟﻼﺳﻮﻳﺔ‪ .‬ﻭﺗﻜﻮﻥ‬
‫ﺍﺳﺘﺠﺎﺑﺎﺕ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﻋﻠﻰ ﺩﺭﺟﺔ ﻣﻦ ﺍﻟﻘﻮﺓ ﲝﻴﺚ ﺗﺘﻄﻠﺐ ﺗﻨﻈﻴﻤﺎ ﻣﺴﺘﻤﺮﺍ ﻟﻠﺘﺄﻛﺪ ﻣﻦ ﺃ‪‬ﺎ ﻟﻦ‬
‫ﺗﺼﺒﺢ ﻣﻔﺮﻃﺔ ﺃﻭ ﻏﲑ ﻣُﻤﹺﻴّﺰﺓ‪ ،‬ﻋﻠﻰ ﺃﻥ ﲢﺘﻔﻆ ﰲ ﺍﻟﻮﻗﺖ ﻧﻔﺴﻪ ﺑﻔﺎﻋﻠﻴﺎ‪‬ﺎ‪ .‬ﻭﺇﺫﺍ ﻣﺎ ﲤﻠﺺ ﺍﳉﻬﺎﺯ‬
‫ﺍﳌﻨﺎﻋﻲ ﻣﻦ ﻫﺬﺍ ﺍﻟﺘﻨﻈﻴﻢ ﺍﻟﺮﻗﺎﰊ‪ ،‬ﻓﺈﻥ ﺃﻣﺮﺍﺽ ﺍﳌﻨﺎﻋﺔ ﺍﻟﺬﺍﺗﻴﺔ ﻭﺍﻷﻣﺮﺍﺽ ﺍﻻﻟﺘﻬﺎﺑﻴﺔ ﻭﻣﺘﻼﺯﻣﺎﺕ ﺍﻟﻌﻮﺯ‬
‫ﺍﳌﻨﺎﻋﻲ ﺗﺒﺪﺃ ﺑﺎﻟﻈﻬﻮﺭ‪.‬‬
 ‫ﻋﻨﺪﻣﺎ ﻧﻮﺍﺟﻪ ﻣﻮﻗﻔﺎ ﻓﻴﻪ ‪‬ﺪﻳﺪ‬
‫ﻟﻠﺤﻴﺎﺓ‪ ،‬ﺗﺴﺎﺭﻉ ﺍﺳﺘﺠﺎﺑﺔ ﺍﻟﻜﺮﺏ‬
‫ﺍﻟﺪﻣﺎﻏﻴﺔ ﺇﱃ ﺍﻟﻌﻤﻞ ﻟﺘﻌﺰﺯ ﺗﺮﻛﻴﺰ‬
‫ﺍﻧﺘﺒﺎﻫﻨﺎ ﻭﺧﻮﻓﻨﺎ ﻭﻳﻘﻈﺘﻨﺎ ﺍﻟﻐﺮﻳﺰﻳﺔ‬
‫ﻟﻼﺳﺘﺠﺎﺑﺔ ﺍﻟﻔﻄﺮﻳﺔ‪ ،‬ﺍﳌﺘﻤﺜﻠﺔ ﺑﻌﺒﺎﺭﺓ‬
‫»ﺍﻟﻜ ّﺮ ﺃﻭ ﺍﻟﻔ ّﺮ«‪ ،‬ﻛﺎﺑﺘ ﹰﺔ ﰲ ﺍﻟﻮﻗﺖ‬
‫ﻧﻔﺴﻪ ﺍﻹﻃﻌﺎﻡ ﻭﺍﳉﻨﺲ ﻭﺍﻟﻨﻮﻡ‪.‬‬

‫ﻭﻟﻠﻮﻫﻠﺔ ﺍﻷﻭﱃ ﻳﺒﺪﻭ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﻭﺍﳉﻤﻠﺔ ﺍﻟﻌﺼﺒﻴﺔ ﺍﳌﺮﻛﺰﻳﺔ ﳐﺘﻠﻔﲔ ﰲ ﺗﻨﻈﻴﻤﻬﻤﺎ )ﺗﻌﻀﻴﻬﻤﺎ(‬
‫ﺍﺧﺘﻼﻓﺎ ﺑﹺﻴّﻨﺎ‪ .‬ﻭﻳُﻨﻈﺮ ﺇﱃ ﺍﻟﺪﻣﺎﻍ ﻋﺎﺩﺓ ﻋﻠﻰ ﺃﻧﻪ ﻣﻘﺮ ﻗﻴﺎﺩﺓ ﻣﺮﻛﺰﻱ ﻳﺮﺳﻞ ﻭﻳﺴﺘﻘﺒﻞ ـ ﻋﱪ ﻣﺴﺎﻟﻚ‬
‫ﺛﺎﺑﺘﺔ ـ ﺇﺷﺎﺭﺍﺕ ﻛﻬﺮﺑﺎﺋﻴﺔ ﻭﻛﺄﻧﻪ ﺷﺒﻜﺔ ﻫﺎﺗﻔﻴﺔ‪ .‬ﻭﻋﻠﻰ ﺍﻟﻨﻘﻴﺾ ﻣﻦ ﺫﻟﻚ‪ ،‬ﻓﺈﻥ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﻳﺘﻤﻴﺰ‬
‫ﺑﻌﺪﻡ ﻣﺮﻛﺰﻳﺘﻪ‪ ،‬ﺇﺫ ﺗﺘﻮﺿﻊ ﺃﻋﻀﺎﺅﻩ )ﺍﻟﻄﺤﺎﻝ ﻭﺍﻟﻌﻘﺪ ﺍﻟﻠﻤﻔﻴﺔ ﻭﺍﻟﺘﻮﺗﺔ ‪ thymus‬ﻭﻧﻘﻲ ﺍﻟﻌﻈﻢ( ﰲ‬
‫ﺃﳓﺎﺀ ﺍﳉﺴﻢ ﻛﺎﻓﺔ‪ .‬ﻭﻭﻓﻘﺎ ﻟﻠﻨﻈﺮﺓ ﺍﻟﺘﻘﻠﻴﺪﻳﺔ‪ ،‬ﻓﺈﻥ ﺍﺗﺼﺎﻝ ﺃﻋﻀﺎﺀ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﺑﻌﻀﻬﺎ ﺑﺒﻌﺾ ﻳﺘﻢ ﻋﻦ‬
‫ﻃﺮﻳﻖ ﲢﺮﻳﺮﻫﺎ ﰲ ﺍﻟﺪﻡ ﺧﻼﻳﺎ ﻣﻨﺎﻋﻴﺔ ﺗﻄﻔﻮ ﻓﻴﻪ ﻛﺎﻟﺰﻭﺍﺭﻕ ﻟﻴﻮﺻﻠﻬﺎ ﺇﱃ ﻣﻮﺍﺿﻌﻬﺎ ﺍﳉﺪﻳﺪﺓ‪ ،‬ﺣﻴﺚ‬
‫ﺗﺒﻠﻎ ﺭﺳﺎﺋﻠﻬﺎ ﺃﻭ ﺗﺆﺩﻱ ﻭﻇﺎﺋﻒ ﺃﺧﺮﻯ ﳏﺪﺩﺓ‪.‬‬

‫ﺑﻴﺪ ﺃﻥ ﺍﳉﻤﻠﺔ ﺍﻟﻌﺼﺒﻴﺔ ﺍﳌﺮﻛﺰﻳﺔ ﻭﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﻳﺘﻤﺎﺛﻼﻥ ﰲ ﺣﻘﻴﻘﺔ ﺍﻷﻣﺮ ﺃﻛﺜﺮ ﳑﺎ ﻳﺘﺒﺎﻳﻨﺎﻥ‪،‬‬
‫ﻭﺫﻟﻚ ﰲ ﻃﺮﻳﻘﺔ ﺗﻠﻘﻴﻬﻤﺎ ﺍﻹﺷﺎﺭﺍﺕ ﺍﻟﱵ ﺗﺮﺩ ﻣﻦ ﺍﻟﻮﺳﻂ ﺍﳋﺎﺭﺟﻲ‪ ،‬ﻭﰲ ﺗﻌﺮﻑ ﻫﺬﻩ ﺍﻹﺷﺎﺭﺍﺕ‬
‫ﻭﻣﻜﺎﻣﻠﺘﻬﺎ‪ ،‬ﻭﻛﺬﻟﻚ ﰲ ﺗﺼﻤﻴﻤﻬﺎ ﺍﻟﺒﻨﻴﻮﻱ ﻹﳒﺎﺯ ﻫﺬﻩ ﺍﳌﻬﻤﺎﺕ‪ .‬ﻭﳝﺘﻠﻚ ﻛﻞ ﻣﻦ ﺍﳉﻤﻠﺔ ﺍﻟﻌﺼﺒﻴﺔ‬
‫ﺍﳌﺮﻛﺰﻳﺔ ﻭﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﻋﻨﺎﺻﺮ »ﺣﺴﻴﺔ« ﺗﺘﻠﻘﻰ ﻣﻌﻠﻮﻣﺎﺕ ﻣﻦ ﺍﻟﻮﺳﻂ ﺍﳋﺎﺭﺟﻲ ﻭﻣﻦ ﺃﻗﺴﺎﻡ ﺃﺧﺮﻯ‬
‫ﻣﻦ ﺍﳉﺴﻢ‪ ،‬ﻛﻤﺎ ﳝﺘﻠﻜﺎﻥ ﻋﻨﺎﺻﺮ »ﳏﺮﻛﺔ« ﺗﻨﻔﺬ ﺍﻻﺳﺘﺠﺎﺑﺎﺕ ﺍﳌﻼﺋﻤﺔ‪.‬‬

‫ﺍﺘﺼﺎل ﻤﺘﻘﺎﻁﻊ‬
‫) ‪(5‬‬
‫ﺇﻥ ﻛﻼ ﻣﻦ ﺍﻟﺪﻣﺎﻍ ﻭﺍﳌﻨﺎﻋﺔ ﻳﻌﺘﻤﺪﺍﻥ ﻟﻼﺗﺼﺎﻝ ﻓﻴﻤﺎ ﺑﻴﻨﻬﻤﺎ ﻋﻠﻰ ﺍﻟﻮﺳﺎﺋﻂ ﺍﻟﻜﻴﻤﻴﺎﺋﻴﺔ؛‬
‫ﻓﺎﻹﺷﺎﺭﺍﺕ ﺍﻟﻜﻬﺮﺑﺎﺋﻴﺔ ﻣﺜﻼ ﻋﻠﻰ ﻃﻮﻝ ﺍﳌﺴﺎﻟﻚ ﺍﻟﻌﺼﺒﻴﺔ ﺗُﺤ َﻮّﻝ ﰲ ﺍﳌﺸﺎﺑﻚ ﺑﲔ ﺍﻟﻌﺼﺒﻮﻧﺎﺕ ﺇﱃ‬
‫ﺇﺷﺎﺭﺍﺕ ﻛﻴﻤﻴﺎﺋﻴﺔ‪ .‬ﻭﻻ ﺗﻘﻮﻡ ﺍﳌﺮﺍﺳﻴﻞ)‪ ،(6‬ﺍﻟﱵ ﺗﻨﺘﺠﻬﺎ ﺍﳋﻼﻳﺎ ﺍﳌﻨﺎﻋﻴﺔ‪ ،‬ﺑﺎﻻﺗﺼﺎﻝ ﺑﺄﺟﺰﺍﺀ ﺍﳉﻬﺎﺯ‬
‫ﺍﳌﻨﺎﻋﻲ ﺍﻷﺧﺮﻯ ﻓﺤﺴﺐ‪ ،‬ﺑﻞ ﺃﻳﻀﺎ ﺑﺎﻟﺪﻣﺎﻍ ﻭﺍﻷﻋﺼﺎﺏ‪ .‬ﻛﻤﺎ ﺃﻥ ﺑﻮﺳﻊ ﺍﻟﻜﻴﻤﻴﺎﺋﻴﺎﺕ‪ ،‬ﺍﻟﱵ ﲢﺮﺭﻫﺎ‬
‫ﺍﳋﻼﻳﺎ ﺍﻟﻌﺼﺒﻴﺔ‪ ،‬ﺃﻥ ﺗﻌﻤﻞ ﻛﺈﺷﺎﺭﺍﺕ ﺗﺴﺘﺜﲑ ﺍﳋﻼﻳﺎ ﺍﳌﻨﺎﻋﻴﺔ‪ .‬ﻭﺗﻨﺘﻘﻞ ﻫﺮﻣﻮﻧﺎﺕ ﺍﳉﺴﻢ ﻋﱪ ﺍﻟﺪﻡ ﺇﱃ‬
‫ﺼ ّﹺﻢ‬
‫ﺍﻟﺪﻣﺎﻍ‪ ،‬ﻛﻤﺎ ﺃﻥ ﺍﻟﺪﻣﺎﻍ ﻳﺼﻨﻊ ﻫﻮ ﺍﻵﺧﺮ ﻫﺮﻣﻮﻧﺎﺕ ﻣﻌﻴﻨﺔ‪ .‬ﻭﻗﺪ ﻳﻜﻮﻥ ﺍﻟﺪﻣﺎﻍ ﺃﻛﺜﺮ ﺍﻷﻋﻀﺎﺀ ﺍﻟ ُّ‬
‫ﰲ ﺍﳉﺴﻢ ﺇﻧﺘﺎﺟﺎ ﻟﻠﻬﺮﻣﻮﻧﺎﺕ‪ ،‬ﻓُﻴ ْﻨﺘ‪‬ﺞ ﻋﺪﺩﺍ ﻛﺒﲑﺍ ﻣﻨﻬﺎ ﺗﺆﺛﺮ ﰲ ﺍﻟﺪﻣﺎﻍ ﻧﻔﺴﻪ ﻭﰲ ﻧﺴﺞ ﺍﳉﺴﻢ‬
‫ﺍﳌﺨﺘﻠﻔﺔ‪.‬‬

‫‪CRH hormnone releasing-corticotropin‬‬ ‫ﻭﻳﻌﺪ ﺍﳍﺮﻣﻮﻥ ﺍﶈﺮﺭ ﻟﻠﻤﻮﺟﻬﺔ ﺍﻟﻘﺸﺮﻳﺔ‬

‫ﺃﺣﺪ ﺍﳍﺮﻣﻮﻧﺎﺕ ﺍﻷﺳﺎﺳﻴﺔ ﺍﻟﱵ ﺗﺘﺸﺎﺭﻙ ﻓﻴﻬﺎ ﺍﳉﻤﻠﺔ ﺍﻟﻌﺼﺒﻴﺔ ﺍﳌﺮﻛﺰﻳﺔ ﻭﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ؛ ﻭﻳﻨﺘﺠﻪ‬
‫ﺍﻟﻮﻃﺎﺀ ‪ hypothalamus‬ﻭﻣﻨﺎﻃﻖ ﺃﺧﺮﻯ ﻣﻦ ﺍﻟﺪﻣﺎﻍ‪ ،‬ﻭﻳﻮﺣﺪ ﺍﺳﺘﺠﺎﺑﺎﺕ ﺍﻟﻜﺮﺏ ﻭﺍﻻﺳﺘﺠﺎﺑﺎﺕ‬
‫ﺍﳌﻨﺎﻋﻴﺔ‪ .‬ﻭﻳُﺤﺮﺭ ﺍﻟﻮﻃﺎﺀ ﺍﳍﺮﻣﻮ ﹶﻥ ‪ CRH‬ﰲ ﺩﺍﺭﺍﺕ ﺩﻣﻮﻳﺔ ﻣﺘﺨﺼﺼﺔ‪ ،‬ﺗﻮﺻﻞ ﻫﺬﺍ ﺍﳍﺮﻣﻮﻥ ﺇﱃ‬
‫ﺍﻟﻨﺨﺎﻣﺔ )ﺍﻟﻐﺪﺓ ﺍﻟﻨﺨﺎﻣﻴﺔ( ﺍﻟﱵ ﺗﺘﻮﺿﻊ ﲢﺖ ﺍﻟﺪﻣﺎﻍ ﻣﺒﺎﺷﺮﺓ‪ .‬ﻭﻳﺪﻓﻊ ﺍﳍﺮﻣﻮﻥ ‪ CRH‬ﺍﻟﻨﺨﺎﻣﺔ ﻟﺘﺤﺮﺭ‬
‫ﺍﳍﺮﻣﻮﻥ ﺍﳌﻮ ﹺﺟّﻪ ﻟﻘﺸﺮﺓ ﺍﻟﻜﻈﺮ ‪ ACTH hormone adrenocorticotropin‬ﰲ ﺍﻟﺪﻡ‪ ،‬ﻓﻴﻌﻤﻞ‬
‫ﻫﺬﺍ ﺍﻷﺧﲑ ﻋﻠﻰ ﺗﻨﺒﻴﻪ ﺍﻟﻐﺪﺓ ﺍﻟﻜﻈﺮﻳﺔ ﻟﺘﻨﺘﺞ ﺍﻟﻜﻮﺭﺗﻴﺰﻭﻝ ‪ ،cortisol‬ﻭﻫﻮ ﺍﳍﺮﻣﻮﻥ ﺍﳌﻌﺮﻭﻑ ﺃﻛﺜﺮ‬
‫ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺎﻻﺳﺘﺠﺎﺑﺔ ﻟﻠﻜﺮﺏ‪.‬‬

‫ﻭﺑﺎﻋﺘﺒﺎﺭﻩ ﻫﺮﻣﻮﻧﺎ ﺳﺘﲑﻭﻳﺪﻳﺎ‪ ،‬ﻓﺈﻥ ﺍﻟﻜﻮﺭﺗﻴﺰﻭﻝ ﻳﺰﻳﺪ ﻣﻌﺪﻝ ﺗﻘﻠﺺ ﺍﻟﻘﻠﺐ ﻭﻗﻮﺗﻪ‪ ،‬ﻭﳛﺴﺲ‬
‫ﺍﻷﻭﻋﻴﺔ ﺍﻟﺪﻣﻮﻳﺔ ﻟﺘﺄﺛﲑ ﺍﻟﻨﻮﺭﺇﭘﻴﻨﻔﺮﻳﻦ ‪) norepinephrine‬ﻫﺮﻣﻮﻥ ﺷﺒﻴﻪ ﺑﺎﻷﺩﺭﻳﻨﺎﻟﲔ(‪ ،‬ﺍﻟﺬﻱ ﻳﺆﺛﺮ‬
‫ﰲ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﻟﻮﻇﺎﺋﻒ ﺍﻻﺳﺘﻘﻼﺑﻴﺔ؛ ﺃﻱ ﺍﻷﻓﻌﺎﻝ ﺍﻟﱵ ﺗﺴﺎﻋﺪ ﻋﻠﻰ ﲢﻀﲑ ﺍﳉﺴﻢ ﳌﻮﺍﺟﻬﺔ ﺣﺎﻟﺔ‬
‫ﻛﺮﺏ‪ .‬ﺃﺿﻒ ﺇﱃ ﺫﻟﻚ‪ ،‬ﺃﻥ ﺍﻟﻜﻮﺭﺗﻴﺰﻭﻝ ﻣﻨﻈﻢ ﻣﻨﺎﻋﻲ ﻗﻮﻱ ﻭﻋﺎﻣﻞ ﻣﻀﺎﺩ ﻟﻼﻟﺘﻬﺎﺏ‪ .‬ﻓﻬﻮ ﻳﺆﺩﻱ‬
‫ﺩﻭﺭﺍ ﺣﺎﲰﺎ ﰲ ﻣﻨﻊ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﻣﻦ ﺃﻥ ﻳﺴﺘﺠﻴﺐ ﺍﺳﺘﺠﺎﺑﺔ ﻣﻔﺮﻃﺔ ﺿﺪ ﺍﻟﻨﺴﺞ ﺍﳌﺼﺎﺑﺔ ﻭﺍﳌﺘﺄﺫﻳﺔ‪.‬‬
‫ﻋﻼﻭﺓ ﻋﻠﻰ ﺫﻟﻚ‪ ،‬ﻓﺈﻥ ﺍﻟﻜﻮﺭﺗﻴﺰﻭﻝ ﻳﺜﺒﻂ ﲢﺮﻳﺮ ﺍﳍﺮﻣﻮﻥ ‪ CRH‬ﻣﻦ ﻗﺒﻞ ﺍﻟﻮﻃﺎﺀ ﺑﻌﺮﻭﺓ ﺗﻐﺬﻳﺔ‬
‫)ﺗﻠﻘﻴﻢ( ﺍﺭﲡﺎﻋﻴﺔ)‪ (7‬ﺑﺴﻴﻄﺔ‪ ،‬ﺗﻀﺒﻂ ﺑﺎﺳﺘﻤﺮﺍﺭ ﻫﺬﺍ ﺍﳌﻜﻮﻥ ﻣﻦ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﳌﻨﺎﻋﻴﺔ‪ .‬ﻭﻫﻜﺬﺍ‪ ،‬ﻓﺈﻥ‬
‫ﺍﳍﺮﻣﻮﻥ ‪ CRH‬ﻭﺍﻟﻜﻮﺭﺗﻴﺰﻭﻝ ﻳﺮﺑﻄﺎﻥ ﺭﺑﻄﺎ ﻣﺒﺎﺷﺮﺍ ﺍﺳﺘﺠﺎﺑﺔ ﺍﳉﺴﻢ ﻟﻠﻜﺮﺏ‪ ،‬ﺍﻟﱵ ﻳﻨﻈﻤﻬﺎ ﺍﻟﺪﻣﺎﻍ‪،‬‬
‫ﺑﺎﻻﺳﺘﺠﺎﺑﺔ ﺍﳌﻨﺎﻋﻴﺔ‪.‬‬
‫ﻭﺗﺮﺳﻞ ﻋﺼﺒﻮﻧﺎﺕ ﺍﻟﻮﻃﺎﺀ ﺍﳌﻔﺮﺯﺓ ﻟﻠﻬﺮﻣﻮﻥ ‪ CRH‬ﺃﻟﻴﺎﻓﺎ ﺇﱃ ﻣﻨﺎﻃﻖ ﻣﻌﻴﻨﺔ ﻣﻦ ﺟﺬﻉ ﺍﻟﺪﻣﺎﻍ‬
‫ﺗﺴﺎﻋﺪ ﻋﻠﻰ ﺗﻨﻈﻴﻢ ﺍﳉﻤﻠﺔ ﺍﻟﻌﺼﺒﻴﺔ ﺍﻟﻮﺩّﻳﺔ ‪ ،system nervous sympathetic‬ﻭﺇﱃ ﻣﻨﻄﻘﺔ‬
‫ﺃﺧﺮﻯ ﰲ ﺍﻟﺪﻣﺎﻍ ﺗﻌﺮﻑ ﺑﺎﳌﻮﺿﻊ ﺍﻷﺯﺭﻕ ‪ .ceruleus locus‬ﻭﺗﻨﺒﻪ ﺍﳉﻤﻠﺔ ﺍﻟﻌﺼﺒﻴﺔ ﺍﻟﻮﺩﻳﺔ ـ ﺍﻟﱵ‬
‫ﺗﺴﺘﻨﻔﺮ ﺍﳉﺴ َﻢ ﺃﺛﻨﺎﺀ ﺍﻟﻜﺮﺏ ـ ﺃﻋﻀﺎﺀ ﻣﻨﺎﻋﻴﺔ‪ ،‬ﻛﺎﻟﺘﻮﺗﺔ ﻭﺍﻟﻌﻘﺪ ﺍﻟﻠﻤﻔﻴﺔ ﻭﺍﻟﻄﺤﺎﻝ‪ ،‬ﻭﺗﺴﺎﻋﺪ ﻋﻠﻰ‬
‫ﺗﻨﻈﻴﻢ ﺍﻻﺳﺘﺠﺎﺑﺎﺕ ﺍﻻﻟﺘﻬﺎﺑﻴﺔ ﰲ ﻣﻨﺎﻃﻖ ﺍﳉﺴﻢ ﻛﺎﻓﺔ‪ .‬ﻭﻳﺆﺩﻱ ﺗﻨﺒﻴﻪ ﺍﳌﻮﺿﻊ ﺍﻷﺯﺭﻕ ﺇﱃ ﺍﺳﺘﺜﺎﺭﺍﺕ‬
‫ﺳﻠﻮﻛﻴﺔ ﻭﺍﺳﺘﻨﻬﺎﺽ ﺍﳋﻮﻑ ﻭﺯﻳﺎﺩﺓ ﺣﺪﺓ ﺍﻟﺘﻴﻘﻆ‪.‬‬

‫ﻭﻗﺪ ﺗﻜﻮﻥ ﺍﻟﻠﻮﺯﺓ ‪ amygdala‬ﺃﻛﺜﺮ ﺍﻷﻋﻀﺎﺀ ﺃﳘﻴﺔ ﰲ ﲢﺮﻳﺾ ﺃﻧﻮﺍﻉ ﺍﻟﺴﻠﻮﻙ ﺍﳌﺮﺗﺒﻄﺔ‬
‫ﺑﺎﳋﻮﻑ‪ ،‬ﺣﻴﺚ ﺗﺼﺒﺢ ﺗﻨﺒﻴﻬﺎﺕ ﻣﻌﻴﻨﺔ ـ ﺗﺮﺩ ﻣﻦ ﺍﻟﻨﻮﺍﺣﻲ ﺍﳊﺴﻴﺔ ﻟﻠﺪﻣﺎﻍ ـ ﻣﻜﺮﺑﺔ ﰲ ﺣﺎﻻﺕ‬
‫ﻣﻌﻴﻨﺔ ﻓﻘﻂ‪ .‬ﻭﺗﺮﺳﻞ ﺍﻟﻌﺼﺒﻮﻧﺎﺕ ﺍﳌﻔﺮﺯﺓ ﻟﻠﻬﺮﻣﻮﻥ ‪ ،CRH‬ﻭﺍﳌﻮﺟﻮﺩﺓ ﰲ ﺍﻟﻨﻮﺍﺓ ﺍﳌﺮﻛﺰﻳﺔ ﻟﻠﻮﺯﺓ‪،‬‬
‫ﺃﻟﻴﺎﻓﺎ ﺇﱃ ﺍﻟﻮﻃﺎﺀ ﻭﺍﳌﻮﺿﻊ ﺍﻷﺯﺭﻕ ﻭﺇﱃ ﺃﻗﺴﺎﻡ ﺃﺧﺮﻯ ﻣﻦ ﺟﺬﻉ ﺍﻟﺪﻣﺎﻍ‪ .‬ﻭﺗﺸﻜﻞ ﻫﺬﻩ ﺍﻟﻌﺼﺒﻮﻧﺎﺕ‬
‫ﺍﶈﺮﺭﺓ ﻟﻠﻬﺮﻣﻮﻥ ‪ CRH‬ﻫﺪﻓﺎ ﻟﻠﻤﺮﺍﺳﻴﻞ ﺍﻟﱵ ﲢﺮﺭﻫﺎ ﺍﳋﻼﻳﺎ ﺍﳌﻨﺎﻋﻴﺔ ﺃﺛﻨﺎﺀ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﳌﻨﺎﻋﻴﺔ‪.‬‬
‫ﻭﺑﺘﻌﺒﺌﺘﻬﺎ ﻟﻠﻌﺼﺒﻮﻧﺎﺕ ﺍﳌﻔﺮﺯﺓ ﻟﻠﻬﺮﻣﻮﻥ ‪ ،CRH‬ﻓﺈﻥ ﺍﻹﺷﺎﺭﺍﺕ ﺍﳌﻨﺎﻋﻴﺔ ﻻ ُﺗ ﹶﻔﻌّﻞ ﻓﻘﻂ ﺍﳊﺠ َﺮ ﻋﻠﻰ‬
‫ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﳌﻨﺎﻋﻴﺔ ﺍﻟﱵ ﻳﺘﻮﺳﻄﻬﺎ ﺍﻟﻜﻮﺭﺗﻴﺰﻭﻝ‪ ،‬ﺑﻞ ﺇ‪‬ﺎ ﺃﻳﻀﺎ ﲢﺮﺽ ﺳﻠﻮﻛﻴﺎﺕ ﺗﺴﺎﻋﺪ ﻋﻠﻰ ﺍﻟﺸﻔﺎﺀ‬
‫ﻣﻦ ﺍﻻﻋﺘﻼﻻﺕ ﻭﺍﻹﺻﺎﺑﺎﺕ‪ .‬ﻛﻤﺎ ﺃﻥ ﻟﻠﻌﺼﺒﻮﻧﺎﺕ ﺍﳌﻔﺮﺯﺓ ﻟﻠﻬﺮﻣﻮﻥ ‪ CRH‬ﺍﺗﺼﺎﻻﺕ ﲟﻨﺎﻃﻖ ﺍﻟﻮﻃﺎﺀ‬
‫ﺍﻟﱵ ﺗﻨﻈﻢ ﺍﳌﺪﺧﻮﻝ ﻣﻦ ﺍﻟﻄﻌﺎﻡ ﻭﺍﻟﺴﻠﻮﻙ ﺍﻟﺘﻮﺍﻟﺪﻱ‪ .‬ﺃﺿﻒ ﺇﱃ ﺫﻟﻚ ﻭﺟﻮﺩ ﻫﺮﻣﻮﻧﺎﺕ ﻭﺃﻟﻴﺎﻑ‬
‫ﻋﺼﺒﻴﺔ ﳐﺘﻠﻔﺔ ﺗﺆﺛﺮ ﰲ ﺍﻟﺘﺂﺛﺮﺍﺕ ﺑﲔ ﺍﻟﺪﻣﺎﻍ ﻭﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ‪ ،‬ﻛﺎﻟﺪﺭﻗﺔ )ﺍﻟﻐﺪﺓ ﺍﻟﺪﺭﻗﻴﺔ( ﻭﻫﺮﻣﻮﻧﺎﺕ‬
‫ﺍﻟﻨﻤﻮ ﻭﺍﳍﺮﻣﻮﻧﺎﺕ ﺍﳉﻨﺴﻴﺔ ﺍﻷﻧﺜﻮﻳﺔ ﻭﺍﳌﺴﺎﻟﻚ ﺍﻟﻨﺨﺎﻋﻴﺔ ﺍﻟﻮﺩﻳﺔ ‪.sympathomedullary‬‬

‫ﺇﺸﺎﺭﺍﺕ ﺍﻟﺠﻬﺎﺯ ﺍﻟﻤﻨﺎﻋﻲ‬

‫ﻳﻌﻤﻞ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﺃﻳﻀﺎ ﻛﺴﻠﺴﻠﺔ ﻟﻌﺪﺩ ﻣﻦ ﺍﻷﺣﺪﺍﺙ ﺍﳋﻠﻮﻳﺔ ﺍﶈﻜﻤﺔ ﺍﻟﺪﻗﺔ‪ ،‬ﻫﺪﻓﻬﺎ ﲣﻠﻴﺺ‬
‫ﺍﳉﺴﻢ ﻣﻦ ﺍﳌﻮﺍﺩ ﺍﻟﻐﺮﻳﺒﺔ ﻭﺍﻟﺒﻜﺘﲑﻳﺎ )ﺍﳉﺮﺍﺛﻴﻢ( ﻭﺍﻟﭭﲑﻭﺳﺎﺕ‪.‬‬

‫ﻭﻳﺘﻤﺜﻞ ﺃﺣﺪ ﺍﻻﻛﺘﺸﺎﻓﺎﺕ ﺍﻟﺮﺋﻴﺴﻴﺔ ﰲ ﻋﻠﻢ ﺍﳌﻨﺎﻋﺔ ﺍﳌﻌﺎﺻﺮ ﺑﺄﻥ ﻛﺮﻳﺎﺕ ﺍﻟﺪﻡ ﺍﻟﺒﻴﺾ ﺗﻨﺘﺞ‬
‫ﺑﺮﻭﺗﻴﻨﺎﺕ ﺻﻐﲑﺓ ﺍﻟﻘﺪ‪ ،‬ﺗﻨﺴﻖ ﺗﻨﺴﻴﻘﺎ ﻏﲑ ﻣﺒﺎﺷﺮ ﺍﺳﺘﺠﺎﺑﺎﺕ ﺃﺟﺰﺍﺀ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﺍﻷﺧﺮﻯ ﳓﻮ‬
‫ﺍ ﹸﳌﻤْﺮﺿﺎﺕ‪ .‬ﻓﱪﻭﺗﲔ ﺍﻹﻧﺘﺮﻟﻴﻮﻛﲔ ‪ (1-IL) 1‬ﻣﺜﻼ‪ ،‬ﻳُﺼﻨﻊ ﻣﻦ ﻗﺒﻞ ﳕﻂ ﻣﻦ ﺍﳋﻼﻳﺎ ﺍﻟﺒﻴﺾ‬
‫ﺍﻟﺪﻣﻮﻳﺔ‪ ،‬ﻳﻌﺮﻑ ﺑﺎﻟﻮﺣﻴﺪﺍﺕ ‪monocytes‬أو ﺍﻟﺒﻠﻌﻤﻴﺎﺕ ﺍﻟﻜﺒﲑﺓ ‪ .macrophages‬ﺇﻥ‬
‫ﺍﻹﻧﺘﺮﻟﻴﻮﻛﲔ ‪ 1‬ﻳﻨﺒﻪ ﳕﻄﺎ ﺁﺧﺮ ﻣﻦ ﺍﻟﻜﺮﻳﺎﺕ ﺍﻟﺒﻴﺾ ﺍﻟﺪﻣﻮﻳﺔ ﻟﺘﻨﺘﺞ ﺍﻹﻧﺘﺮﻟﻴﻮﻛﲔ ‪،(2-IL) 2‬‬
‫ﺍﻟﺬﻱ ﳛﺮﺽ ﺑﺪﻭﺭﻩ ﺍﻟﻠﻤﻔﺎﻭﻳﺎﺕ ﻟﺘﺘﻨﺎﻣﻰ ﺇﱃ ﺧﻼﻳﺎ ﻣﻨﺎﻋﻴﺔ ﻧﺎﺿﺠﺔ‪ .‬ﺇﻥ ﺑﻌﺾ ﺍﻟﻠﻤﻔﺎﻭﻳﺎﺕ ﺍﻟﻨﺎﺿﺠﺔ‪،‬‬
‫ﻭﺗﻌﺮﻑ ﺑﺎﳋﻼﻳﺎ ﺍﻟﭙﻼﺯﻣﻴﺔ )ﺍﻟﭙﻠﺰﻣﻴﺔ(‪ ،‬ﺗﺼﻨﻊ ﺍﻷﺿﺪﺍﺩ ‪ antibodies‬ﺍﻟﱵ ﺗﻜﺎﻓﺢ ﺍﳋﻤﺞ )ﺍﻟﻌﺪﻭﻯ(؛‬
‫ﰲ ﺣﲔ ﺃﻥ ﺧﻼﻳﺎ ﺃﺧﺮﻯ‪ ،‬ﺗﻌﺮﻑ ﺑﺎﻟﻠﻤﻔﺎﻭﻳﺎﺕ ﺍﻟﺴﺎﻣﺔ ﻟﻠﺨﻼﻳﺎ ‪ ،cytotoxic‬ﺗﻘﺘﻞ ﺍﻟﭭﲑﻭﺳﺎﺕ‬
‫ﻣﺒﺎﺷﺮﺓ‪ .‬ﻭﺗﺘﻮﺳﻂ ﺇﻧﺘﺮﻟﻴﻮﻛﻴﻨﺎﺕ ﺃﺧﺮﻯ ﺗﻨﺸﻴﻂ ﺧﻼﻳﺎ ﻣﻨﺎﻋﻴﺔ ﻣﻌﻴﻨﺔ ﺫﺍﺕ ﻋﻼﻗﺔ ﺑﺎﻟﺘﻔﺎﻋﻼﺕ ﺍﻷﺭﺟﻴﺔ‬
‫)ﺍﻟﺘﺤﺴﺴﻴﺔ( ‪.allergic‬‬

‫)ﺍﻟﻭﻁﺎﺀ ـ ﺍﻟﻨﺨﺎﻤﺔ ـ ﺍﻟﻜﻅﺭ(‬ ‫‪HPA‬‬ ‫ﺍﻟﻤﺤﻭﺭ‬

‫ﻳﻌﺪ ﺍ ‪‬ﳌﺤْﻮﺭ( ‪ HPA‬ﺍﻟﻮﻃﺎﺀ ـ ﺍﻟﻨﺨﺎﻣﺔ ـ ﺍﻟﻜﻈﺮ( ﻣﻜﻮﻧﺎ ﻣﺮﻛﺰﻳﺎ‬

‫ﻻﺳﺘﺠﺎﺑﺔ ﺍﻟﺪﻣﺎﻍ ﺍﳍﺮﻣﻮﻧﻴﺔ )ﺍﻟﻐﺪﻳﺔ ﺍﻟﺼﻤﺎﻭﻳﺔ( ﺍﻟﻌﺼﺒﻴﺔ ﻟﻠﻜﺮﺏ‪ .‬ﻓﻌﻨﺪﻣﺎ‬
‫ﻳُﻨﺒّﻪ ﺍﻟﻮﻃﺎﺀ‪ ،‬ﻳُﻔﺮﺯ ﺍﳍﺮﻣﻮﻥ ﺍﶈﺮﺭ ﻟﻠﻤﻮﺟﻬﺔ ﺍﻟﻘﺸﺮﻳﺔ )‪ (CRH‬ﰲ‬
‫ﺍﳉﻤﻠﺔ ﺍﻟﺒﺎﺑﻴﺔ ﺍﻟﻨﺨﺎﻣﻴﺔ‪ ،‬ﺍﻟﱵ ﺗﺰﻭﺩ ﺍﻟﻨﺨﺎﻣﺔ ﺍﻷﻣﺎﻣﻴﺔ ﺑﺎﻟﺪﻡ‪ .‬ﻭﻋﻨﺪﺋﺬ ﻳﻨﺒﻪ‬
‫ﺍﳍﺮﻣﻮﻥ ‪ CRH‬ﺍﻟﻨﺨﺎﻣ ﹶﺔ( ﺗﺒﻴّﻦ ﺍﻷﺳﻬﻢ ﺍﳊﻤﺮ ﺍﻟﺴﺒﻞ ﺍﻟﺘﻨﺒﻴﻬﻴﺔ( ﻟﺘﻔﺮﺯ‬
‫ﰲ ﺍﻟﺪﻡ ﺍﳍﺮﻣﻮﻥ ﺍﳌﻮﺟﻪ ﻟﻘﺸﺮﺓ ﺍﻟﻜﻈﺮ ‪ (ACTH).‬ﰒ ﻳﺪﻓﻊ ﻫﺬﺍ‬
‫ﺍﳍﺮﻣﻮﻥ ﻏﺪﺓ ﺍﻟﻜﻈﺮ ﻟﺘﺤﺮﺭ ﺍﻟﻜﻮﺭﺗﻴﺰﻭﻝ‪ ،‬ﺍﳍﺮﻣﻮﻥ ﺍﳌﹸﺘﻌﺎﺭﻑ ﻟﻠﻜﺮﺏ‬
‫ﻭﺍﻟﺬﻱ ﻳﺴﺘﺜﲑ ﺍﳉﺴﻢ ﻟﻴﻮﺍﺟﻪ ﻣﻮﺍﻗﻒ ﺍﻟﺘﺤﺪﻱ‪ .‬ﺑﻴﺪ ﺃﻥ ﺍﻟﻜﻮﺭﺗﻴﺰﻭﻝ‬
‫ﻳﻌﺪﻝ ﺁﻧﺌﺬ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﻟﻜﺮﺑﻴﺔ( ﺗﺸﲑ ﺍﻷﺳﻬﻢ ﺍﻟﺰﺭﻕ ﺇﱃ ﺍﻟﺘﺄﺛﲑﺍﺕ‬
‫ﺍﳌﺜﺒﻄﺔ( ﺑﺘﺄﺛﲑﻩ ﰲ ﺍﻟﻮﻃﺎﺀ‪ ،‬ﻟﻴﺜﺒﻂ ﺍﻟﺘﺤﺮﻳﺮ ﺍﳌﺴﺘﻤﺮ ﻟﻠﻬﺮﻣﻮﻥ ‪CRH.‬‬
‫ﻭﻟﻜﻮﻧﻪ ﺃﻳﻀﺎ ﻣﻨﻈﻤﺎ ﻣﻨﺎﻋﻴﺎ ﻗﻮﻳﺎ‪ ،‬ﻓﺈﻥ ﺍﻟﻜﻮﺭﺗﻴﺰﻭﻝ ﻳﻌﻤﻞ ﻋﻠﻰ ﺃﺟﺰﺍﺀ ﻣﻦ‬
‫ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﻛﻲ ﳝﻨﻌﻬﺎ ﻣﻦ ﺃﻥ ﺗﻔﺮﻁ ﰲ ﻓﺎﻋﻠﻴﺘﻬﺎ‪ ،‬ﻓﻼ ﺗﻠﺤﻖ ﺍﻷﺫﻳﺔ‬
‫ﺑﺎﳋﻼﻳﺎ ﻭﺍﻟﻨﺴﺞ ﺍﻟﺼﺤﻴﺤﺔ‪.‬‬
‫ﻭﺳُﻤﻴﺖ ﺍﻹﻧﺘﺮﻟﻴﻮﻛﻴﻨﺎﺕ ﻬﺑﺬﺍ ﺍﻻﺳﻢ ﻛﻲ ﻳﻌﻜﺲ ﻣﺎ ﻛﺎﻥ ﻳﻌﺘﱪ ﻭﻇﻴﻔﺘﻬﺎ ﺍﻷﻭﻟﻴﺔ‪ :‬ﺍﻻﺗﺼﺎﻝ ﺑﲔ‬
‫)"‪ ("inter-‬ﺍﳋﻼﻳﺎ ﺍﻟﺒﻴﺾ ﺍﻟﺪﻣﻮﻳﺔ )"‪ .("leukins‬ﻭﻟﻜﻦ ﻳﻌﺮﻑ ﺍﻵﻥ ﺃﻥ ﺍﻹﻧﺘﺮﻟﻴﻮﻛﻴﻨﺎﺕ ﺗﻌﻤﻞ‬
‫ﺃﻳﻀﺎ ﻛﺈﺷﺎﺭﺍﺕ ﻛﻴﻤﻴﺎﺋﻴﺔ ﺑﲔ ﺍﳋﻼﻳﺎ ﺍﳌﻨﺎﻋﻴﺔ ﻭﺑﲔ ﺃﳕﺎﻁ ﺧﻠﻮﻳﺔ ﻭﺃﻋﻀﺎﺀ ﺃﺧﺮﻯ‪ ،‬ﲟﺎ ﰲ ﺫﻟﻚ ﺃﺟﺰﺍﺀ‬
‫ﻣﻦ ﺍﻟﺪﻣﺎﻍ؛ ﻭﳍﺬﺍ ﺍﺑُﺘﻜ‪‬ﺮ ﳍﺎ ﺍﺳﻢ ﺟﺪﻳﺪ ﻫﻮ ﺍﻟﺴﻴﺘﻮﻛﻴﻨﺎﺕ ‪ .cytokines‬ﻓﺎﻟﺴﻴﺘﻮﻛﻴﻨﺎﺕ ﻫﻲ‬
‫ﺟﺰﻳﺌﺎﺕ ﺑﻴﻮﻟﻮﺟﻴﺔ ﺗﺴﺘﻌﻤﻠﻬﺎ ﺍﳋﻼﻳﺎ ﰲ ﺍﻻﺗﺼﺎﻝ‪ .‬ﺇﻥ ﻛﻞ ﻭﺍﺣﺪ ﻣﻨﻬﺎ ﻧﻮﻉ ﻣﻦ ﺍﳉﺰﻳﺌﺎﺕ ﺍﻟﱪﻭﺗﻴﻨﻴﺔ‬
‫ﺍﳌﺘﻔﺮﺩﺓ ﺗﻜﻮﺩﻩ)‪ (8‬ﺟﻴﻨﺔ ﺧﺎﺻﺔ ﺑﻪ ﻭﻳﺴﺘﻬﺪﻑ ﳕﻄﺎ ﺧﻠﻮﻳﺎ ﳏﺪﺩﺍ‪ .‬ﻭﳝﻜﻦ ﻟﻠﺴﻴﺘﻮﻛﲔ ﺇﻣﺎ ﺃﻥ ﻳﻨﺒﻪ‬
‫ﺍﺳﺘﺠﺎﺑﺔ ﻣﺎ ﺃﻭ ﺃﻥ ﻳﺜﺒﻄﻬﺎ‪ ،‬ﻭﺫﻟﻚ ﺑﺎﻻﻋﺘﻤﺎﺩ ﻋﻠﻰ ﻭﺟﻮﺩ ﺳﻴﺘﻮﻛﻴﻨﺎﺕ ﺃﺧﺮﻯ ﺃﻭ ﻣﻨﺒﻬﺎﺕ ﺃﺧﺮﻯ ﻭﺗﺒﻌﺎ‬
‫ﻟﻠﺤﺎﻟﺔ ﺍﻟﻈﺮﻓﻴﺔ ﻟﻠﻔﺎﻋﻠﻴﺔ ﺍﻻﺳﺘﻘﻼﺑﻴﺔ‪ .‬ﻭﺗﺘﻴﺢ ﻫﺬﻩ ﺍﳌﺮﻭﻧﺔ ﻟﻠﺠﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﺍﲣﺎﺫ ﺃﻛﺜﺮ ﺍﻟﺘﺪﺍﺑﲑ ﻣﻼﺀﻣﺔ‬
‫ﺑﻐﻴﺔ ﺍﺳﺘﻘﺮﺍﺭ ﺍﻟﻮﺳﻂ ﺍﳋﻠﻮﻱ ﺍﳌﻮﺿﻌﻲ ﻭﺍﳊﻔﺎﻅ ﻋﻠﻰ ﺍﻻﺳﺘﺘﺒﺎﺏ‪.‬‬

‫ﻭﺑﻮﺳﻊ ﺳﻴﺘﻮﻛﻴﻨﺎﺕ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﻟﻠﺠﺴﻢ ﺃﻥ ﺗﺮﺳﻞ ﺇﺷﺎﺭﺍﺕ ﺇﱃ ﺍﻟﺪﻣﺎﻍ ﺑﻄﺮﺍﺋﻖ ﻋﺪﻳﺪﺓ‪.‬‬
‫ﻭﻋﺎﺩﺓ ﻣﺎ ﻳﻘﻲ ﺍﳊﺎﺟ ُﺰ )ﺍﳊﺎﺋﻞ( ﺍﻟﺪﻣﻮﻱ ﺍﻟﺪﻣﺎﻏﻲ)‪ barrier brain-blood (9‬ﺍﳉﻤﻠ ﹶﺔ ﺍﻟﻌﺼﺒﻴﺔ‬
‫ﺍﳌﺮﻛﺰﻳﺔ ﻣﻦ ﺍﳉﺰﻳﺌﺎﺕ ﺫﺍﺕ ﺍﳋﻄﻮﺭﺓ ﺍﻟﻜﺎﻣﻨﺔ ﺍﳌﻮﺟﻮﺩﺓ ﰲ ﺍﻟﺪﻭﺭﺍﻥ ﺍﻟﺪﻣﻮﻱ‪ .‬ﺑﻴﺪ ﺃﻥ ﻫﺬﺍ ﺍﳊﺎﺟﺰ‬
‫)‪(10‬‬
‫ﻳﺼﺒﺢ ﺃﻛﺜﺮ ﻧﻔﻮﺫﻳﺔ ﺃﺛﻨﺎﺀ ﺍﻻﻟﺘﻬﺎﺏ ﺃﻭ ﺍﻻﻋﺘﻼﻝ‪ ،‬ﻓﺘُﺤﻤﻞ ﺍﻟﺴﻴﺘﻮﻛﻴﻨﺎﺕ ﻋﻨﺪﺋﺬ ﻣﻊ ﺍﻟﻐُﺬﻳﺎﺕ‬
‫ﺍﳌﻮﺟﻮﺩﺓ ﰲ ﺍﻟﺪﻡ ﺇﱃ ﺍﻟﺪﻣﺎﻍ‪ .‬ﻭﻣﻊ ﺃﻥ ﺳﻴﺘﻮﻛﻴﻨﺎﺕ ﺃﺧﺮﻯ ﺗﻌﱪ ﻫﺬﺍ ﺍﳊﺎﺟﺰ ﺑﺎﺳﺘﻤﺮﺍﺭ‪ ،‬ﻓﺈﻥ ﺗﺄﺛﲑﺍ‪‬ﺎ‬
‫ﻻ ﺗﺘﻄﻠﺐ ﺑﺎﻟﻀﺮﻭﺭﺓ ﺍﺟﺘﻴﺎﺯﻫﺎ ﺍﳊﺎﺟﺰ ﺍﻟﺪﻣﻮﻱ ﺍﻟﺪﻣﺎﻏﻲ‪ .‬ﻭﳝﻜﻦ ﻟﻠﺴﻴﺘﻮﻛﻴﻨﺎﺕ ﺍﻟﱵ ﺗﺼﻨﻌﻬﺎ ﺑﻄﺎﻧﺔ‬
‫ﺍﻷﻭﻋﻴﺔ ﺍﻟﺪﻣﻮﻳﺔ ﻟﻠﺪﻣﺎﻍ‪ ،‬ﺃﻥ ﺗﻨﺒﻪ ﲢﺮﻳﺮ ﺇﺷﺎﺭﺍﺕ ﻛﻴﻤﻴﺎﺋﻴﺔ ﺛﺎﻧﻮﻳﺔ ﰲ ﻧﺴﺞ ﺍﻟﺪﻣﺎﻍ ﺍﶈﻴﻄﺔ ﺑﺎﻷﻭﻋﻴﺔ‬
‫ﺍﻟﺪﻣﻮﻳﺔ‪.‬‬

‫ﻭﳝﻜﻦ ﺃﻳﻀﺎ ﻟﻠﺴﻴﺘﻮﻛﻴﻨﺎﺕ ﺃﻥ ﺗﺒﻌﺚ ﺇﺷﺎﺭﺍﺕ ﺇﱃ ﺍﻟﺪﻣﺎﻍ ﻋﱪ ﺳﺒﻞ ﻋﺼﺒﻴﺔ ﻣﺒﺎﺷﺮﺓ‪ ،‬ﻛﺎﻟﻌﺼﺐ‬
‫ﺤﻘﹾﻦ‬
‫ﺍﳌﺒﻬﻢ ‪ vagus‬ﺍﻟﺬﻱ ﻳﻌﺼﺐ ﺍﻟﻘﻠﺐ ﻭﺍﳌﻌﺪﺓ ﻭﺍﳌﻌﻲ ﺍﻟﺪﻗﻴﻖ ﻭﺃﻋﻀﺎﺀ ﺃﺧﺮﻯ ﰲ ﺍﳉﻮﻑ ﺍﻟﺒﻄﲏ‪ .‬ﹶﻓ َ‬
‫ﺍﻹﻧﺘﺮﻟﻴﻮﻛﲔ‪ 1‬ﰲ ﻫﺬﺍ ﺍﳉﻮﻑ ﻳُ ﹶﻔ ‪‬ﻌّﻞ ﻧﻮﺍﺓ ﺍﻟﺴﺒﻴﻞ ﺍﳌﻔﺮﺩ ‪) solitarius tractus‬ﺍﳌﻨﻄﻘﺔ ﺍﻟﺮﺋﻴﺴﻴﺔ ﰲ‬
‫ﺟﺬﻉ ﺍﻟﺪﻣﺎﻍ(‪ ،‬ﺍﻟﱵ ﺗﺘﻠﻘﻰ ﺍﻹﺷﺎﺭﺍﺕ ﺍﳊﺴﻴﺔ ﺍﳊﺸﻮﻳﺔ‪ .‬ﻭﻗﻄﻊ ﺍﻟﻌﺼﺐ ﺍﳌﺒﻬﻢ ﳛﺼﺮ ﺗﻔﻌﻴﻞ ﺍﻟﺴﺒﻴﻞ‬
‫ﺍﻟﻨﻮﻭﻱ ﺑﻮﺳﺎﻃﺔ ﺍﻹﻧﺘﺮﻟﻮﻛﲔ ‪ .1‬ﻫﺬﺍ ﻭﺇﻥ ﺇﺭﺳﺎﻝ ﺍﻹﺷﺎﺭﺍﺕ ﻋﱪ ﺍﻟﺴﺒﻞ ﺍﻟﻌﺼﺒﻴﺔ ﻳُﻌﺘﱪ ﺍﻵﻟﻴﺔ‬
‫ﺍﻷﺳﺮﻉ )ﻣﻦ ﺭﺗﺒﺔ ﻣﻠﹼﻲ ﺛﺎﻧﻴﺔ(‪ ،‬ﺍﻟﱵ ﺗﻘﻮﻡ ﺍﻟﺴﻴﺘﻮﻛﻴﻨﺎﺕ ﺑﻮﺳﺎﻃﺘﻬﺎ ﺑﺘﻮﺻﻴﻞ ﺍﻹﺷﺎﺭﺍﺕ ﺇﱃ ﺍﻟﺪﻣﺎﻍ‪.‬‬

‫ﺇﻥ ﺗﻔﻌﻴﻞ ﺍﻟﺪﻣﺎﻍ ﺑﻮﺳﺎﻃﺔ ﺍﻟﺴﻴﺘﻮﻛﻴﻨﺎﺕ ﺍﻟﻮﺍﺭﺩﺓ ﻣﻦ ﺍﻷﻗﺴﺎﻡ ﺍﶈﻴﻄﻴﺔ ﻟﻠﺠﺴﻢ‪ ،‬ﻳُﺤ ﹺﺮّﺽ‬
‫ﺳﻠﻮﻛﻴﺎﺕ ﺍﺳﺘﺠﺎﺑﺔ ﺍﻟﻜﺮﺏ‪ ،‬ﻛﺎﻟﻘﻠﻖ ﻭﺍﻟﺘﺠﻨﺐ ﺍﳊﺬﺭ؛ ﻫﺬﻩ ﺍﻟﺴﻠﻮﻛﻴﺎﺕ ﺍﻟﱵ ﺗُﺒﻘﻲ ﺍﻟﻔﺮﺩ ﺑﻌﻴﺪﺍ ﻋﻦ‬
‫ﺇﻣﻜﺎﻧﺎﺕ ﺍﻟﺘﺄﺫﻱ ﺭﻳﺜﻤﺎ ﺗﺰﻭﻝ ﺍﳌﺴﺒﺒﺎﺕ ﲤﺎﻣﺎ‪ .‬ﻭﻣﻦ ﻋﺎﱏ ﺍﻟﻮﺳﻦ ‪ lethargy‬ﻭﻓﺮﻁ ﺍﻟﻨﻮﻡ ﺧﻼﻝ‬
‫ﺴّﻘﺎﻡ«)‪.(11‬‬
‫ﺍﻋﺘﻼﻝ ﻣﺎ‪ ،‬ﻳﺘﻌﺮّﻑ ﻫﺬﻩ ﺍﺠﻤﻟﻤﻮﻋﺔ ﻣﻦ ﺍﻻﺳﺘﺠﺎﺑﺎﺕ ﺍﳌﻤﻴﺰﺓ‪ ،‬ﺍﻟﱵ ﺗﻌﺮﻑ »ﺑﺴﻠﻮﻙ ﺍﻟ ُ‬

‫ﻭﺗﻨﺘﺞ ﺍﻟﻌﺼﺒﻮﻧﺎﺕ ﻭﺧﻼﻳﺎ ﺍﻟﺪﻣﺎﻍ ﺍﻟﻼﻋﺼﺒﻮﻧﻴﺔ ﺳﻴﺘﻮﻛﻴﻨﺎﺕ ﺗﺼﻨﻌﻬﺎ ﺑﻨﻔﺴﻬﺎ‪ .‬ﻭﺗﻨﻈﻢ‬

‫ﺍﻟﺴﻴﺘﻮﻛﻴﻨﺎﺕ ﰲ ﺍﻟﺪﻣﺎﻍ ﳕﻮ ﺍﳋﻼﻳﺎ ﺍﻟﻌﺼﺒﻴﺔ ﻭﻣﻮ‪‬ﺎ‪ ،‬ﻛﻤﺎ ﺃ‪‬ﺎ ﺗُﻌﺒﺄ ﻣﻦ ﻗﺒﻞ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﻟﺘﻨﺒﻪ ﲢﺮﻳﺮ‬
‫ﺍﳍﺮﻣﻮﻥ ‪ .CRH‬ﻭﻣﻨﻈﻮﻣﺔ ﺍﻟﺴﻴﺘﻮﻛﲔ ‪-‬ﺍﻹﻧﺘﺮﻟﻴﻮﻛﲔ‪ 1‬ﰲ ﺍﻟﺪﻣﺎﻍ ﻫﻲ ﺣﺎﻟﻴﺎ ﺃﻓﻀﻞ ﻣﺎ ﺩُﺭﺱ ﻣﻦ‬
‫‪antagonists‬‬ ‫ﻣﻨﻈﻮﻣﺎﺕ‪ ،‬ﻓﻠﻘﺪ ﰎ ﺗﻌ ُﺮّﻑ ﲨﻴﻊ ﻣﻜﻮﻧﺎ‪‬ﺎ‪ ،‬ﲟﺎ ﰲ ﺫﻟﻚ ﺍﳌﺴﺘﻘﺒﻼﺕ ﻭﺍﻟﻀﺎﺩﺍﺕ‬
‫ﺍﻟﻄﺒﻴﻌﻴﺔ ﺍﳊﺪﻭﺙ‪ ،‬ﺍﻟﱵ ﺗﺘﺮﺍﺑﻂ ﲟﺴﺘﻘﺒﻼﺕ ﺍﻹﻧﺘﺮﻟﻮﻛﲔ ‪ 1‬ﻣﻦ ﺩﻭﻥ ﺃﻥ ﺗﻔ ‪‬ﻌّﻠﻬﺎ‪ .‬ﻭﻳﺘﻢ ﺣﺎﻟﻴﺎ ﻭﺿﻊ‬
‫ﺧﺮﻳﻄﺔ ﺍﻟﺘﻮﺿﻌﻴْﻦ ﺍﻟﺘﺸﺮﳛﻲ ﻭﺍﳋﻠﻮﻱ ﻟﺪﺍﺭﺍﺕ ﺍﻹﻧﺘﺮﻟﻴﻮﻛﲔ ‪ 1‬ﻋﻠﻰ ﳓﻮ ﺗﻔﺼﻴﻠﻲ‪ ،‬ﻛﻤﺎ ﺃﻥ ﻫﺬﻩ‬
‫ﺍﳌﻌﺎﺭﻑ ﺳﺘﺴﺎﻋﺪ ﺍﻟﺒﺎﺣﺜﲔ ﻋﻠﻰ ﺗﺼﻤﻴﻢ ﻋﻘﺎﻗﲑ ﺗﻌﻮﻕ ﺃﻭ ﺗﻌﺰﺯ ﺃﻓﻌﺎﻝ ﺗﻠﻚ ﺍﻟﺪﺍﺭﺍﺕ ﻭﺍﻟﻮﻇﺎﺋﻒ ﺍﻟﱵ‬
‫ﺗﻨﻈﹼﻤﻬﺎ‪.‬‬

‫ﺘﺄﺜﺭ ﺍﻟﺩﻤﺎﻍ ﻭﺍﻟﺠﻬﺎﺯ ﺍﻟﻤﻨﺎﻋﻲ‬

‫ﳝﻜﻦ ﻟﻠﺪﻣﺎﻍ ﻭﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ( ﺍﻷﺳﻬﻢ ﺍﳊﻤﺮ( ﺇﻣﺎ ﺃﻥ ﻳُﻨﺒﻪ ﺃﻭ ﻳﺜﺒﻂ‬

‫ﺃﺣﺪﳘﺎ ﺍﻵﺧﺮ )ﺍﻷﺳﻬﻢ ﺍﻟﺰﺭﻕ ‪).‬ﻓﺨﻼﻳﺎ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﺗﻨﺘﺞ‬
 ‫ﺍﻟﺴﻴﺘﻮﻛﻴﻨﺎﺕ )ﺇﺷﺎﺭﺍﺕ ﻛﻴﻤﻴﺎﺋﻴﺔ(‪ ،‬ﺍﻟﱵ ﺗﻨﺒﻪ ﺍﻟﻮﻃﺎﺀ ﻋﱪ ﺍﻟﺪﻭﺭﺓ ﺍﻟﺪﻣﻮﻳﺔ‬
‫ﺸّﻂ ﺍﳍﺮﻣﻮﻥ‬
‫)ﺍﻟﺪﻭﺭﺍﻥ( ﺃﻭ ﺍﻷﻋﺼﺎﺏ ﺍﳌﻨﺘﺸﺮﺓ ﰲ ﺃﳓﺎﺀ ﺍﳉﺴﻢ‪ .‬ﻭﻳُﻨ ‪‬‬
‫‪ ،CRH‬ﺍﻟﺬﻱ ﻳﻨﺘﺠﻪ ﺍﻟﻮﻃﺎﺀ‪ ،‬ﺍﶈﻮﺭ ‪ HPA.‬ﻭﻳﻌﻤﻞ ﲢﺮﻳﺮ‬
‫ﺍﻟﻜﻮﺭﺗﻴﺰﻭﻝ ﻋﻠﻰ ﺇﲬﺎﺩ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ‪ .‬ﻭﺑﺘﺄﺛﲑﻩ ﰲ ﺟﺬﻉ ﺍﻟﺪﻣﺎﻍ‪ ،‬ﻓﺈﻥ‬
‫ﺍﳍﺮﻣﻮﻥ ‪ CRH‬ﻳﻨﺒﻪ ﺍﳉﻤﻠﺔ ﺍﻟﻌﺼﺒﻴﺔ ﺍﻟﻮﺩﻳﺔ ﺍﻟﱵ ﺗﺴﺘﺜﲑ ﺍﻷﻋﻀﺎﺀ‬
‫ﺍﳌﻨﺎﻋﻴﺔ‪ ،‬ﻭﻳﻨﻈﻢ ﻫﺬﺍ ﺍﳍﺮﻣﻮﻥ ﺍﻻﺳﺘﺠﺎﺑﺎﺕ ﺍﻻﻟﺘﻬﺎﺑﻴﺔ ﰲ ﺃﳓﺎﺀ ﺍﳉﺴﻢ‬
‫ﻛﺎﻓﺔ‪ .‬ﻭﻳﺆﺩﻱ ﺗﻌﻄﻞ ﻫﺬﻩ ﺍﻻﺗﺼﺎﻻﺕ ﺑﺄﻳﺔ ﻃﺮﻳﻘﺔ ﻣﻦ ﺍﻟﻄﺮﻕ‪ ،‬ﺇﱃ‬
‫ﺍﺳﺘﻌﺪﺍﺩ ﺃﻛﱪ ﻟﻺﺻﺎﺑﺔ ﺑﺎﻷﻣﺮﺍﺽ ﻭﺇﱃ ﻣﻀﺎﻋﻔﺎﺕ ﻣﻨﺎﻋﻴﺔ‪.‬‬

‫ﻭﳝﻜﻦ ﻟﻜﻤﻴﺎﺕ ﺯﺍﺋﺪﺓ ﻣﻦ ﺍﻟﺴﻴﺘﻮﻛﻴﻨﺎﺕ ﰲ ﺍﻟﺪﻣﺎﻍ ﺃﻥ ﺗﻐﺪﻭ ﺳﺎﻣﺔ ﻟﻸﻋﺼﺎﺏ‪ .‬ﻭﺗﺒﺪﻱ ﺍﳉﻴﻨﺎﺕ‬
‫ﺍﳌﻐﺘﺮﺳﺔ ﰲ ﻓﺌﺮﺍﻥ ﻣﻬﻨﺪﺳﺔ ﺟﻴﻨﻴﺎ )ﻭﺍﻟﱵ ﺗُﻌﹺﺒّﺮ ﺑﺈﻓﺮﺍﻁ ﻋﻦ ﺍﻟﺴﻴﺘﻮﻛﻴﻨﺎﺕ( ﺗﺄﺛﲑﺍﺕ ﺳﺎﻣﺔ ﻟﻸﻋﺼﺎﺏ‪.‬‬
‫ﻛﻤﺎ ﺃﻥ ﺑﻌﺾ ﺍﻷﻋﺮﺍﺽ ﺍﻟﻌﺼﺒﻴﺔ ﻟﻺﻳﺪﺯ ﰲ ﺍﻹﻧﺴﺎﻥ ﺗﻨﺠﻢ ﻋﻦ ﺗﻌﺒﲑ ﻣﻔﺮﻁ ﰲ ﺍﻟﺪﻣﺎﻍ ﻣﻦ‬
‫ﺳﻴﺘﻮﻛﻴﻨﺎﺕ ﻣﻌﻴﻨﺔ‪ .‬ﻭﻟﻘﺪ ﻭُﺟﺪﺕ ﺗﺮﺍﻛﻴﺰ ﻋﺎﻟﻴﺔ ﻣﻦ ﺍﻹﻧﺘﺮﻟﻴﻮﻛﲔ ‪) 1‬ﻭﻣﻦ ﺳﻴﺘﻮﻛﻴﻨﺎﺕ ﺃﺧﺮﻯ( ﰲ‬
‫ﻧُﺴﺞﹴ ﺩﻣﺎﻏﻴﺔ ﺃﹸﺧﺬﺕ ﻣﻦ ﻣﺮﺿﻰ ﻳﺘﻌﺎﻳﺸﻮﻥ ﻣﻊ ﺍﻹﻳﺪﺯ‪ ،‬ﻭﺗﺒﲔ ﺃﻥ ﻫﺬﻩ ﺍﻟﺘﺮﺍﻛﻴﺰ ﺗﺘﻤﺮﻛﺰ ﰲ ﻣﻨﺎﻃﻖ‬
‫ﲢﻴﻂ ﺑﺎﻟﺒﻠﻌﻤﻴﺎﺕ ﺍﻟﻌﻤﻼﻗﺔ ﺍﻟﱵ ﲡﺘﺎﺡ ﻧﺴﺞ ﺩﻣﺎﻍ ﺍﳌﺮﻳﺾ‪.‬‬

‫ﻭﻳﺆﺩﻱ ﺿﻌﻒ ﺍﻻﺗﺼﺎﻝ ﺑﲔ ﺍﻟﺪﻣﺎﻍ ﻭﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﺇﱃ ﺗﻌﺎﻇﻢ ﺍﻻﺳﺘﻌﺪﺍﺩ ﻟﻺﺻﺎﺑﺔ ﺑﺎﻷﻣﺮﺍﺽ‬
‫ﺍﻻﻟﺘﻬﺎﺑﻴﺔ‪ ،‬ﻭﺃﺣﻴﺎﻧﺎ ﺇﱃ ﺯﻳﺎﺩﺓ ﻭﺧﺎﻣﺔ ﺍﻻﺧﺘﻼﻃﺎﺕ ﺍﳌﻨﺎﻋﻴﺔ‪ .‬ﻓﻌﻠﻰ ﺳﺒﻴﻞ ﺍﳌﺜﺎﻝ‪ ،‬ﺗﻐﺪﻭ ﺍﳊﻴﻮﺍﻧﺎﺕ )ﺍﻟﱵ‬
‫ﻗﻄﻌﺖ ﻟﺪﻳﻬﺎ ﺍﻻﺗﺼﺎﻻﺕ ﺍﻟﺪﻣﺎﻏﻴﺔ‪-‬ﺍﳌﻨﺎﻋﻴﺔ ﺑﺎﳉﺮﺍﺣﺔ ﺃﻭ ﺑﺎﻟﻌﻘﺎﻗﲑ( ﻛﺜﲑﺓ ﺍﻟﺘﻌﺮﺽ ﻟﻼﺧﺘﻼﻃﺎﺕ‬
‫ﺍﳌﻤﻴﺘﺔ ﺍﻟﱵ ﺗﻨﺸﺄ ﻋﻦ ﺍﻹﺻﺎﺑﺔ ﺑﺎﻷﻣﺮﺍﺽ ﺍﻻﻟﺘﻬﺎﺑﻴﺔ ﻭﺍﳋﻤﺠﻴﺔ‪.‬‬

‫ﻭﻳﺘﺮﺍﻓﻖ ﺍﻻﺳﺘﻌﺪﺍﺩ ﻟﻺﺻﺎﺑﺔ ﺑﺎﻷﻣﺮﺍﺽ ﺍﻻﻟﺘﻬﺎﺑﻴﺔ ﻣﻊ ﺍﻟﻀﻌﻒ ﺍﳉﻴﲏ )ﺍﻟﻮﺭﺍﺛﻲ( ﻟﻼﺳﺘﺠﺎﺑﺔ‬

‫ﺍﻟﻜﺮﺑﻴﺔ ﻟﺪﻯ ﺃﻧﻮﺍﻉ ﺣﻴﻮﺍﻧﻴﺔ ﻋﺪﻳﺪﺓ‪ ،‬ﻛﺎﳉﺮﺫﺍﻥ ﻭﺍﻟﻔﺌﺮﺍﻥ ﻭﺍﻟﺪﺟﺎﺝ‪ ،‬ﻭﺭﲟﺎ ﻟﺪﻯ ﺍﻹﻧﺴﺎﻥ ﺃﻳﻀﺎ‪ ،‬ﻋﻠﻤ‪‬ﺎ‬
‫ﺑﺄﻥ ﺍﻟﺪﻟﻴﻞ ﻫﻨﺎ ﻏﲑ ﻣﺒﺎﺷﺮ‪ .‬ﻓﺬﺭﻳﺔ ﻟﻮﻳﺰ ‪ Lewis‬ﺍﳉﺮﺫﻳﺔ ﻣﺜﻼ ﻫﻲ ﻋﺮﺿﺔ ﺑﺸﻜﻞ ﻃﺒﻴﻌﻲ ﻟﻺﺻﺎﺑﺔ‬
‫ﺑﺄﻣﺮﺍﺽ ﺍﻟﺘﻬﺎﺑﻴﺔ ﻋﺪﻳﺪﺓ ﻧﺘﻴﺠﺔ ﺿﻌﻒ ﺷﺪﻳﺪ ﻟﻠﻤﺤﻮﺭ ‪) HPA‬ﺍﻟﻮﻃﺎﺀ ـ ﺍﻟﻨﺨﺎﻣﺔ ـ ﺍﻟﻜﻈﺮ(‪ ،‬ﺣﻴﺚ‬
‫ُﻳ ْﻨﻘ‪‬ﺺ ﻫﺬﺍ ﺍﻟﻀﻌﻒ ﻛﺜﲑﺍ ﺇﻓﺮﺍﺯ ﺍﳍﺮﻣﻮﻥ ‪ CRH‬ﻛﺎﺳﺘﺠﺎﺑﺔ ﻟﻠﻜﺮﺏ‪ .‬ﻭﻋﻠﻰ ﺍﻟﻨﻘﻴﺾ ﻣﻦ ﺫﻟﻚ‪ ،‬ﻓﺈﻥ‬
‫ﺍﶈﻮﺭ ‪ HPA‬ﺍﳌﻔﺮﻁ ﺍﻻﺳﺘﺠﺎﺑﺔ ﻟﺪﻯ ﺍﻟﺬﺭﻳﺔ ﺍﳉﺮﺫﻳﺔ ﻓﻴﺸﺮ ‪ Fischer‬ﳝﻨﺤﻬﺎ ﻣﻘﺎﻭﻣﺔ ﻋﺎﻟﻴﺔ ﲡﺎﻩ‬
‫ﺍﻷﻣﺮﺍﺽ ﺍﻻﻟﺘﻬﺎﺑﻴﺔ‪.‬‬
 ‫ﻭﺍﻟﻤﻭﻀﻊ ﺍﻷﺯﺭﻕ ﻭﺍﻟﺠﻤﻠﺔ ﺍﻟﻌﺼﺒﻴﺔ ﺍﻟﻭﺩﻴﺔ‬ ‫‪CRH‬‬ ‫ﺍﻟﻬﺭﻤﻭﻥ‬

‫ﺍﳍﺮﻣﻮﻥ ﺍﻟﻮﻃﺎﺋﻲ ‪ CRH‬ﺗﻐﲑﺍﺕ ﻣﻬﻤﺔ ﰲ ﺗﻼﺅﻡ ﺍﻟﻜﺮﺏ ﻭﺍﻻﻟﺘﻬﺎﺏ‬

‫ﺑﻄﺮﻕ ﲣﺘﻠﻒ ﻋﻦ ﲢﺮﻳﺾ ﲢﺮﻳﺮ ﺍﻟﻜﻮﺭﺗﻴﺰﻭﻝ ﻣﻦ ﻏﺪﺓ ﺍﻟﻜﻈﺮ‪ .‬ﻭﲤﺘﺪ‬
‫ﺍﻟﺴﺒﻞ ﺍﻟﺼﺎﺩﺭﺓ ﻋﻦ ﺍﻟﻌﺼﺒﻮﻧﺎﺕ ﺍﳌﻔﺮﺯﺓ ﻟﻠﻬﺮﻣﻮﻥ ‪ CRH‬ﰲ ﺍﻟﻮﻃﺎﺀ‬
‫ﺇﱃ ﺍﳌﻮﺿﻊ ﺍﻷﺯﺭﻕ ﰲ ﺟﺬﻉ ﺍﻟﺪﻣﺎﻍ ‪.‬ﻭﺗﺆﺛﺮ ﺳﺒﻞ ﻣﺴﺘﻘﻠﺔ ﻟﻌﺼﺒﻮﻧﺎﺕ‬
‫ﻭﻃﺎﺋﻴﺔ ﺃﺧﺮﻯ )ﻣﺘﺠﻬﺔ ﺇﱃ ﺟﺬﻉ ﺍﻟﺪﻣﺎﻍ( ﰲ ﻓﺎﻋﻠﻴﺎﺕ ﺍﳉﻤﻠﺔ ﺍﻟﻌﺼﺒﻴﺔ‬
‫ﺍﻟﻮﺩﻳﺔ ﺍﻟﱵ ﺗﻌﺪﻝ ﺍﻻﺳﺘﺠﺎﺑﺎﺕ ﺍﻻﻟﺘﻬﺎﺑﻴﺔ‪ ،‬ﻛﻤﺎ ﺃ‪‬ﺎ ﺗﻨﻈﻢ ﺍﻟﻔﺎﻋﻠﻴﺎﺕ‬
‫ﺍﻻﺳﺘﻘﻼﺑﻴﺔ ﻭﺍﻟﻘﻠﺒﻴﺔ ﺍﻟﻮﻋﺎﺋﻴﺔ‪ .‬ﻭﳛﺪﺙ ﺗﻨﺒﻴﻪ ﺍﳌﻮﺿﻊ ﺍﻷﺯﺭﻕ ﺑﻮﺳﺎﻃﺔ‬
‫ﺍﳍﺮﻣﻮﻥ ‪ CRH‬ﺳﻠﻮﻛﺎ ﺻﺎﺋﻨﺎ ﻛﺎﻟﺘﻴﻘﻆ ﻭﺍﳋﻮﻑ )ﻳﺸﲑ ﺍﻟﻠﻮﻥ ﺍﻷﲪﺮ‬
‫ﺇﱃ ﺍﻟﺘﻨﺒﻴﻪ ﻭﺍﻷﺯﺭﻕ ﺇﱃ ﺍﻟﺘﺜﺒﻴﻂ ‪).‬ﻭﻳﺰﻭﺩ ﺍﳌﻮﺿﻊ ﺍﻷﺯﺭﻕ ﺑﺪﻭﺭﻩ ﺍﻟﻮﻃﺎﺀ‬
‫ﺑﺘﻐﺬﻳﺔ )ﺑﺘﻠﻘﻴﻢ( ﺍﺭﲡﺎﻋﻴﺔ‪ ،‬ﻟﻴﺴﺘﻤﺮ ﰲ ﺇﻧﺘﺎﺝ ﺍﳍﺮﻣﻮﻥ‪ ، CRH‬ﻭﻳﺆﺛﺮ‬
‫ﺃﻳﻀﺎ ﰲ ﺍﳉﻤﻠﺔ ﺍﻟﻌﺼﺒﻴﺔ ﺍﻟﻮﺩﻳﺔ‪ .‬ﻭﺇﻥ ﺍﻟﺘﻐﺬﻳﺔ ﺍﻻﺭﲡﺎﻋﻴﺔ ﺍﻟﺬﺍﺗﻴﺔ ﺍﻟﺘﺜﺒﻴﻂ‬
‫ﺗُﺒﻘﻲ ﻋﻠﻰ ﻓﻌﺎﻟﻴﺎﺕ ﺍﳍﺮﻣﻮﻥ ‪ CRH‬ﻭﺍﳌﻮﺿﻊ ﺍﻷﺯﺭﻕ ﲢﺖ ﺍﻟﺴﻴﻄﺮﺓ‪.‬‬

‫ﻭﺗﺰﻭﺩﻧﺎ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﻭﺍﳉﺮﺍﺣﻴﺔ ﺑﺎﻷﺩﻟﺔ ﻋﻦ ﺍﻟﻌﻼﻗﺔ ﺍﻟﺴﺒﺒﻴﺔ ﺑﲔ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﻟﻜﺮﺑﻴﺔ‬

‫ﺍﳌﹸﻀﻌﻔﺔ ﻭﺑﲔ ﺍﻻﺳﺘﻌﺪﺍﺩ ﻟﻺﺻﺎﺑﺔ ﺑﺎﻷﻣﺮﺍﺽ ﺍﻻﻟﺘﻬﺎﺑﻴﺔ‪ .‬ﻓﺎﳌﺪﺍﺧﻼﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ‪ ،‬ﻛﺎﳌﻌﺎﳉﺔ ﺑﻌﻘﺎﺭ ﻳﻌﻴﻖ‬
‫ﻣﺴﺘﻘﺒﻼﺕ ﺍﻟﻜﻮﺭﺗﻴﺰﻭﻝ‪ ،‬ﺗﻌﺰﺯ ﺃﻣﺮﺍﺽ ﺍﳌﻨﺎﻋﺔ ﺍﻟﺬﺍﺗﻴﺔ ﺍﻻﻟﺘﻬﺎﺑﻴﺔ‪ .‬ﻛﻤﺎ ﺃﻥ ﺣﻘﻦ ﺟﺮﻉ ﻣﻨﺨﻔﻀﺔ ﰲ‬
‫ﺟﺮﺫﺍﻥ ﻟﺪﻳﻬﺎ ﺍﺳﺘﻌﺪﺍﺩ ﻟﻺﺻﺎﺑﺔ ﺑﺎﻷﻣﺮﺍﺽ ﺍﻻﻟﺘﻬﺎﺑﻴﺔ ﻳﻌﺰﺯ ﻣﻘﺎﻭﻣﺘﻬﺎ ﳍﺬﻩ ﺍﻷﻣﺮﺍﺽ‪ .‬ﻭﺍﺳﺘﺌﺼﺎﻝ‬
‫ﺍﻟﻐﺪﺓ ﺍﻟﻨﺨﺎﻣﻴﺔ ﺃﻭ ﺍﻟ ﹸﻜﻈﹾﺮﻳْﻦ ﻣﻦ ﺟﺮﺫﺍﻥ ﺗﻘﺎﻭﻡ ﻋﺎﺩﺓ ﺍﻷﻣﺮﺍﺽ ﺍﻻﻟﺘﻬﺎﺑﻴﺔ‪ ،‬ﳚﻌﻠﻬﺎ ﺫﺍﺕ ﺍﺳﺘﻌﺪﺍﺩ ﻛﺒﲑ‬
‫ﻟﻺﺻﺎﺑﺔ ﻬﺑﺬﻩ ﺍﻷﻣﺮﺍﺽ‪ .‬ﻭﺗﺄﰐ ﺃﺩﻟﺔ ﺃﺧﺮﻯ ﺇﺿﺎﻓﻴﺔ ﻣﻦ ﺩﺭﺍﺳﺎﺕ ﰎ ﻓﻴﻬﺎ ﺍﻏﺘﺮﺍﺱ ﻧﺴﻴﺞ ﺍﻟﻮﻃﺎﺀ‬
‫ﳉﺮﺫﺍﻥ ﻣﻘﺎﻭﻣﺔ ﳍﺬﻩ ﺍﻷﻣﺮﺍﺽ ﰲ ﺃﺩﻣﻐﺔ ﺟﺮﺫﺍﻥ ﺃﺧﺮﻯ ﺫﺍﺕ ﺍﺳﺘﻌﺪﺍﺩ ﻟﻺﺻﺎﺑﺔ‪ ،‬ﻓﺄﺩﻯ ﺫﻟﻚ ﺇﱃ‬
‫ﲢﺴﻦ ﻣﺜﲑ ﻟﺪﻳﻬﺎ ﰲ ﻣﻘﺎﻭﻣﺔ ﻫﺬﻩ ﺍﻷﺧﲑﺓ ﻟﻸﻣﺮﺍﺽ ﺍﻻﻟﺘﻬﺎﺑﻴﺔ ﺍﶈﻴﻄﻴﺔ)‪.(12‬‬
‫ﻭﺗﻮﺿﺢ ﻫﺬﻩ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﻟﱵ ﺃﺟﺮﻳﺖ ﻋﻠﻰ ﺍﳊﻴﻮﺍﻧﺎﺕ ﺑﺄﻥ ﺍﺧﺘﻼﻝ ﺍﺳﺘﺠﺎﺑﺔ ﺍﻟﺪﻣﺎﻍ ﻟﻠﻜﺮﺏ‬
‫ﻳﻌﺰﺯ ﺍﺳﺘﺠﺎﺑﺔ ﺍﳉﺴﻢ ﻟﻸﻣﺮﺍﺽ ﺍﻻﻟﺘﻬﺎﺑﻴﺔ‪ ،‬ﻭﺃﻥ ﺇﻋﺎﺩﺓ ﺑﻨﻴﺎﻥ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﻟﻜﺮﺑﻴﺔ ﺗُﺨﻔﺾ ﺍﻻﺳﺘﻌﺪﺍﺩ‬
‫ﻟﻼﻟﺘﻬﺎﺏ‪ .‬ﻭﻳﺘﻤﺜﻞ ﺃﺣﺪ ﺍﻷﻣﻮﺭ‪ ،‬ﺍﻟﱵ ﺗﻘﺘﻀﻴﻬﺎ ﻫﺬﻩ ﺍﻻﻛﺘﺸﺎﻓﺎﺕ‪ ،‬ﺑﺄﻥ ﺗﻌﻄﻴﻞ ﻣﻨﻈﻮﻣﺔ ﺍﻻﺗﺼﺎﻝ‬
‫ﺍﻟﺪﻣﺎﻏﻲ ﺍﳌﻨﺎﻋﻲ ﺑﻮﺳﺎﻃﺔ ﻋﻮﺍﻣﻞ ﺍﻟﺘﻬﺎﺑﻴﺔ ﺃﻭ ُﺳﻤّﻴﺔ ﺃﻭ ﲬﺠﻴﺔ‪ ،‬ﻳﺴﻬﻢ ﰲ ﺣﺪﻭﺙ ﺑﻌﺾ ﺍﻟﺘﺒﺎﻳﻨﺎﺕ ﰲ‬
‫ﺳﲑﻭﺭﺓ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﻻﻟﺘﻬﺎﺑﻴﺔ ﻟﻠﺠﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ‪.‬‬

‫ﺍﻟﻬﺭﻤﻭﻥ ﺍﻟﻤﺤﺭﺭ ﻟﻠﻤﻭﺠﻬﺔ ﺍﻟﻘﺸﺭﻴﺔ ﻭﺍﻻﻜﺘﺌﺎﺏ‬

‫ﻭﻣﻊ ﺃﻥ ﺍﻟﱪﻫﺎﻥ ﻋﻠﻰ ﺩﻭﺭ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﻟﻜﺮﺑﻴﺔ ﰲ ﺍﻷﻣﺮﺍﺽ ﺍﻻﻟﺘﻬﺎﺑﻴﺔ ﻟﺪﻯ ﺍﻹﻧﺴﺎﻥ ﺃﻛﺜﺮ‬
‫‪HPA‬‬ ‫ﺻﻌﻮﺑﺔ‪ ،‬ﻓﺈﻥ ﺍﻷﺩﻟﺔ ﺗﺘﻨﺎﻣﻰ ﻋﻠﻰ ﺃﻥ ﻃﻴﻔﺎ ﻭﺍﺳﻌﺎ ﻣﻦ ﻫﺬﻩ ﺍﻷﻣﺮﺍﺽ ﻳﺘﺮﺍﻓﻖ ﻣﻊ ﺇﺧﻼﻝ ﺍﶈﻮﺭ‬
‫)ﺍﻟﻮﻃﺎﺀ ـ ﺍﻟﻨﺨﺎﻣﺔ ـ ﺍﻟﻜﻈﺮ( ﻭﻣﻊ ﻣﺴﺘﻮﻳﺎﺕ ﺃﻛﺜﺮ ﺍﳔﻔﺎﺿﺎ ﻣﻦ ﺇﻓﺮﺍﺯ ﺍﳍﺮﻣﻮﻥ ‪ CRH‬ﺍﻟﺬﻱ ﻳﺪﻓﻊ‬
‫ﰲ ﺍﻟﻨﻬﺎﻳﺔ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﻟﻴﻐﺪﻭ ﻣﻔﺮﻁ ﺍﻟﻔﺎﻋﻠﻴﺔ‪ .‬ﻭﻋﻼﻭﺓ ﻋﻠﻰ ﺫﻟﻚ‪ ،‬ﻓﺈﻥ ﻣﺮﺿﻰ ﺍﺿﻄﺮﺍﺏ ﺍﳌﺰﺍﺝ‪،‬‬
‫ﺍﳌﻌﺮﻭﻑ ﺑﺎﻻﻛﺘﺌﺎﺏ ﺍﻟﻼﳕﻄﻲ ‪ ،depression atypical‬ﻳﻌﺎﻧﻮﻥ ﺃﻳﻀﺎ ﺍﺳﺘﺠﺎﺑﺔ ﻛﺮﺑﻴﺔ ﻣﻮﻫﻨﺔ‬
‫ﻭﺿﻌﻔﺎ ﰲ ﻭﻇﻴﻔﺔ ﺍﳍﺮﻣﻮﻥ ‪ ،CRH‬ﺍﻷﻣﺮ ﺍﻟﺬﻱ ﻳﺆﺩﻱ ﻬﺑﻢ ﺇﱃ ﺍﻟﻮﺳﻦ ﻭﺍﻟﺘﻌﺐ ﻭﺯﻳﺎﺩﺓ ﺍﻟﻨﻮﻡ ﻭﺍﺭﺗﻔﺎﻉ‬
‫ﺗﻮﺍﺗﺮ ﺍﻹﻃﻌﺎﻡ ﺍﻟﺬﻱ ﻏﺎﻟﺒﺎ ﻣﺎ ﻳﻨﺠﻢ ﻋﻨﻪ ﺯﻳﺎﺩﺓ ﰲ ﻭﺯﻥ ﺍﳉﺴﻢ‪.‬‬

‫ﻛﻤﺎ ﺃﻥ ﺍﳌﺼﺎﺑﲔ ﺑﺄﻣﺮﺍﺽ ﺗﺘﻤﻴﺰ ﺑﺎﻟﻮﺳﻦ ﻭﺍﻟﺘﻌﺐ‪ ،‬ﻛﻤﺘﻼﺯﻣﺔ ﺍﻟﺘﻌﺐ ﺍﳌﺰﻣﻦ ﻭﺍﻷﱂ ﺍﻟﻌﻀﻠﻲ ﺍﻟﻠﻴﻔﻲ‬
‫‪ fibromyalgia‬ﻭﺍﻻﺿﻄﺮﺍﺏ ﺍﻻﻋﺘﻼﱄ ﺍﻟﻔﺼﻠﻲ)‪ ،(13) (SAD‬ﻳﺒﺪﻭﻥ ﻣﻼﻣﺢ ﺍﻻﻛﺘﺌﺎﺏ ﻭﻓﺮﻃﺎ ﰲ‬
‫ﻓﺎﻋﻠﻴﺔ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ‪ .‬ﻭﻋﻠﻰ ﳓﻮ ﳕﻮﺫﺟﻲ‪ ،‬ﻳُﻈﻬﺮ ﻣﺮﻳﺾ ﻣﺘﻼﺯﻣﺔ ﺍﻟﺘﻌﺐ ﺍﳌﺰﻣﻦ ﻭﺳﻨﺎ ﻣﻮﻫﻨﺎ ﺃﻭ‬
‫ﺇﺭﻫﺎﻗﺎ ﻳﻄﻮﻝ ﻣﺪﺓ ﺳﺘﺔ ﺃﺷﻬﺮ ﺃﻭ ﺃﻛﺜﺮ ﻣﻦ ﺩﻭﻥ ﺳﺒﺐ ﻃﱯ ﻭﺍﺿﺢ‪ ،‬ﻭﻳﺼﺎﺏ ﲝﻤﻰ ﻭﻳﻌﺎﱐ ﺁﻻﻣﺎ ﰲ‬
‫ﺍﳌﻔﺎﺻﻞ ﻭﺍﻟﻌﻀﻼﺕ‪ ،‬ﻛﻤﺎ ﻳُﻈﻬﺮ ﺃﻋﺮﺍﺿﺎ ﺃﺭﺟﻴﺔ ﻭﻣﺴﺘﻮﻳﺎﺕ ﻋﺎﻟﻴﺔ ﻣﻦ ﺍﻷﺿﺪﺍﺩ ﺍﳋﺎﺻﺔ ﺑﻄﻴﻒ ﻭﺍﺳﻊ‬
‫ﻣﻦ ﺍﳌﺴﺘﻀﺪﺍﺕ ﺍﻟﭭﲑﻭﺳﻴﺔ )ﲟﺎ ﰲ ﺫﻟﻚ ﭬﲑﻭﺱ ﺇﭘﻴﺸﺘﺎﻳﻦ ـ ﺑﺎﺭ ‪.(virus Barr-Epstein‬‬

‫ﻭﻳﻌﺎﱐ ﻣﺮﺿﻰ ﺍﻷﱂ ﺍﻟﻌﻀﻠﻲ ﺍﻟﻠﻴﻔﻲ ﺃﻭﺟﺎﻋﺎ ﻋﻀﻠﻴﺔ ﻭﺁﻻﻣﺎ ﰲ ﺍﳌﻔﺎﺻﻞ ﻭﺍﺿﻄﺮﺍﺑﺎ ﰲ ﺍﻟﻨﻮﻡ‬
‫ﻭﺃﻋﺮﺍﺿﺎ ﲤﺎﺛﻞ ﺑﺪﺍﻳﺔ ﺍﻟﺘﻬﺎﺏ ﺍﳌﻔﺼﻞ ﺍﻟﺮﺛﻴﺎﱐ ‪ arthritis rheumatoid‬ﻏﲑ ﺍﳊﺎﺩ‪ .‬ﻭﻳﺘﺮﺍﻓﻖ ﻛﻞ‬
‫ﻣﻦ ﻫﺬﻳﻦ ﺍﻻﻋﺘﻼﻟﲔ ﺑﺘﻌﺐ ﺷﺪﻳﺪ‪ ،‬ﻳﺸﺒﻪ ﺗﻌﺐ ﺍﻻﻛﺘﺌﺎﺏ ﺍﻟﻼﳕﻄﻲ‪ .‬ﺃﻣﺎ ﺍﻻﺿﻄﺮﺍﺏ ﺍﻻﻋﺘﻼﱄ‬
‫ﺍﻟﻔﺼﻠﻲ ‪ ،SAD‬ﺍﻟﺬﻱ ﳛﺪﺙ ﻋﺎﺩﺓ ﰲ ﺍﻟﺸﺘﺎﺀ‪ ،‬ﻓﻴﺘﻤﻴﺰ ﳕﻄﻴﺎ ﺑﺎﻟﻮﺳﻦ ﻭﺍﻟﺘﻌﺐ ﻭﺯﻳﺎﺩﺓ ﺍﳌﺪﺧﻮﻝ‬
‫ﺍﻟﻄﻌﺎﻣﻲ ﻭﺍﺗﺴﺎﻉ ﻓﺘﺮﺍﺕ ﺍﻟﻨﻮﻡ‪ .‬ﺇﻥ ﻛﺜﺮﺓ ﻣﻦ ﺃﻋﺮﺍﺽ ﺍﳌﺮﺽ ‪ SAD‬ﲤﺎﺛﻞ ﺗﻠﻚ ﺍﳋﺎﺻﺔ ﺑﺎﻻﻛﺘﺌﺎﺏ‬
 ‫ﺍﻟﻼﳕﻄﻲ‪.‬‬

‫ﻭﻳﺴﻬﻢ ﻋﻮﺯ ﺍﳍﺮﻣﻮﻥ ‪ CRH‬ﰲ ﺣﺪﻭﺙ ﺍﻟﻮﺳﻦ ﻟﺪﻯ ﻣﺮﺿﻰ ﻳﻌﺎﻧﻮﻥ ﻣﺘﻼﺯﻣﺔ ﺍﻟﺘﻌﺐ ﺍﳌﺰﻣﻦ‪ .‬ﺇﻥ‬
‫ﺣﻘﻦ ﻣﺮﺿﻰ ﻫﺬﻩ ﺍﳌﺘﻼﺯﻣﺔ ﺑﺎﳍﺮﻣﻮﻥ ‪ CRH‬ﻳﺆﺩﻱ ﺇﱃ ﺇﻓﺮﺍ ﹴﺯ ﺁﺟ ﹴﻞ ﻭﻣﺘﺒﺎﻃﺊ ﻟﻠﻬﺮﻣﻮﻥ ‪ ACTH‬ﻣﻦ‬
‫ﻗﺒﻞ ﺍ ‪‬ﳌﺤْﻮﺭ ‪ .HPA‬ﻭﻟﻘﺪ ﻟﻮﺣﻈﺖ ﺍﻻﺳﺘﺠﺎﺑﺔ ﻧﻔﺴﻬﺎ ﰲ ﻣﺮﺿﻰ ﺃﹸﺻﻴﺒﺖ ﻭﻃﺎﺀﺍ‪‬ﻢ ﻭﰲ ﻣﺮﺿﻰ‬
‫ﺃﺻﻴﺒﻮﺍ ﺑﺄﻭﺭﺍﻡ‪ .‬ﻛﻤﺎ ﺃﻥ ﺍﻟﺘﻌﺐ ﻭﻓﺮﻁ ﻓﺎﻋﻠﻴﺔ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﳌﻨﺎﻋﻴﺔ‪ ،‬ﻳﺘﺮﺍﻓﻘﺎﻥ ﻣﻊ ﻋﻮﺯ ﺍﻟﻜﻮﺭﺗﻴﺰﻭﻝ‬
‫ﺍﻟﺬﻱ ﳛﺪﺙ ﻋﻨﺪﻣﺎ ﻳﺘﻨﺎﻗﺺ ﺇﻓﺮﺍﺯ ﺍﳍﺮﻣﻮﻥ ‪ .CRH‬ﺇﻥ ﺗﺮﺍﻛﻴﺰ ﺍﳍﺮﻣﻮﻥ ﻭﺍﺳﺘﺠﺎﺑﺎﺕ ﻣﺮﺿﻰ‬
‫ﺿﻌُﻔﺖ‪ ،‬ﻓﻨﺠﻢ ﻋﻦ‬
‫ﻣﺘﻼﺯﻣﺎﺕ ﺍﻟﺘﻌﺐ ﻻ ﺗُﱪﻫﻦ‪ ،‬ﺇﳕﺎ ﺗﻘﺘﺮﺡ ﻓﻘﻂ ﺃﻥ ﻭﻇﺎﺋﻒ ﺍﶈﻮﺭ ‪ HPA‬ﻟﺪﻳﻬﻢ ﻗﺪ َ‬
‫ﺫﻟﻚ ﺍﳔﻔﺎﺽ ﰲ ﺇﻓﺮﺍﺯ ﺍﳍﺮﻣﻮﻥ ‪ CRH‬ﻭﺍﻟﻜﻮﺭﺗﻴﺰﻭﻝ ﻭﺍﺯﺩﻳﺎﺩ ﰲ ﻓﺎﻋﻠﻴﺔ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ‪ .‬ﺇﻥ ﻫﺬﻩ‬
‫ﺍﻻﻛﺘﺸﺎﻓﺎﺕ ﺑﻌﻀﻬﺎ ﻣﻊ ﺑﻌﺾ ﺗﺸﲑ ﺇﱃ ﺃﻧﻪ ﳝﻜﻦ ﻣﻌﺎﳉﺔ ﺍﻻﻋﺘﻼﻝ ﺍﻟﺒﺸﺮﻱ ﺍﳌﺘﻤﻴﺰ ﺑﺎﻟﺘﻌﺐ ﻭﻓﺮﻁ‬
‫ﺍﳌﻨﺎﻋﺔ‪ ،‬ﻭﺫﻟﻚ ﺑﻌﻘﺎﻗﲑ ﲢﺎﻛﻲ ﺗﺄﺛﲑﺍﺕ ﺍﳍﺮﻣﻮﻥ ‪ CRH‬ﰲ ﺍﻟﺪﻣﺎﻍ‪.‬‬

‫ﻭﻋﻠﻰ ﺍﻟﻨﻘﻴﺾ ﻣﻦ ﺫﻟﻚ‪ ،‬ﻓﺈﻥ ﺍﻟﺸﻜﻞ ﺍﳌﻌﻬﻮﺩ ﻟﻼﻛﺘﺌﺎﺏ‪ ،‬ﺃﻭ ﺍﻟﺴﻮﺩﺍﻭﻳﺔ ‪ ،melancholia‬ﻫﻮ‬
‫ﰲ ﻭﺍﻗﻊ ﺍﻷﻣﺮ ﻟﻴﺲ ﺗﻌﻄﻼ ﻭﻛﺒﺘﺎ ﻟﻸﻓﻜﺎﺭ ﻭﺍﳌﺸﺎﻋﺮ؛ ﺑﻞ ﳝﺜﻞ‪ ،‬ﻋﻠﻰ ﺍﻷﺻﺢ‪ ،‬ﺣﺎﻟﺔ ﻣﻨﻈﻤﺔ ﻣﻦ ﺍﻟﻘﻠﻖ‪.‬‬
‫ﺇﻥ ﻗﻠﻖ ﺍﻟﺴﻮﺩﺍﻭﻳﺔ ﻫﻮ ﺃﺳﺎﺳﺎ ﻓﺮﻁ ﰲ ﺍﳊﺮﺹ ﻋﻠﻰ ﺍﻟﺬﺍﺕ‪ .‬ﻭﻳﺸﻌﺮ ﺍﳌﺮﺿﻰ ﺍﻟﺴﻮﺩﺍﻭﻳﻮﻥ ﺃ‪‬ﻢ‬
‫ُﻣ ﹾﻔﻘﹶﺮﻭﻥ ﻭﻣﻌﻴﺒﻮﻥ‪ ،‬ﻭﻏﺎﻟﺒﺎ ﻣﺎ ﻳﺸﻌﺮﻭﻥ ﺑﺎﻟﻴﺄﺱ ﻓﻴﻤﺎ ﳝﻜﻦ ﺃﻥ ﺗﺘﻮﻗﻌﻪ ﻧﻔﻮﺳﻬﻢ ﺍﻟﱵ ﻳﻌﺘﱪﻭ‪‬ﺎ ﻏﲑ‬
‫ﺟﺪﻳﺮﺓ ﺑﺎﳊﺐ ﺃﻭ ﺑﺎﻟﻨﺠﺎﺡ ﰲ ﺍﻟﻌﻤﻞ‪ .‬ﻛﻤﺎ ﺃﻥ ﻓﺮﻁ ﻓﺎﻋﻠﻴﺔ ﺍﻟﻘﻠﻖ ﻟﺪﻯ ﺍﳌﺮﺿﻰ ﺍﻟﺴﻮﺩﺍﻭﻳﲔ ﻳﺘﺒﺪﻯ‬
‫ﺑﺸﻌﻮﺭﻫﻢ ﺃ‪‬ﻢ ﻏﲑ ﺣﺼﻴﻨﲔ ﻭﺃ‪‬ﻢ ﻣﻌﺮﺿﻮﻥ ﺩﺍﺋﻤﺎ ﻟﻠﻬﺠﻮﻡ‪ .‬ﻭﻏﺎﻟﺒﺎ ﻣﺎ ﻳﻔﺴﺮ ﺍﳌﺮﺿﻰ ﺍﻟﺴﻮﺩﺍﻭﻳﻮﻥ‬
‫ﺨﻞﹴّ ﻋﻨﻬﻢ ﺃﻭ ﺍﺭﺗﺒﺎﻙ‪ ‬ﳛﻞ ﻬﺑﻢ‪.‬‬
‫ﺗﻠﻤﻴﺤﺎ ﺣﻴﺎﺩﻳﺎ ﻧﺴﺒﻴﺎ ﻋﻠﻰ ﺃﻧﻪ ﻧﺬﻳ ُﺮ َﺗ َ‬

‫ﺇﻥ ﺍﳌﺮﺿﻰ ﺍﻟﺴﻮﺩﺍﻭﻳﲔ ُﻳﻈﹾﻬﺮﻭﻥ ﺃﻳﻀﺎ ﺗﻐﲑﺍﺕ ﺳﻠﻮﻛﻴﺔ ﺗﺸﲑ ﺇﱃ ﻓﺮﻁ ﺍﺳﺘﺜﺎﺭﺓ ﻓﻴﺰﻳﻮﻟﻮﺟﻴﺔ‪.‬‬
‫ﻕ )ﺍﻻﺳﺘﻴﻘﺎﻅ ﻋﺎﺩﺓ ﰲ ﺳﺎﻋﺔ ﻣﺒﻜﺮﺓ( ﻭﻓﻘﺪﺍﻥ ﺍﻟﺸﻬﻴﺔ ﻭﺍﻟﻔﺎﻋﻠﻴ ‪‬ﺔ‬
‫ﻛﻤﺎ ﺃ‪‬ﻢ ﻳﻌﺎﻧﻮﻥ ﻋﻠﻰ ﳓﻮ ﳑﻴﺰ ﺍﻷﺭ َ‬
‫ﺍﳉﻨﺴﻴﺔ ﻭﺍﳊﻴﺾ‪ .‬ﻭﻳُﻌﺪ ﺍﻟﻔﺮﻁ ﺍﳌﺴﺘﺪﺍﻡ ﻹﻓﺮﺍﺯ ﺍﻟﻜﻮﺭﺗﻴﺰﻭﻝ ﺃﻛﺜﺮ ﺍﻟﺸﺬﻭﺫﺍﺕ ﺍﻟﺒﻴﻮﻟﻮﺟﻴﺔ ﺍﻧﺘﺸﺎﺭﺍ‬
‫ﻟﺪﻯ ﻣﺮﺿﻰ ﺍﻟﺴﻮﺩﺍﻭﻳﺔ‪.‬‬
 ‫ﺗﻨﺘﻘﻞ ﺍﻹﺷﺎﺭﺍﺕ ﺍﳌﻨﺎﻋﻴﺔ ﺇﱃ ﺍﻟﺪﻣﺎﻍ ﻋﱪ ﺍﻟﺪﻭﺭﺓ ﺍﻟﺪﻣﻮﻳﺔ ﺇﻣﺎ ﻣﺒﺎﺷﺮﺓ ﻭﺇﻣﺎ‬
‫ﺑﺼﻮﺭﺓ ﻏﲑ ﻣﺒﺎﺷﺮﺓ ‪.‬ﻓﺎﳋﻼﻳﺎ ﺍﳌﻨﺎﻋﻴﺔ‪ ،‬ﻛﺎﻟﻮﺣﻴﺪﺍﺕ )ﳕﻂ ﻣﻦ ﺍﳋﻼﻳﺎ‬
‫ﺍﻟﺪﻣﻮﻳﺔ ﺍﻟﺒﻴﺾ)‪ ،‬ﺗﻨﺘﺞ ﻣﺮﺳﺎﻻ ﻛﻴﻤﻴﺎﺋﻴﺎ‪ ،‬ﻳﻌﺮﻑ ﺑﺎﻹﻧﺘﺮﻟﻴﻮﻛﲔ‪IL-‬‬
‫)‪1) 1‬ﺍﻟﺬﻱ ﻻ ﳚﺘﺎﺯ ﻋﺎﺩﺓ ﺍﳊﺎﺟﺰ ﺍﻟﺪﻣﻮﻱ ﺍﻟﺪﻣﺎﻏﻲ‪ .‬ﺑﻴﺪ ﺃﻥ ﺃﻭﻋﻴﺔ‬
‫ﺩﻣﻮﻳﺔ ﺩﻣﺎﻏﻴﺔ ﲢﻮﻱ ﻣﻮﺻﻼﺕ ﻓﻴﻬﺎ ﻣَﺴﺮﺏ‪ ،‬ﺗﺴﻤﺢ ﳉﺰﻳﺌﺎﺕ‬
‫ﺍﻹﻧﺘﺮﻟﻴﻮﻛﲔ ‪ 1‬ﺑﺎﻟﻌﺒﻮﺭ ﺇﱃ ﺍﻟﺪﻣﺎﻍ‪ .‬ﻋﻨﺪﺋﺬ ﺗﻔﻌّﻞ ﻫﺬﻩ ﺍﳉﺰﻳﺌﺎﺕ ﺍﶈﻮﺭ‬
‫‪HPA‬ﻭﲨﻼ ﻋﺼﺒﻴﺔ ﺃﺧﺮﻯ ‪.‬ﻛﻤﺎ ﺃﻥ ﺍﻹﻧﺘﺮﻟﻴﻮﻛﲔ ‪ 1‬ﻳﺘﺮﺍﺑﻂ‬
‫ﲟﺴﺘﻘﺒﻼﺕ ﻣﻮﺟﻮﺩﺓ ﻋﻠﻰ ﺍﳋﻼﻳﺎ ﺍﻟﺒﻄﺎﻧﻴﺔ )ﺍﻟﱵ ﺗﺒﻄﻦ ﺍﻷﻭﻋﻴﺔ ﺍﻟﺪﻣﻮﻳﺔ‬
‫ﺍﻟﺪﻣﺎﻏﻴﺔ(‪ .‬ﻭﻳﺪﻓﻊ ﻫﺬﺍ ﺍﻟﺘﺮﺍﺑﻂ ﺇﻧﺰﳝﺎﺕ ﺍﳋﻼﻳﺎ ﻟﺘﻨﺘﺞ ﺃﻛﺴﻴﺪ ﺍﻟﻨﺘﺮﻳﻚ ﺃﻭ‬
‫ﺍﻟﭙﺮﻭﺳﺘﺎﮔﻼﻧﺪﻳﻨﺎﺕ‪ ، prostaglandins‬ﺍﻟﱵ ﺗﻨﺘﺸﺮ ﺇﱃ‬
‫ﺍﻟﺪﻣﺎﻍ ﻭﺗﺆﺛﺮ ﻣﺒﺎﺷﺮﺓ ﰲ ﺍﻟﻌﺼﺒﻮﻧﺎﺕ‪.‬‬

‫ﻟﻘﺪ ﺃﹸﺟﺮﻳﺖ ﺩﺭﺍﺳﺎﺕ ﻋﺪﻳﺪﺓ ﻋﻠﻰ ﻣﺮﺿﻰ ﺍﻻﻛﺘﺌﺎﺏ ﺍﳋﻄﲑ ﺑﻐﻴﺔ ﲢﺪﻳﺪ ﻣﺎ ﺇﺫﺍ ﻛﺎﻥ ﺍﳌﺴﺘﻮﻯ‬
‫ﺍﳌﺮﺗﻔﻊ ﻟﻠﻜﻮﺭﺗﻴﺰﻭﻝ ﻭﺍﳌﺘﺮﺍﻓﻖ ﻣﻊ ﺍﻻﻛﺘﺌﺎﺏ‪ ،‬ﺫﺍ ﻋﻼﻗﺔ ﺑﺎﻻﺳﺘﺠﺎﺑﺔ ﺍﳌﻨﺎﻋﻴﺔ ﺍﳌﻜﺒﻮﺗﺔ‪ .‬ﻟﻘﺪ ﻭﺟﺪ‬
‫ﺑﻌﻀﻬﻢ ﻋﻼﻗﺔ ﺑﲔ ﺍﻟﻜﻮﺭﺗﻴﺰﻭﻟﻴﺔ ﺍﳌﻔﺮﻃﺔ ‪ hypercortisolism‬ﻭﺍﻟﻜﺒﺖ ﺍﳌﻨﺎﻋﻲ‪ ،‬ﰲ ﺣﲔ ﱂ ﻳﻠﺤﻆ‬
‫ﺑﻌﻀﻬﻢ ﺍﻵﺧﺮ ﻫﺬﻩ ﺍﻟﻌﻼﻗﺔ‪ .‬ﻭﻷﻥ ﻟﻼﻛﺘﺌﺎﺏ ﺃﺳﺒﺎﺑﺎ ﻋﻘﻠﻴﺔ ﻭﻛﻴﻤﻴﺎﺋﻴﺔ ﺣﻴﻮﻳﺔ ﻣﺘﻨﻮﻋﺔ‪ ،‬ﻳُﻼﺣﻆ ﺍﻟﻜﺒﺖ‬
‫ﺍﳌﻨﺎﻋﻲ ﻟﺪﻯ ﺑﻌﺾ ﻣﺮﺿﻰ ﺍﻻﻛﺘﺌﺎﺏ ﻓﻘﻂ‪.‬‬

‫ﻭﺑﺼﻮﺭﺓ ﺃﺳﺎﺳﻴﺔ ﻳﻨﺠﻢ ﺍﻹﻓﺮﺍﺯ ﺍﳌﻔﺮﻁ ﻟﻠﻜﻮﺭﺗﻴﺰﻭﻝ ﻟﺪﻯ ﻣﺮﺿﻰ ﺍﻟﺴﻮﺩﺍﻭﻳﺔ ﻣﻦ ﺍﻹﻓﺮﺍﺯ ﺍﻟﺰﺍﺋﺪ‬
‫ﻟﻠﻬﺮﻣﻮﻥ ‪ ،CRH‬ﺍﻟﺬﻱ ﻳﺘﺄﺗﻰ ﺑﺪﻭﺭﻩ ﻣﻦ ﻋﻴﺐ ﰲ ﺑﻨﻴﺔ ﺍﻟﻮﻃﺎﺀ ﺃﻭ ﰲ ﺍﻟﺒﲎ ﺍﻟﱵ ﺗﻌﻠﻮﻩ‪ .‬ﻭﻫﻜﺬﺍ‪ ،‬ﻓﺈﻥ‬
‫ﺍﳌﻈﺎﻫﺮ ﺍﻟﺴﺮﻳﺮﻳﺔ ﻭﺍﻟﻜﻴﻤﻴﺎﺋﻴﺔ ﺍﳊﻴﻮﻳﺔ ﻟﻠﺴﻮﺩﺍﻭﻳﺔ‪ ،‬ﺗﻌﻜﺲ ﺍﺳﺘﺠﺎﺑﺔ ﻛﺮﺑﻴﺔ ﺷﺎﻣﻠﺔ‪ ،‬ﲤﻠﺼﺖ ﻣﻦ‬
 ‫ﺍﻟﺘﻨﻈﻴﻢ ﺍﳌﻀﺎﺩ ﺍﳌﻌﺘﺎﺩ‪ ،‬ﺍﻷﻣﺮ ﺍﻟﺬﻱ ﻳﺒﻘﻴﻬﺎ ﰲ ﺍﻟﻮﺿﻌﻴﺔ ﺍﻟﻔﺎﻋﻠﺔ‪.‬‬

‫ﺇﻥ ﺗﺄﺛﲑﺍﺕ ﺍﻷﺩﻭﻳﺔ ﺍﻟﺜﻼﺛﻴﺔ ﺍﳊﻠﻘﺎﺕ ﺍﳌﻀﺎﺩﺓ ﻟﻼﻛﺘﺌﺎﺏ ﻋﻠﻰ ﻣﻜﻮﻧﺎﺕ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﻟﻜﺮﺑﻴﺔ‪،‬‬
‫ﺗﺪﻋﻢ ﺍﳌﻔﻬﻮﻡ ﺍﻟﻘﺎﺋﻞ ﺑﺄﻥ ﺍﻟﺴﻮﺩﺍﻭﻳﺔ ﺗﺘﺮﺍﻓﻖ ﻣﻊ ﺍﺳﺘﺠﺎﺑﺔ ﻛﺮﺑﻴﺔ ﺣﺎﺩﺓ‪ .‬ﻓﺈﻋﻄﺎﺀ ﺍﳉﺮﺫﺍﻥ )ﻋﻠﻰ ﳓﻮ‬
‫ﻣﻨﺘﻈﻢ( ﺟﺮﻋﺎ ﻣﻌﺘﺪﻟﺔ ﻣﻦ ﻣﻀﺎﺩ ﺍﻻﻛﺘﺌﺎﺏ ﺍﻟﺜﻼﺛﻲ ﺍﳊﻠﻘﺎﺕ ﺇﳝﻴﭙﺮﺍﻣﲔ ‪ imipramine‬ﳜﻔﺾ‬
‫ﲣﻔﻴﻀﺎ ﻣﻌﻨﻮﻳﺎ ﻃﻼﺋﻊ ﺍﳍﺮﻣﻮﻥ ‪ CRH‬ﰲ ﺍﻟﻮﻃﺎﺀ‪ .‬ﻛﻤﺎ ﺃﻥ ﺇﻋﻄﺎﺀ ﺍﻹﳝﻴﭙﺮﺍﻣﲔ ﻣﺪﺓ ﺷﻬﺮﻳﻦ ﻷﻧﺎﺱ‬
‫ﺃﺻﺤﺎﺀ ﻳﺘﻤﺘﻌﻮﻥ ﲟﺴﺘﻮﻳﺎﺕ ﺳﻮﻳﺔ ﻣﻦ ﺍﻟﻜﻮﺭﺗﻴﺰﻭﻝ‪ ،‬ﳜﻔﺾ ﲣﻔﻴﻀﺎ ﺗﺪﺭﳚﻴﺎ ﻭﻣﺴﺘﺪﳝﺎ ﺇﻓﺮﺍﺯ ﺍﳍﺮﻣﻮﻥ‬
‫‪ CRH‬ﻭﺍﻟﻮﻇﺎﺋﻒ ﺍﻷﺧﺮﻯ ﻟﻠﻤﺤﻮﺭ ‪ ،HPA‬ﺍﻷﻣﺮ ﺍﻟﺬﻱ ﻳﺸﲑ ﺇﱃ ﺃﻥ ﺍﻟﺘﻨﻈﻴﻢ ﺍﻟﻨﺎﺯﻝ)‪ (14‬ﳌﻜﻮﻧﺎﺕ‬
‫ﻣﻬﻤﺔ ﻣﻦ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﻟﻜﺮﺑﻴﺔ ﻫﻮ ﺗﺄﺛﲑ ﺩﺍﺧﻠﻲ ﺍﳌﻨﺸﺄ ﻟﻺﳝﻴﭙﺮﺍﻣﲔ‪.‬‬

‫ﻭﻳﺘﺮﺍﻓﻖ ﺍﻻﻛﺘﺌﺎﺏ ﺃﻳﻀﺎ ﻣﻊ ﺍﻷﻣﺮﺍﺽ ﺍﻻﻟﺘﻬﺎﺑﻴﺔ‪ .‬ﻓﻌﺸﺮﻭﻥ ﰲ ﺍﳌﺌﺔ ﻣﻦ ﻣﺮﺿﻰ ﺍﻟﺘﻬﺎﺏ ﺍﳌﻔﺼﻞ‬
‫ﺍﻟﺮﺛﻴﺎﱐ ﻳﺘﻄﻮﺭ ﻟﺪﻳﻬﻢ ﺍﻛﺘﺌﺎﺏ ﺳﺮﻳﺮﻱ ﰲ ﻣﺮﺣﻠﺔ ﻣﺎ ﻣﻦ ﻣﺮﺍﺣﻞ ﺳﲑﻭﺭﺓ ﺇﺻﺎﺑﺘﻬﻢ ﺍﳌﻔﺼﻠﻴﺔ‪ .‬ﻭﻏﺎﻟﺒﺎ‬
‫ﻣﺎ ﻳﺴﺘﻌﻤﻞ ﺍﻟﺴﺮﻳﺮﻳﻮﻥ ﰲ ﺗﺸﺨﻴﺺ ﺍﻻﻛﺘﺌﺎﺏ ﺍﺳﺘﺒﻴﺎﻧﺎ ﻳﺸﺘﻤﻞ ﻋﻠﻰ ﳓﻮ ﺩﺯﻳﻨﺔ ﻣﻦ ﺍﻷﺳﺌﻠﺔ‪ ،‬ﳚﺎﺏ‬
‫ﻋﻨﻬﺎ ﺩﺍﺋﻤﺎ ﺑﺎﻹﳚﺎﺏ ﻣﻦ ﻗﺒﻞ ﻣﺮﺿﻰ ﺍﻟﺘﻬﺎﺏ ﺍﳌﻔﺎﺻﻞ‪.‬‬

‫ﺍﻻﻜﺘﺌﺎﺏ ﻭﺍﻻﻋﺘﻼل‬
‫ﰲ ﺍﳌﺎﺿﻲ ﻛﺎﻥ ﺍﻷﻃﺒﺎﺀ ﻳﻌﺘﱪﻭﻥ ﺃﻥ ﺍﻟﺘﺮﺍﺑﻂ ﺑﲔ ﺍﻷﻣﺮﺍﺽ ﺍﻻﻟﺘﻬﺎﺑﻴﺔ ﻭﺍﻟﻜﺮﺏ ﻫﻮ ﻧﺘﻴﺠﺔ ﺛﺎﻧﻮﻳﺔ‬
‫ﺑﺎﻟﻨﺴﺒﺔ ﺇﱃ ﺍﻷﱂ ﺍﳌﺰﻣﻦ ﻭﺍﻟﻮﻫﻦ ﺍﻟﻠﺬﻳﻦ ﳛﺪﺛﻬﻤﺎ ﺍﳌﺮﺽ‪ .‬ﺇﻥ ﺍﻻﻛﺘﺸﺎﻑ ﺍﻟﺬﻱ ﺣﺪﺙ ﻣﺆﺧﺮﺍ ﻟﻸﺳﺎﺱ‬
‫ﺍﳌﺸﺘﺮﻙ ﻟﻼﺳﺘﺠﺎﺑﺘﲔ ﺍﳌﻨﺎﻋﻴﺔ ﻭﺍﻟﻜﺮﺑﻴﺔ‪ ،‬ﻳﻘﺪﻡ ﺗﻔﺴﲑﺍ ﳌﻼﺣﻈﺔ ﺃﻥ ﺍﳌﺮﻳﺾ ﻳﺒﺪﻱ ﺍﺳﺘﻌﺪﺍﺩﺍ ﻟﻸﻣﺮﺍﺽ‬
‫ﺍﻻﻟﺘﻬﺎﺑﻴﺔ ﻭﻟﻼﻛﺘﺌﺎﺏ ﰲ ﺁﻥ ﻭﺍﺣﺪ‪ .‬ﻓﺨﻠﻞ ﺍﻟﺘﻨﻈﻴﻢ ﺍﳍﺮﻣﻮﱐ‪ ،‬ﺍﻟﺬﻱ ﻳﺸﻜﻞ ﺃﺳﺎﺳﺎ ﻣﺰﺩﻭﺟﺎ ﻟﻸﻣﺮﺍﺽ‬
‫ﺍﻻﻟﺘﻬﺎﺑﻴﺔ ﻭﻟﻼﻛﺘﺌﺎﺏ‪ ،‬ﺇﻣﺎ ﺃﻥ ﻳﺆﺩﻱ ﺇﱃ ﺍﻻﻋﺘﻼﻝ )ﰲ ﺣﺎﻝ ﺃﻥ ﺍﳌﻨﺒﻪ ﺍﳌﺆﺛﺮ ﳛﺮﺽ ﻋﻠﻰ ﺍﻻﻟﺘﻬﺎﺏ( ﺃﻭ‬
‫ﺇﱃ ﺍﻻﻛﺘﺌﺎﺏ ﺍﻟﻨﻔﺴﻲ‪ .‬ﻭﻫﺬﺍ ﻣﺎ ﻳﻔﺴﺮ ﳌﺎﺫﺍ ﻻ ﻳﺘﻮﺍﻓﻖ ﺩﺍﺋﻤﺎ ﰲ ﻣﺮﺿﻰ ﺍﻟﺘﻬﺎﺏ ﺍﳌﻔﺼﻞ ﺗﻌﺎﻇﻢ‪ ،‬ﺃﻭ‬
‫ﺗﻀﺎﺅﻝ‪ ،‬ﺍﻻﻛﺘﺌﺎﺏ ﻣﻊ ﺛﻮﺭﺓ ﺍﻻﻟﺘﻬﺎﺏ‪.‬‬

‫ﺇﻥ ﺍﻻﻋﺘﻘﺎﺩ ﺍﻟﺸﺎﺋﻊ ﺑﺄﻥ ﺍﻟﻜﺮﺏ ﻳﻌﻤﻞ ﻋﻠﻰ ﺗﻔﺎﻗﻢ ﺍﻻﻋﺘﻼﻻﺕ ﺍﻻﻟﺘﻬﺎﺑﻴﺔ ﻭﺇﻥ ﺍﻻﺭﲣﺎﺀ ﺃﻭ ﺇﺯﺍﻟﺔ‬
‫ﺍﻟﻜﺮﺏ ﳛﺴﻦ ﺣﺎﻟﺔ ﺍﳌﺮﻳﺾ ﺍﻻﻟﺘﻬﺎﺑﻴﺔ‪ ،‬ﻳﺴﺘﻨﺪ ﻓﻌﻼ ﺇﱃ ﺃﺳﺎﺱ ﻭﺍﻗﻌﻲ‪ .‬ﻓﺎﻟﺘﺂﺛﺮﺍﺕ ﺑﲔ ﺍﻟﻜﺮﺏ‬
‫ﻭﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﻭﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﳍﺮﻣﻮﻧﻴﺔ‪ ،‬ﺍﻟﱵ ﺗﺘﺸﺎﺭﻙ ﻫﺬﻩ ﺍﳉﻤﻞ ﻓﻴﻬﺎ‪ ،‬ﺗﻔﺴﺮ ﻛﻴﻒ ﺗﺆﺛﺮ ﺍﶈﺎﻭﻻﺕ‬
 ‫ﺍﻟﻮﺍﻋﻴﺔ ﰲ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﳌﻨﺎﻋﻴﺔ ﻣﻦ ﺃﺟﻞ ﺗﻠﻄﻴﻒ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﻟﻜﺮﺑﻴﺔ‪.‬‬

‫ﻭﻻ ﻳُﻌﺮﻑ ﺣﱴ ﺍﻵﻥ ﻣﻘﺪﺍﺭ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﻟﻜﺮﺑﻴﺔ ﺍﶈﺪﺩ ﺟﻴﻨﻴﺎ )ﻭﺭﺍﺛﻴﺎ(‪ ،‬ﻭﻻ ﻳﻌﺮﻑ ﺃﻳﻀﺎ ﻧﺴﺒﺔ ﻣﺎ‬
‫ﳝﻜﻦ ﻟﻠﻮﻋﻲ ﺃﻥ ﻳﺘﺤﻜﻢ ﻓﻴﻪ‪ .‬ﻭﻟﻜﻦ ﻣﻦ ﺍﳌﺆﻛﺪ ﺇﱃ ﺣﺪ ﻣﺎ ﺃﻥ ﻋﺘﺒﺔ ﺍﺳﺘﻬﻼﻝ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﻟﻜﺮﺑﻴﺔ‬
‫ﳏﺪﺩﺓ ﺟﻴﻨﻴﺎ‪ .‬ﻓﻴﻤﻜﻦ ﳊﺪﺙ ﻣﻌﲔ ﺃﻥ ﻳﻜﻮﻥ ﻓﻴﺰﻳﻮﻟﻮﺟﻴﺎ ﺷﺪﻳﺪ ﺍﻟﻜﺮﺏ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﻔﺮﺩ ﻣﺎ‪ ،‬ﻭﺃﻥ‬
‫ﻳﻜﻮﻥ ﺃﻗﻞ ﻛﺮﺑﺎ ﺑﻜﺜﲑ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﻔﺮﺩ ﺁﺧﺮ؛ ﺇﺫ ﺇﻥ ﺫﻟﻚ ﻣﻨﻮﻁ ﺑﺪﺭﺟﺔ ﻧﺰﻭﻉ ﺍﻟﻔﺮﺩ ﺍﻟﻮﺭﺍﺛﻴﺔ‬
‫ﻟﻠﺘﻔﺎﻋﻞ ﻣﻊ ﺍﳍﺮﻣﻮﻧﺎﺕ‪ .‬ﻓﺎﻟﺪﺭﺟﺔ‪ ،‬ﺍﻟﱵ ﳝﻜﻦ ﻟﻠﻜﺮﺏ ﺃﻥ ﻳﻌﺠﻞ ﺃﻭ ﻳﻔﺎﻗﻢ ﻓﻴﻬﺎ ﺍﳌﺮﺽ ﺍﻻﻟﺘﻬﺎﰊ‪،‬‬
‫ﺗﻌﺘﻤﺪ ﻋﻨﺪﺋﺬ ﻋﻠﻰ ﺷﺪﺓ ﺍﳌﻨﺒﻪ ﺍﳌﹸﻜﺮﺏ ﻭﻋﻠﻰ ﻋﺘﺒﺔ ﺍﺳﺘﻬﻼﻝ ﻋﻤﻞ ﺍﳉﻬﺎﺯ ﺍﻟﻜﺮﰊ‪.‬‬

‫ﻳُﻌﺪ ﺗﺒﺪﻳﻞ ﺍﻟﻔﺎﻋﻠﻴﺔ ﺍﳉﻴﻨﻴﺔ ﻟﻠﺨﻼﻳﺎ ﺍﳌﻨﺎﻋﻴﺔ ﺃﺣﺪ ﺗﺄﺛﲑﺍﺕ ﺍﻟﻜﻮﺭﺗﻴﺰﻭﻝ‪.‬‬

‫ﻭﺇﻥ ﻣﺴﺘﻘﺒﻠﺔ ﺍﻟﻜﻮﺭﺗﻴﺰﻭﻝ ﰲ ﺍﳋﻠﻴﺔ ﺍﳌﻨﺎﻋﻴﺔ ﺗُﻄﻮﻯ ﻭﺗﺮﺑﻂ ﺑﱪﻭﺗﻴﻨﺎﺕ‬
‫»ﺻﺪﻣﺔ ﺣﺮﺍﺭﻳﺔ« ﺿﺨﻤﺔ ‪.‬ﻓﻌﻨﺪﻣﺎ ﻳﺪﺧﻞ ﺍﻟﻜﻮﺭﺗﻴﺰﻭﻝ ﺍﳋﻠﻴﺔ ﻭﻳﻨﻀﻢ ﺇﱃ‬
‫ﻣﺴﺘﻘﺒﻠﺘﻪ‪ ،‬ﻳﱰﺍﺡ ﺍﻟﱪﻭﺗﲔ ﻭﺗﻨﺒﺴﻂ ﺍﳌﺴﺘﻘﺒﻠﺔ‪ .‬ﻭﻋﻨﺪﺋﺬ ﺗﻨﻀﻢ ﺍﳌﺴﺘﻘﺒﻠﺔ‬
‫ﺇﱃ ﺍﻟﺪﻧﺎ ‪ DNA‬ﰲ ﺍﻟﻨﻮﺍﺓ‪ ،‬ﻣﻐﲑﺓ ﺑﺬﻟﻚ ﺍﻧﺘﺴﺎﺥ ﺍﳋﻠﻴﺔ ﻟﻠﺮﻧﺎ ﺍﳌﺮﺳﺎﻝ‬
‫)‪mRNA‬ﻭﺇﻧﺘﺎﺟﻬﺎ ﻟﻠﱪﻭﺗﲔ ‪.‬ﻭﻳﺘﺮﺍﺑﻂ ﺟﺰﻳﺌﺎﻥ ﺁﺧﺮﺍﻥ‪ ،‬ﳘﺎ‪c-‬‬
‫‪foc‬ﻭ‪ ، c-jun‬ﺑﺎﳌﺴﺘﻘﺒﻠﺔ ﻟﺰﻳﺎﺩﺓ ﻧﻮﻋﻴﺔ ﻓﻌﻠﻬﺎ‪ .‬ﺗﻐﺎﺩﺭ ﺍﻟﱪﻭﺗﻴﻨﺎﺕ‬
‫ﺍﳌﹸﻨﺘَﺠﺔ ﺍﳋﻠﻴ ﹶﺔ ﻭﺗﺆﺛﺮ ﺗﺄﺛﲑﺍ ﻣﺒﺎﺷﺮﺍ ﰲ ﺇﻧﺘﺎﺝ ﺍﻟﺴﻴﺘﻮﻛﻴﻨﺎﺕ ﻭﺍﻟﻠﻤﻔﺎﻭﻳﺎﺕ‪.‬‬
‫ﻭﳝﻜﻦ ﻟﻠﻜﺮﺏ ﺍﻟﻨﻔﺴﻲ ﺃﻥ ﻳﺆﺛﺮ ﰲ ﺍﺳﺘﻌﺪﺍﺩ ﺍﳌﺮﺀ ﻟﻺﺻﺎﺑﺔ ﺑﺎﻷﻣﺮﺍﺽ ﺍﳋﻤﺠﻴﺔ‪ .‬ﻓﺘﻨﻈﻴﻢ ﺍﳉﻬﺎﺯ‬
‫ﺍﳌﻨﺎﻋﻲ ﺑﻮﺳﺎﻃﺔ ﻣﻨﻈﻮﻣﺔ ﺍﻟﻜﺮﺏ ﺍﳍﺮﻣﻮﻧﻴﺔ ﺍﻟﻌﺼﺒﻴﺔ ﻳﺰﻭﺩﻧﺎ ﺑﺎﻷﺳﺎﺱ ﺍﻟﺒﻴﻮﻟﻮﺟﻲ ﻟﻔﻬﻢ ﺍﻟﻜﻴﻔﻴﺔ ﺍﻟﱵ‬
‫ﻳﺆﺛﺮ ﻭﻓﻘﺎ ﳍﺎ ﺍﻟﻜﺮﺏ ﰲ ﻫﺬﻩ ﺍﻷﻣﺮﺍﺽ‪ .‬ﻭﻫﻨﺎﻟﻚ ﻣﺎ ﻳﺪﻝ ﻋﻠﻰ ﺃﻥ ﺍﻟﻜﺮﺏ ﻳﺆﺛﺮ ﻓﻌﻼ ﰲ ﺍﻻﺳﺘﺠﺎﺑﺔ‬
‫ﺍﳌﻨﺎﻋﻴﺔ ﻟﻺﻧﺴﺎﻥ ﲡﺎﻩ ﺍﻟﭭﲑﻭﺳﺎﺕ ﻭﺍﻟﺒﻜﺘﲑﻳﺎ‪ .‬ﻓﻠﻘﺪ ﺃﻭﺿﺤﺖ ﺍﻟﺪﺭﺍﺳﺎﺕ‪ ،‬ﺍﻟﱵ ﺃﺟﺮﻳﺖ ﻋﻠﻰ‬
‫ﻣﺘﻄﻮﻋﲔ ﺃﹸﻋﻄﻮﺍ ﺟﺮﻋﺎ ﻣﻌﻴﺎﺭﻳﺔ ﻣﻦ ﭬﲑﻭﺱ ﺍﻟﺰﻛﺎﻡ )ﺍﻟﭭﲑﻭﺱ ﺍﻷﻧﻔﻲ ‪ ،(rhinovirus‬ﺑﺄﻥ ﺍﻷﻓﺮﺍﺩ‬
‫ﺍﻟﺬﻳﻦ ﺗﻌﺮﺿﻮﺍ ﺗﺰﺍﻣﻨﻴﺎ ﻟﻠﻜﺮﺏ ﺃﺻﻴﺒﻮﺍ ﺑﻌﺪﺩ ﺃﻛﱪ ﻣﻦ ﺍﳉﺴﻴﻤﺎﺕ ﺍﻟﭭﲑﻭﺳﻴﺔ ﻭﺃﻧﺘﺠﻮﺍ ﻛﻤﻴﺎﺕ ﺃﻛﱪ‬
‫ﻣﻦ ﺍﳌﺨﺎﻁ ﻣﻘﺎﺭﻧﺔ ﺑﺄﻗﺮﺍ‪‬ﻢ ﻏﲑ ﺍﳌﻜﺮﻭﺑﲔ‪ .‬ﻛﻤﺎ ﺃﻥ ﻃﻠﺒﺔ ﺍﻟﻄﺐ‪ ،‬ﺍﻟﺬﻳﻦ ﺗﻠﻘﹼﻮﺍ ﻟﻘﺎﺡ ﺍﻟﺘﻬﺎﺏ ﺍﻟﻜﺒﺪ‬
‫ﺃﺛﻨﺎﺀ ﺍﻣﺘﺤﺎﻧﺎ‪‬ﻢ ﺍﻟﻨﻬﺎﺋﻴﺔ‪ ،‬ﱂ ﻳﻄﻮﺭﻭﺍ ﲪﺎﻳﺔ ﻛﺎﻣﻠﺔ ﺿﺪ ﺍﻟﺘﻬﺎﺏ ﺍﻟﻜﺒﺪ‪ .‬ﻭﺗﻨﻄﻮﻱ ﻫﺬﻩ ﺍﻻﻛﺘﺸﺎﻓﺎﺕ‬
‫ﻋﻠﻰ ﺟﻮﺍﻧﺐ ﻣﻬﻤﺔ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﱪﳎﺔ ﺍﻟﺘﻠﻘﻴﺢ‪ .‬ﻓﺎﻟﻨﺎﺱ ﺍﻟﺬﻳﻦ ﻳﺘﻢ ﺗﻠﻘﻴﺤﻬﻢ ﺃﺛﻨﺎﺀ ﻓﺘﺮﺍﺕ ﺍﻟﻜﺮﺏ ﻻ‬
‫ﻳﻄﻮﺭﻭﻥ ﻋﻠﻰ ﺍﻷﺭﺟﺢ ﲪﺎﻳﺔ ﺿﺪﻳﺔ ﺗﺎﻣﺔ‪.‬‬

‫ﻭﺗﻘﺪﻡ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﻟﱵ ﺗُﺠﺮﻯ ﻋﻠﻰ ﺍﳊﻴﻮﺍﻧﺎﺕ ﺩﻟﻴﻼ ﺇﺿﺎﻓﻴﺎ ﻋﻠﻰ ﺃﻥ ﺍﻟﻜﺮﺏ ﻳﺆﺛﺮ ﰲ ﺳﲑﻭﺭ ‪‬ﺓ‬
‫ﻭﺷﺪﺓ ﺍﻻﻋﺘﻼﻝ ﺍﻟﭭﲑﻭﺳﻲ ﻭﺍﳌﺮﺽ ﺍﻟﺒﻜﺘﲑﻱ ﻭﺍﻟﺼﺪﻣﺔ ﺍﻹﻧﺘﺎﻧﻴﺔ‪ .‬ﻭﳚﻌﻞ ﺍﻟﻜﺮﺏ ﺷﺪﺓ ﺍﻹﻧﻔﻠﻮﻧﺰﺍ‬
‫)ﺍﻟﱰﻟﺔ ﺍﻟﻮﺍﻓﺪﺓ( ﻟﺪﻯ ﺍﻟﻔﺌﺮﺍﻥ ﺃﺳﻮﺃ‪ ،‬ﻭﻳﺆﺛﺮ ﰲ ﻛﻞ ﻣﻦ ﺍﶈﻮﺭ ‪ HPA‬ﻭﺍﳉﻤﻠﺔ ﺍﻟﻌﺼﺒﻴﺔ ﺍﻟﻮﺩﻳﺔ‪.‬‬
‫ﻭﺗﺸﲑ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﻟﱵ ﺃﺟﺮﻳﺖ ﻋﻠﻰ ﺍﳊﻴﻮﺍﻧﺎﺕ ﺇﱃ ﺃﻥ ﺁﻟﻴﺎﺕ ﻫﺮﻣﻮﻧﻴﺔ )ﻏﺪﻳﺔ ﺻﻤﺎﻭﻳﺔ( ﻋﺼﺒﻴﺔ‬
‫ﺗﺆﺩﻱ ﺩﻭﺭﺍ ﳑﺎﺛﻼ ﰲ ﺃﲬﺎﺝ ﭬﲑﻭﺳﻴﺔ ﺃﺧﺮﻯ‪ ،‬ﲟﺎ ﰲ ﺫﻟﻚ ﭬﲑﻭﺱ ﺍﻟﻌﻮﺯ ﺍﳌﻨﺎﻋﻲ ﺍﻟﺒﺸﺮﻱ )‪،(HIV‬‬
‫ﻭﺗﻘﺪﻡ ﺁﻟﻴﺔ ﻟﻔﻬﻢ ﺍﳌﻼﺣﻈﺎﺕ ﺍﻟﺴﺮﻳﺮﻳﺔ ﺍﻟﱵ ﺗﺸﲑ ﺇﱃ ﺃﻥ ﺍﻟﻜﺮﺏ ﻗﺪ ﻳﻌﻤﻞ ﻋﻠﻰ ﺗﻔﺎﻗﻢ ﺳﲑﻭﺭﺓ‬
‫ﺍﻹﻳﺪﺯ‪ .‬ﻭﻳﺰﻳﺪ ﺍﻟﻜﺮﺏ ﺍﺳﺘﻌﺪﺍﺩ ﺍﻟﻔﺌﺮﺍﻥ ﻟﻠﺨﻤﺞ ﺑﺎﳌﺘﻔﻄﺮﺓ ﺍﻟﺴﻠﹼﻴﺔ ‪ mycobacteria‬ﺍﻟﱵ ﺗﺴﺒﺐ‬
‫ﺍﻟﺘﺪﺭﻥ )ﺍﻟﺴﻞ(‪ .‬ﻭﻟﻘﺪ ﺃﻣﻜﻦ ﺍﻟﱪﻫﺎﻥ ﻋﻠﻰ ﺃﻥ ﺳﻼﻣﺔ ﺍﶈﻮﺭ ‪ HPA‬ﺗﺼﻮﻥ ﺍﳉﺮﺫﺍﻥ ﻣﻦ ﺍﻟﺘﺄﺛﲑ‬
‫ﻼ‪ .‬ﻭﺃﺧﲑﺍ‪ ،‬ﻓﺈﻥ ﻓﻬﻢ ﺍﻟﺘﺂﺛﺮﺍﺕ ﺑﲔ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﳌﻨﺎﻋﻴﺔ ﻭﺍﻻﺳﺘﺠﺎﺑﺔ‬
‫ﺍﻹﻧﺘﺎﱐ ﺍﳌﻤﻴﺖ ﻟﺒﻜﺘﲑﻳﺎ ﺍﻟﺴﺎﳌﻮﻧﻴ ﹼ‬
‫ﺍﻟﻜﺮﺑﻴﺔ‪ ،‬ﻳﺴﺎﻋﺪ ﻋﻠﻰ ﺗﻔﺴﲑ ﺍﳌﻼﺣﻈﺎﺕ ﺍﶈﲑﺓ ﺍﻟﱵ ﺗﺸﲑ ﺇﱃ ﺃﻥ ﺍﻟﺘﻜﻴﻴﻒ ﺍﻟﻨﻔﺴﻲ ﺍﳌﻌﻬﻮﺩ ﻟﻠﺤﻴﻮﺍﻥ‬
‫ﳝﻜﻦ ﺃﻥ ﻳﺆﺛﺮ ﰲ ﺍﺳﺘﺠﺎﺑﺎﺗﻪ ﺍﳌﻨﺎﻋﻴﺔ‪ .‬ﻓﻤﺜﻼ‪ ،‬ﻣﺰﺝ ﻛﻞ ﻣﻦ >‪ .R‬ﺃﺩﺭ< ﻭ >‪ .N‬ﻛﻮﻫﻦ< )ﻣﻦ‬
‫ﺟﺎﻣﻌﺔ ﺭﻭﺷﺴﺘﺮ(‪ ،‬ﰲ ﻋﻤﻠﻬﻤﺎ ﻋﻠﻰ ﺍﳉﺮﺫﺍﻥ‪ ،‬ﺍﳌﺎﺀ ﺍﳌﻨ ﹶﻜّﻪ ﺑﺎﻟﺴﻜﺎﺭﻳﻦ ﻣﻊ ﻋﻘﺎﺭ ﻛﺎﺑﺖ ﻣﻨﺎﻋﻴﺎ‪ ،‬ﻓﺘﺒﲔ‬
‫ﳍﻤﺎ ﰲ ﺍﻟﻨﻬﺎﻳﺔ ﺃﻥ ﺍﻟﺴﻜﺎﺭﻳﻦ ﲟﻔﺮﺩﻩ ﺃﻧﻘﺺ ﺍﻟﻮﻇﻴﻔﺔ ﺍﳌﻨﺎﻋﻴﺔ ﻋﻠﻰ ﳓﻮ ﳝﺎﺛﻞ ﻣﺎ ﺳﺒّﺒﻪ ﺍﻟﻌﻘﺎﺭ‪.‬‬

‫ﻭﻟﻴﺲ ﺍﻟﻜﺮﺏ ﺷﺨﺼﻴﺎ ﻓﺤﺴﺐ‪ ،‬ﺑﻞ ﺇﻧﻪ ﻳُﺪﺭﻙ ﻋﱪ ﺍﻟﺘﺂﺛﺮﺍﺕ ﻣﻊ ﺍﻵﺧﺮﻳﻦ‪ .‬ﻓﺎﻟﺘﺂﺛﺮﺍﺕ‬
‫ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻗﺪ ﺗﺰﻳﺪ‪ ،‬ﺃﻭ ﺗﻨﻘﺺ‪ ،‬ﺍﻟﻜﺮﺏ ﺍﻟﻨﻔﺴﻲ ﻭﺗﺆﺛﺮ ﻋﻠﻰ ﳓﻮ ﳑﺎﺛﻞ ﰲ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﳍﺮﻣﻮﻧﻴﺔ ﲡﺎﻩ‬
‫ﻫﺬﺍ ﺍﻟﻜﺮﺏ‪ ،‬ﺍﻷﻣﺮ ﺍﻟﺬﻱ ﻳﺆﺩﻱ ﺇﱃ ﺗﻐﻴﲑ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﳌﻨﺎﻋﻴﺔ‪ .‬ﻭﻫﻜﺬﺍ‪ ،‬ﻓﺈﻥ ﺍﻟﻜﺮﺏ ﺍﻻﺟﺘﻤﺎﻋﻲ‬
‫ﺍﻟﻨﻔﺴﻲ ﺍﻟﺬﻱ ﻳﻌﺎﻧﻴﻪ ﺍﻟﻔﺮﺩ‪ ،‬ﻳﺆﺛﺮ ﰲ ﺍﺳﺘﻌﺪﺍﺩﻩ ﻟﻺﺻﺎﺑﺔ ﺑﺎﻷﻣﺮﺍﺽ ﺍﻻﻟﺘﻬﺎﺑﻴﺔ ﻭﺍﳋﻤﺠﻴﺔ‪ ،‬ﻛﻤﺎ ﻳﺆﺛﺮ ﰲ‬
‫ﺳﲑﻭﺭﺓ ﺍﳌﺮﺽ‪ .‬ﻓﻤﺜﻼ‪ ،‬ﺑَﻴّﻨﺖ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺃﻥ ﺍﻷﺷﺨﺎﺹ ﺍﻟﺬﻳﻦ ﻳﺘﻌﺮﺿﻮﻥ ﻟﻜﺮﺏ ﺍﺟﺘﻤﺎﻋﻲ ﻣﺰﻣﻦ‬
‫ﻷﻛﺜﺮ ﻣﻦ ﺷﻬﺮﻳﻦ‪ ،‬ﻳﺰﺩﺍﺩ ﺍﺳﺘﻌﺪﺍﺩﻫﻢ ﻟﻺﺻﺎﺑﺔ ﺑﺎﻟﺰﻛﺎﻡ‪.‬‬

‫ﻭﺃﻭﺿﺤﺖ ﺩﺭﺍﺳﺎﺕ ﺃﺧﺮﻯ ﺃﻥ ﺍﻻﺳﺘﺠﺎﺑﺎﺕ ﺍﳌﻨﺎﻋﻴﺔ ﻟﻠﺬﻳﻦ ﻳﺴﻬﺮﻭﻥ ﻓﺘﺮﺓ ﻃﻮﻳﻠﺔ ﻋﻠﻰ ﺭﺍﺣﺔ‬
‫ﺍﳌﺮﻳﺾ‪ ،‬ﻛﺄﺯﻭﺍﺝ ﻣﺮﺿﻰ ﺃﻟﺰﺍﳝﺮ‪ ،‬ﺗﻐﺪﻭ ﻣﻜﺒﻮﺗﺔ‪ .‬ﻛﻤﺎ ﺃﻥ ﻫﺬﻩ ﺍﻻﺳﺘﺠﺎﺑﺎﺕ ﺗﻜﻮﻥ ﻛﺬﻟﻚ ﻟﺪﻯ‬
‫ﺍﻷﺯﻭﺍﺝ ﺍﻟﺘﻌﺴﺎﺀ ﰲ ﺣﻴﺎ‪‬ﻢ ﺍﻟﺰﻭﺟﻴﺔ ﻭﻟﺪﻯ ﺍﳌﻄﻠﻘﲔ ﺃﻳﻀﺎ‪ ،‬ﻭﻏﺎﻟﺒﺎ ﻣﺎ ﻳﺘﻮﻟﺪ ﻟﺪﻯ ﺍﻟﺰﻭﺟﺔ ﺷﻌﻮﺭ‬
‫ﺑﺎﻟﻴﺄﺱ ﻭﺗﻌﺎﱐ ﺍﻟﻘﺪﺭ ﺍﻷﻋﻈﻢ ﻣﻦ ﺍﻟﻜﺮﺏ‪ .‬ﻭﰲ ﻣﺜﻞ ﻫﺬﺍ ﺍﻟﺴﻴﻨﺎﺭﻳﻮ‪ ،‬ﺗﺒﻴّﻦ ﺃﻥ ﻣﺴﺘﻮﻳﺎﺕ ﻫﺮﻣﻮﻧﺎﺕ‬
‫ﺍﻟﻜﺮﺏ ﻗﺪ ﺍﺭﺗﻔﻌﺖ ﻭﺃﻥ ﺩﺭﺟﺎﺕ ﺍﻻﺳﺘﺠﺎﺑﺎﺕ ﺍﳌﻨﺎﻋﻴﺔ ﻏﺎﻟﺒﺎ ﻣﺎ ﺗﻨﺨﻔﺾ ﻟﺪﻯ ﺍﻟﺰﻭﺟﺔ ﻭﻟﻴﺲ ﻟﺪﻯ‬
‫ﺍﻟﺰﻭﺝ‪.‬‬

‫ﺠّﻌﺔ ﻟﻌﻼﻗﺎﺕ ﺍﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﺳﻌﺔ ﺃﻭ ﳌﻌﺎﳉﺎﺕ‬

‫ﻭﻋﻠﻰ ﺍﻟﻨﻘﻴﺾ ﻣﻦ ﺫﻟﻚ‪ ،‬ﻓﺈﻥ ﺍﻟﺒﻴﺌﺔ ﺍﻹﳚﺎﺑﻴﺔ ﺍﳌﺸ ﹺ‬
‫ﻧﻔﺴﻴﺔ ﲨﺎﻋﻴﺔ‪ ،‬ﺗﻌﺰﺯ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﳌﻨﺎﻋﻴﺔ ﻭﻣﻘﺎﻭﻣﺔ ﺍﻷﻣﺮﺍﺽ‪ ،‬ﲟﺎ ﰲ ﺫﻟﻚ ﺍﻟﺴﺮﻃﺎﻥ‪ .‬ﻛﻤﺎ ﺃﻥ ﺍﻟﻨﺴﻮﺓ‬
‫ﺻ ْﺒْﻦ ﺑﺴﺮﻃﺎﻥ ﺍﻟﺜﺪﻱ ﻣﺜﻼ ﻭﻳﺘﻠﻘﲔ ﺃﺛﻨﺎﺀ ﺍﳌﺮﺽ ﺗﺸﺠﻴﻌﺎ ﺍﺟﺘﻤﺎﻋﻴﺎ ﺇﳚﺎﺑﻴﺎ ﻗﻮﻳﺎ‪ ،‬ﺗﻜﻮﻥ‬
‫ﺍﻟﻠﻮﺍﰐ ﹸﺃ ‪‬‬
‫ﺃﻋﻤﺎﺭﻫﻢ ﺃﻃﻮﻝ ﺑﺸﻜﻞ ﺑﻴّﻦ ﻣﻦ ﺃﻋﻤﺎﺭ ﻗﺮﻳﻨﺎ‪‬ﻦ ﺍﻟﻠﻮﺍﰐ ﻛﻦ ﳏﺮﻭﻣﺎﺕ ﻣﻦ ﺫﻟﻚ ﺍﻟﺘﺸﺠﻴﻊ‪.‬‬

‫ﻤﻘﺎﺭﺒﺎﺕ ﻋﻼﺠﻴﺔ ﺠﺩﻴﺩﺓ‬

‫ﻭﻟﻘﺮﻭﻥ ﻋﺪﻳﺪﺓ‪ ،‬ﻛﺎﻧﺖ ﺍﳌﻌﺎﳉﺔ ﺍﳌﺘﺎﺣﺔ ﻟﻜﺜﺮﺓ ﻣﻦ ﺍﻷﻣﺮﺍﺽ ﺍﳌﺰﻣﻨﺔ ﺗﺘﻢ ﺣﺼﺮﺍ ﺇﻣﺎ ﰲ ﻣﺼﺢ‬
‫ﺟﺒﻠﻲ ﺃﻭ ﰲ ﻣﻨﺘﺠﻊ ﻟﻠﻤﻴﺎﻩ ﺍﳌﻌﺪﻧﻴﺔ ﺍﳊﺎﺭﺓ‪ .‬ﺑﻴﺪ ﺃﻥ ﺍﻟﻔﻬﻢ ﺍﳌﻌﺎﺻﺮ ﻟﻼﺗﺼﺎﻝ ﺑﲔ ﺍﻟﺪﻣﺎﻍ ﻭﺍﳉﻬﺎﺯ‬
‫ﺍﳌﻨﺎﻋﻲ ﺯﻭّﺩ ﺍﻟﺒﺎﺣﺜﲔ ﺑﺘﻔﺴﲑ ﻓﻴﺰﻳﻮﻟﻮﺟﻲ ﻟﻨﺠﺎﺡ ﻫﺬﻩ ﺍﳌﻌﺎﳉﺎﺕ ﰲ ﺑﻌﺾ ﺍﻷﺣﻴﺎﻥ‪ .‬ﻓﺘﻌ ﹸﻄّﻞ ﺷﺒﻜﺔ‬
‫ﺍﻻﺗﺼﺎﻝ ﻫﺬﻩ ﻳﺆﺩﻱ ﺇﱃ ﺯﻳﺎﺩﺓ ﺍﻻﺳﺘﻌﺪﺍﺩ ﻟﻠﻤﺮﺽ ﻭﳚﻌﻞ ﺳﲑﻭﺭﺓ ﺍﻻﻋﺘﻼﻝ ﺃﺳﻮﺃ‪ .‬ﻛﻤﺎ ﺃﻥ ﺇﺻﺤﺎﺡ‬
‫ﻣﻨﻈﻮﻣﺔ ﺍﻻﺗﺼﺎﻝ ﻫﺬﻩ )ﺳﻮﺍﺀ ﺑﻮﺳﺎﻃﺔ ﻋﻮﺍﻣﻞ ﺩﻭﺍﺋﻴﺔ ﺃﻭ ﲟﺆﺛﺮﺍﺕ ﺍﻻﺭﲣﺎﺀ ﳌﻨﺘﺠﻊ ﻟﻠﻤﻴﺎﻩ ﺍﳌﻌﺪﻧﻴﺔ‬
‫ﺍﳊﺎﺭﺓ( ﺳﻴﺸﻜﻞ ﺍﳋﻄﻮﺓ ﺍﻷﻭﱃ ﻋﻠﻰ ﻃﺮﻳﻖ ﺍﻟﺸﻔﺎﺀ‪.‬‬

‫ﻭﺍﻟﻨﺘﻴﺠﺔ ﺍﻟﻄﺒﻴﻌﻴﺔ ﳍﺬﻩ ﺍﻻﻛﺘﺸﺎﻓﺎﺕ ﻫﻲ ﺃﻧﻪ ﳝﻜﻦ ﺍﺳﺘﻌﻤﺎﻝ ﺍﻟﻌﻘﺎﻗﲑ ﺍﻟﻔﺎﻋﻠﺔ ﻧﻔﺴﻴﺎ ﳌﻌﺎﳉﺔ‬
‫ﺍﻷﻣﺮﺍﺽ ﺍﻻﻟﺘﻬﺎﺑﻴﺔ‪ ،‬ﻭﺃﻥ ﺍﻷﺩﻭﻳﺔ ﺍﻟﱵ ﺗﺆﺛﺮ ﰲ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﻗﺪ ﺗﻜﻮﻥ ﻣﻔﻴﺪﺓ ﰲ ﻣﻌﺎﳉﺔ ﺑﻌﺾ‬
‫ﺍﻻﺿﻄﺮﺍﺑﺎﺕ ﺍﻟﻨﻔﺴﻴﺔ‪ .‬ﻭﺗﺘﻨﺎﻣﻰ ﺍﻷﺩﻟﺔ ﻋﻠﻰ ﺃﻥ ﻧﻈﺮﺗﻨﺎ ﺇﱃ ﺃﻧﻔﺴﻨﺎ ﻭﺇﱃ ﺍﻵﺧﺮﻳﻦ‪ ،‬ﻭﺃﺳﻠﻮﺏ ﺗﻌﺎﻣﻠﻨﺎ‬
‫ﻣﻊ ﺍﻟﻜﺮﺏ‪ ،‬ﻭﻛﺬﻟﻚ ﺗﺮﻛﻴﺒﻨﺎ ﺍﳉﻴﲏ )ﺍﻟﻮﺭﺍﺛﻲ(‪ ،‬ﺗﺆﺛﺮ ﻛ ﹸﻠّﻬﺎ ﰲ ﻓﺎﻋﻠﻴﺔ ﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ‪ .‬ﻭﺑﺎﳌﺜﻞ‪ ،‬ﺗﺘﻮﺍﻓﺮ‬
‫ﺃﺩﻟﺔ ﻗﻮﻳﺔ ﻋﻠﻰ ﺃﻥ ﺍﻷﻣﺮﺍﺽ ﺍﳌﺮﺗﺒﻄﺔ ﺑﺎﻻﻟﺘﻬﺎﺑﺎﺕ ﺍﳌﺰﻣﻨﺔ ﺗﺆﺛﺮ ﺗﺄﺛﲑﺍ ﺑﺎﺭﺯﺍ ﰲ ﻣﺰﺍﺝ ﺍﳌﺮﺀ ﻭﺩﺭﺟﺔ‬
‫ﻗﻠﻘﻪ‪ .‬ﻭﺃﺧﲑﺍ‪ ،‬ﻓﺈﻥ ﻫﺬﻩ ﺍﻻﻛﺘﺸﺎﻓﺎﺕ ﺗﺸﲑ ﺇﱃ ﺃﻥ ﺗﺼﻨﻴﻒ ﺍﻷﻣﺮﺍﺽ ﰲ ﺍﺧﺘﺼﺎﺻﺎﺕ ﻃﺒﻴﺔ ﻭﻧﻔﺴﻴﺔ‪،‬‬
‫ﻭﻛﺬﻟﻚ ﺍﳊﺪﻭﺩ ﺍﻟﱵ ﻭﺿﻌﺖ ﺑﲔ ﺍﻟﻌﻘﻞ ﻭﺍﳉﺴﺪ‪ ،‬ﻫﻲ ﺃﻣﻮﺭ ﻣﺼﻄﻨﻌﺔ ﻟﻴﺲ ﺇﻻ‪.‬‬

‫ﺍﳌﺆﻟﻔﺎﻥ‬
‫‪E. M. Sternberg - Ph. W. Gold‬‬
‫ﻗﺎﻣﺎ ﺑﺒﺤﻮﺛﻬﻤﺎ ﻋﻠﻰ ﺍﻟﻜﺮﺏ ﻭﺍﳉﻬﺎﺯ ﺍﳌﻨﺎﻋﻲ ﰲ ﺍﳌﻌﻬﺪ ﺍﻟﻮﻃﲏ ﻟﻠﺼﺤﺔ ﺍﻟﻌﻘﻠﻴﺔ‪ ،‬ﺣﻴﺚ ﺗﺮﺃﺳﺖ ﺳﺘﺮﻧﱪﮒ ﺷﻌﺒﺔ ﻋﻠﻢ ﺍﻟﻐﺪﺩ ﺍﻟﺼﻤﺎﻭﻳﺔ‬
‫ﺼ ّﻢ ﺍﻟﺴﺮﻳﺮﻱ‪ .‬ﺣﺼﻠﺖ ﺳﺘﺮﻧﱪﮒ ﻋﻠﻰ ﺍﻟﺪﻛﺘﻮﺭﺍﻩ ﰲ ﺍﻟﻄﺐ ﻣﻦ ﺟﺎﻣﻌﺔ ﻣﺎﮔﻴﻞ‪،‬‬
‫ﺍﻟﻌﺼﺒﻴﺔ ﻭﺍﻟﺴﻠﻮﻙ‪ ،‬ﻭﻳﺮﺃﺱ ﮔﻮﻟﺪ ﻓﺮﻉ ﻋﻠﻢ ﺍﻟﻐﺪﺩ ﺍﻟ ُّ‬
‫ﻭﻗﺪ ﺃﺳﻔﺮﺕ ﲝﻮﺛﻬﺎ ﻋﻠﻰ ﺁﻟﻴﺔ ﺍﻻﺗﺼﺎﻝ ﺍﳌﻨﺎﻋﻲ ﺍﻟﻌﺼﱯ ﻭﺃﺳﺎﺳﻬﺎ ﺍﳉﺰﻳﺌﻲ ﻋﻦ ﺗﻨﺎﻣﻲ ﺍﻻﻋﺘﺮﺍﻑ ﺑﺄﳘﻴﺔ ﺍﻟﺘﺂﺛﺮ ﺍﻟﻌﻘﻠﻲ ﺍﳉﺴﺪﻱ‪ .‬ﻛﻤﺎ‬
‫ﳊﻤ‪‬ﻀﺎﺕ ﻟﻠﺘﺮﭘﺘﻮﻓﺎﻥ ﺍﻟﻴﺴﺎﺭﻱ )ﺍﳌﺪﻭﺭ ﻟﻠﻴﺴﺎﺭ( ‪L-‬‬
‫ﺃ‪‬ﺎ ﺗﻌﺪ ﺣﺠﺔ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﲟﺘﻼﺯﻣﺔ ﺍﻷﱂ ﺍﻟﻌﻀﻠﻲ ﺍﻟﻨﺎﺟﻢ ﻋﻦ ﻛﺜﺮﺓ ﺍ ﹶ‬
‫‪ ،eosinophilia myalgia syndrome tryptophan‬ﻫﺬﻩ ﺍﳌﺘﻼﺯﻣﺔ ﺍﻟﱵ ﻛﺎﺩﺕ ﺗﺸﻜﻞ ﻭﺑﺎﺀ )ﺟﺎﺋﺤﺔ(‬
‫ﻋﺎﻡ ‪ .1989‬ﺃﻣﺎ ﮔﻮﻟﺪ‪ ،‬ﻓﺘﻠﻘﻰ ﺗﺪﺭﻳﺒﻪ ﺍﻟﻄﱯ ﰲ ﺟﺎﻣﻌﱵ ﺩﻳﻮﻙ ﻭﻫﺎﺭﭬﺎﺭﺩ‪ ،‬ﻗﺒﻞ ﺃﻥ ﻳﻠﺘﺤﻖ ﻋﺎﻡ ‪ 1989‬ﺑﺎﳌﻌﻬﺪ ﺍﻟﻮﻃﲏ ﻟﻠﺼﺤﺔ‬
‫ﺍﻟﻌﻘﻠﻴﺔ‪ .‬ﻳﻌﺪ ﮔﻮﻟﺪ ﻭﻓﺮﻳﻘﻪ ﻣﻦ ﺍﻷﻭﺍﺋﻞ ﺍﻟﺬﻳﻦ ﻗﺪﻣﻮﺍ ﺑﻴﺎﻧﺎﺕ ﺗﺸﲑ ﺇﱃ ﺗﻮﺭﻁ ﺍﳍﺮﻣﻮﻥ ﺍﶈﺮﺭ ﻟﻠﻤﻮﺟﻬﺔ ﺍﻟﻘﺸﺮﻳﺔ )‪، (CRH‬‬
‫ﻭﺍﳍﺮﻣﻮﻧﺎﺕ ﺍﻷﺧﺮﻯ ﺫﺍﺕ ﺍﻟﺼﻠﺔ ﻬﺑﺬﺍ ﺍﳍﺮﻣﻮﻥ‪ ،‬ﰲ ﺍﻟﻔﻴﺰﻳﻮﻟﻮﺟﻴﺎ ﺍﳌﺮﺿﻴﺔ ﻟﻼﻛﺘﺌﺎﺏ ﺍﻟﺴﻮﺩﺍﻭﻱ ﻭﻟﻼﻛﺘﺌﺎﺏ ﺍﻟﻼﳕﻄﻲ ﻭﰲ ﺁﻟﻴﺎﺕ ﺗﺄﺛﲑ‬
‫ﺍﻟﻌﻘﺎﻗﲑ ﺍﳌﻀﺎﺩﺓ ﻟﻼﻛﺘﺌﺎﺏ‪.‬‬

‫ﻣﺮاﺟﻊ ﻟﻼﺳﺘﺰادة‬
‫‪NEURAL-IMMUNE INTERACTIONS. David L. Felton and Suzanne Y. Felton‬‬
‫‪in Encyclopedia of Human Biology. Academic Press, 1991.‬‬
‫‪THE CONCEPTS OF STRESS AND STRESS SYSTEM DISORDERS. G. P.‬‬
‫‪Chrousos and P. W. Gold in Journal of the American Medical Association, Vol.‬‬
‫‪267, No. 9, pages 1244-1252; March 4, 1992.‬‬
‫‪ENDOCRINE AND IMMUNE FUNCTION. J. K. Kiecolt-Glaser, W. Malarkey,‬‬
‫‪J. T. Cacioppo and R. Glaser in Handbook of Human Stress and Immunity.‬‬
‫‪Edited by R. Glaser and J. K. Kiecolt-Glaser. Academic Press, 1994.‬‬
‫‪STRESS: MECHANISMS AND CLINICAL IMPLICATIONS. G. P.‬‬
‫‪CIIIOUS05, R. McCarty, K. Pacak, G. Cizza, Esiher M. Sternberg, Philip W.‬‬
‫‪Gold and R. Kvetnansky in Annals of the New York Academy of Sciences, Vol.‬‬
‫‪771, 1995.‬‬
‫‪EMOTIONS AND DISEASE: FROM BALANCE OF HUMORS TO BALANCE‬‬
‫‪OF MOLECULES. Esther M. Sternberg in Nature Medicine, Vol. 3, No. 3, pages‬‬
‫‪264-267; March 1997.‬‬
‫‪THE NEUROLOGIC BASIS OF FEVER. Clifford B. Saper and Christopher D.‬‬
Breder in New England Journal o f Medicine, Vol. 330, No. 26, pages 1880-1886;
June 30, 1997.
EMOTIONS AND DISEASE. Catalogue for an Exhibition at the National
Library of Medicine and National Institutes of Health. Edited by Esther M.
Sternberg and Elizabeth Fee. Friends of the National Library of Medicine,
Bethesda Md. May 1997.
National Institutes of Health World Wide Web site for information on emotions
and disease: http://ohrm.od.nih.gov/ose/snapshots/

(*) The Mind-Body Interaction in Disease

.‫ ﺍﻟﻌﻮﺍﻣﻞ ﺍﳌﺴﺒﺒﺔ ﻟﻸﻣﺮﺍﺽ‬:pathogens (1)

.‫ ﺍﻟﺒﻘﺎﺀ ﻋﻠﻰ ﻗﻴﺪ ﺍﳊﻴﺎﺓ‬:survival (2)
‫ ﻭُﺗﺤْﺸﺪ ﻟﻪ ﻭﻇﺎﺋﻒ‬،‫ ﻳﺘﻜﻮﻥ ﻋﻨﺪ ﻣﻮﺍﺟﻬﺔ ﺧﻄﺮ ﻣﻬﺪﺩ ﻟﻠﺤﻴﺎﺓ‬،‫ ﺭﺩ ﻓﻌﻞ ﻏﺮﻳﺰﻱ ﻫﺮﻣﻮﱐ ﻋﺼﱯ‬:fight-or-flight (3)
.‫ﺍﻟﺘﺼﺪﻱ ﻭﺍﻟﻘﺘﺎﻝ ﺃﻭ ﺍﳍﺮﺏ‬
suboptional (4)
cross communication (5)
messengers (6)
feedback (7)
.encode(8)
[30 ‫ ﺹ‬،(1994)9/8 ‫ ﺍﻟﻌﺪﺩﺍﻥ‬،‫ ﳎﻠﺔ ﺍﻟﻌﻠﻮﻡ‬،«‫ »ﺍﺧﺘﺮﺍﻕ ﺍﳊﺎﺟﺰ ﺍﻟﺪﻣﻮﻱ‬:‫( ]ﺍﻧﻈﺮ‬9)
nutrients (10)
.‫ ﳎﻤﻮﻋﺔ ﻣﻦ ﺍﻻﺳﺘﺠﺎﺑﺎﺕ ﺗﺘﻤﻴﺰ ﺑﺎﻟﻜﺮﺏ ﻭﺍﻟﻘﻠﻖ ﻭﺍﻟﺘﺠﻨﺐ ﺍﳊﺬﺭ ﻭﻓﺮﻁ ﺍﻟﻨﻮﻡ ﻭﺍﻟﻮﺳﻦ‬:sickness behavior (11)
peripheral inflammation (12)
.‫ ﺍﻋﺘﻼﻝ ﻳﺘﻤﻴﺰ ﺑﺎﻟﻮﺳﻦ ﻭﺍﻟﺘﻌﺐ ﻭﺍﻻﻛﺘﺌﺎﺏ ﻭﻏﺎﻟﺒﺎ ﻣﺎ ﳛﺪﺙ ﰲ ﺍﻟﺸﺘﺎﺀ‬:seasonal affective disorder (13)
.‫ ﺗﻨﺴﻴﻖ ﻭﻇﺎﺋﻒ ﺍﳉﺰﻳﺌﺎﺕ ﻣﻦ ﻣﻮﺿﻊ ﺗﺮﻛﻴﺒﻬﺎ ﺑﺎﲡﺎﻩ ﺍﻷﻋﻀﺎﺀ ﺍﳌﺴﺘﻔﻌﻠﺔ ﻬﺑﺎ‬:down regulation (14)