INTEGRATED HORMONAL-IMMUNOLOGICAL-VASCULAR (H-I-V TRIAD) SYSTEMS INTERACTIONS IN THE RHEUMATIC DISEASES

An expanded paradigm far the diffuse rheumatic diseases is presented w hich focuses upon the integrated interactions of hormonal, immunologic al and vascular systems, i.e. the ''H-I-V'' triad. The reciprocal inte ractions between the (neuro)hormonal and immunological systems are inc reasingly recognized in experimental models and human examples of thes e diseases. Other important two-way interactions, e.g. between the hor monal and vascular systems are also believed to be operating, but are relatively unexplored at present. An overview of the triad interaction s between these vital regulatory systems of the body is offered. These interactions are further influenced by their relationships to broader genetic controls, physiological modulators, and environmental influen ces. Earlier physiopathogenic stages of these evolving rheumatic disor ders need to be understood, if prevention and optimal healing are to b e achieved in the future.