Autonomic neural regulation of immunity

CZURA, C. J.; TRACEY, K. J.

doi:10.1111/j.1365-2796.2004.01442.x

Cited by 255Vagus Nerve Stimulation ResearchHeart Rate Variability and Autonomic ControlNeuropeptides and Animal Physiology

Autonomic neural regulation of immunity

CZURA, C. J., TRACEY, K. J.·2005·Journal of Internal Medicine

DOI 10.1111/j.1365-2796.2004.01442.x

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Abstract

The 'cytokine theory of disease' states that an overproduction of cytokines can cause the clinical manifestations of disease. Much effort has been expended to determine how cytokines are regulated in normal health. Transcriptional, translational and other molecular control mechanisms protect the host from excessive cytokine production. A recent discovery revealed an unexpected pathway that inhibits macrophage cytokine production. The inflammatory reflex is a physiological pathway in which the autonomic nervous system detects the presence of inflammatory stimuli and modulates cytokine production. Afferent signals to the brain are transmitted via the vagus nerve, which activates a reflex response that culminates in efferent vagus nerve signalling. Termed the 'cholinergic anti-inflammatory pathway', efferent activity in the vagus nerve releases acetylcholine (ACh) in the vicinity of macrophages within the reticuloendothelial system. ACh can interact specifically with macrophage alpha7 subunits of nicotinic ACh receptors, leading to cellular deactivation and inhibition of cytokine release. This 'hard-wired' connection between the nervous and immune systems can be harnessed therapeutically in animal models of inflammatory disease, via direct electrical stimulation of the vagus nerve, or through the use of cholinergic agonists that specifically activate the macrophage alpha7 subunit of the ACh receptor. Autonomic dysfunction has been associated with human inflammatory diseases including rheumatoid arthritis, diabetes and sepsis; whether this dysfunction results from the inflammatory component of these diseases, or is actually an underlying cause, is now less clear. The description of the cholinergic anti-inflammatory now brings to the fore several new therapeutic strategies for inflammatory disease, and suggests that many of these diseases may actually be diseases of autonomic dysfunction.

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There are increased rates of cardiac disease, depression and anxiety, sleep disturbances, skin and reproductive cancers, and hearing loss in this population.
“There are also increased rates of cardiac disease, depression and anxiety (Pinkerton et al., 2012), sleep disturbances, skin and reproductive cancers and hearing loss (Czura, 2005; McNeely et al., 2014).”
From Effectiveness of a Novel Qigong Meditative Movement Practice for Impaired Health in Flight Attendants Exposed to Second-Hand Cigarette Smoke (2017) · cites this paper as Czura, 2005

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Authors: CZURA, C. J., & TRACEY, K. J.
Affiliations: Northwell Health (US)
Corresponding author: CZURA, C. J.
ORCID: CZURA, C. J.
TRACEY, K. J.
Venue: Journal of Internal Medicine
Publisher: Wiley
Published: 2005-01-17
Volume: 257
Issue: 2
Pages: 156-166
ISSN: 0954-6820 (ISSN-L)
1365-2796
DOI: 10.1111/j.1365-2796.2004.01442.x
OpenAlex: W1991458707
Cited by: 255
References: 78
Citations by year: 2026: 2 · 2025: 7 · 2024: 8 · 2023: 6 · 2022: 7 · 2021: 5 · 2020: 3 · 2019: 16 · 2018: 9 · 2017: 4 · 2016: 11 · 2015: 10 · 2014: 17 · 2013: 20 · 2012: 11
FWCI: 14.09
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Journal of Internal Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuropeptides and Animal Physiology
Keywords: cholinergic anti-inflammatory pathway, vagus nerve, autonomic nervous system, cytokine regulation, acetylcholine, neuroimmune interactions, vagus nerve stimulation, cholinergic agonists, rheumatoid arthritis, diabetes mellitus, sepsis, autonomic dysfunction
MeSH terms: Autonomic Nervous System, Humans, Inflammation, Models, Neurological, Reflex, Neuroimmunomodulation, Cytokines

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Autonomic neural regulation of immunity

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