IntroductionBecause of their crucial role in initiation and control of innate and adaptive immunity, myeloid dendritic cells (DCs) are the preferred target Ag-presenting cells for positive cellular vaccination protocols. 1 During the past decade, ex vivo-generated DCs have been used in immunization approaches for prevention and treatment of cancer and infectious diseases. 2 Current DC-based vaccines focus on the adjuvant effect of proinflammatory mediators, conferring DCs the capability to initiate and bias T-cell immune responses. [3][4][5] However, despite initial promising results, DC-based vaccines do not always elicit potent T-cell immunity. 6 Generation of efficient T-cell immunity using ex vivo-generated DCs requires a critical number of adoptively transferred DCs capable of surviving apoptosis. 7 Indeed, DCs used as cellular vaccines are exposed to proapoptotic stimuli at the injection sites and in tissue-draining lymph nodes (DLNs). 7,8 Accordingly, exposure of DCs to proapoptotic stimuli triggered by lytic infections, ultraviolet B (UVB) irradiation, tumor mediators, and cytotoxic cells results in immune suppression. 9 In addition, interaction of DCs with cells in early apoptosis down-regulates the T cellstimulatory ability of DCs and induces immunological tolerance. [10][11][12][13] Conversely, proinflammatory mediators and growth factors promoting DC survival, including granulocyte macrophagecolony stimulating factor (GM-CSF), 14 prostaglandin E 2 (PG-E 2 ), 15 lipopolysaccharide (LPS), 16 and CCR7 17 and CD40 18 ligands, correlate with enhanced T-cell immunity.The intracellular signaling involved in DC survival is currently being elucidated. Activation through CD40 promotes DC survival by favoring a positive balance of nuclear factor kappa B (NF-B) versus activator protein-1 (AP-1) pathway, 19 whereas GM-CSF, LPS, and PG-E 2 prevent DC apoptosis by signaling via phosphatidylinositol 3-kinase (PI3K) and protein kinase B (referred as Akt). 14,15,20 In contrast, the immune-suppressive drug rapamycin induces DC death by antagonizing GM-CSF signaling via inhibition of the PI3K-Akt signaling cascade. 14,21 Recently, it has become evident that the outcome of the immune response is highly regulated by neuropeptides. The balance between anti-inflammatory and proinflammatory neuropeptides is crucial to maintain the immune privilege of the central nervous system (CNS) and the steady-state condition in peripheral tissues, and altering this delicate balance plays a relevant role in the pathogenesis of chronic inflammatory and autoimmune diseases. [22][23][24][25][26] Proinflammatory neuropeptides such as substance P (SP) favor CD4 ϩ T helper (Th)1 bias and cellular immunity, whereas vasoactive intestinal peptide promotes CD4 ϩ Th2 bias. 27-34 Conversely, calcitonin gene-related peptide and the anti-inflammatory products of proopiomelanocortin cleavage, ␣-melanocyte-stimulating hormone and adrenocorticotropin, are potent suppressors of cellular immunity. 23 The proinflammatory tachykinins SP and hemokinin-1 (HK-1...