Reflex control of immunity

Nat Rev Immunol. 2009 Jun;9(6):418-28. doi: 10.1038/nri2566.


Inflammation can cause damage and even death. What controls this primitive and potentially lethal innate immune response to injury and infection? Molecular and neurophysiological studies during the past decade have revealed a pivotal answer: immunity is coordinated by neural circuits that operate reflexively. The afferent arc of the reflex consists of nerves that sense injury and infection. This activates efferent neural circuits, including the cholinergic anti-inflammatory pathway, that modulate immune responses and the progression of inflammatory diseases. It might be possible to develop therapeutics that target neural networks for the treatment of inflammatory disorders.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Cardiovascular Physiological Phenomena
  • Catecholamines / immunology
  • Catecholamines / metabolism
  • Efferent Pathways / immunology
  • Efferent Pathways / physiology*
  • Homeostasis / immunology
  • Homeostasis / physiology
  • Humans
  • Hypertension / immunology
  • Hypertension / metabolism
  • Immunity, Innate*
  • Inflammation / immunology*
  • Inflammation / metabolism
  • Neuroimmunomodulation / immunology
  • Neuroimmunomodulation / physiology*
  • Receptors, Cholinergic / immunology*
  • Receptors, Cholinergic / metabolism
  • Reflex / immunology*


  • Catecholamines
  • Receptors, Cholinergic