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Published online before print December 7, 2007

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© by The Society for Leukocyte Biology
Journal of Leukocyte Biology, doi:10.1189/jlb.0607363

Received for publication June 8, 2007.
Revised October 11, 2007.
Accepted for publication October 11, 2007.

Article

From CNI-1493 to the immunological homunculus: physiology of the inflammatory reflex

Feinstein Institute for Medical Research, North Shore-Long Island Jewish Health System, Manhasset, New York, USA

^@ To whom correspondence should be addressed. E-mail: kjtracey{at}nshs.edu.

	Abstract

The inflammatory reflex is a neurophysiological mechanism that regulates the immune system. The efferent branch of the reflex arc or the cholinergic anti-inflammatory pathway involves the vagus nerve, which inhibits inflammation by suppressing cytokine synthesis via release of acetylcholine in organs of the reticuloendothelial system, including spleen, liver, and gastrointestinal tract. Acetylcholine binds to 7 nicotinic acetylcholine receptors expressed by macrophages (and other cytokine-producing cells). Receptor-ligand engagement suppresses proinflammatory cytokines and prevents tissue damage. Herein is a review of some of the experimental studies that define the inflammatory reflex and its anatomic and physiologic components.

Key Words: cytokine • TNF • inflammation • cholinergic anti-inflammatory pathway