Article

The Cholinergic Anti-inflammatory Pathway: A Missing Link in Neuroimmunomodulation

Laboratory of Biomedical Science, North Shore LIJ-Research Institute, Manhasset, NY 11030, USA.
Molecular Medicine (Impact Factor: 4.82). 05/2003; 9(5-8):125-34.
Source: PubMed

ABSTRACT This review outlines the mechanisms underlying the interaction between the nervous and immune systems of the host in response to an immune challenge. The main focus is the cholinergic anti-inflammatory pathway, which we recently described as a novel function of the efferent vagus nerve. This pathway plays a critical role in controlling the inflammatory response through interaction with peripheral a7 subunit-containing nicotinic acetylcholine receptors expressed on macrophages. We describe the modulation of systemic and local inflammation by the cholinergic anti-inflammatory pathway and its function as an interface between the brain and the immune system. The clinical implications of this novel mechanism also are discussed.

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    • "The afferent and efferent limbs of the vagus nerve constitute the cholinergic antiinflammatory pathway (Pavlov et al., 2003; Tracey, 2002) which acts as an interface "
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    • "Because the penetration of systemic MLA to the CNS is negligible (Medhurst et al., 2008; Turek et al., 1995), these findings suggest that the vagus nerve mediates this effect from the spinal cord to the periphery with the involvement of α7 nAChRs. This is consistent with the inhibitory effect of the distal vagus nerve, on the cytokine response in the inflamed hind paw (Borovikova et al., 2000; Pavlov et al., 2003) and with the presence of α7 nAChRs on peripheral immune cells. The activation of α7 nAChRs is a well-documented mechanism for the suppression of inflammatory and neuropathic pain (Loram et al., 2012; Medhurst et al., 2008). "
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