The cholinergic anti-inflammatory pathway: a missing link in neuroimmunomodulation

Mol Med. 2003 May-Aug;9(5-8):125-34.


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.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Animals
  • Antibody Formation / immunology
  • Brain / drug effects
  • Brain / immunology*
  • Brain / metabolism
  • Cholinergic Agents / pharmacology*
  • Humans
  • Immune System* / drug effects
  • Inflammation / drug therapy
  • Inflammation / immunology
  • Inflammation / metabolism*
  • Neuroimmunomodulation / drug effects
  • Neuroimmunomodulation / immunology
  • Neuroimmunomodulation / physiology*
  • Vagus Nerve / metabolism


  • Cholinergic Agents