The sympathetic nervous response in inflammation
Open accessAbstract
Over the past decades evidence has accumulated clearly demonstrating a pivotal role for the sympathetic nervous system (SNS) and its neurotransmitters in regulating inflammation. The first part of this review provides the reader with an overview showing that the interaction of the SNS with the immune system to control inflammation is strongly context-dependent (for example, depending on the activation state of the immune cell or neuro-transmitter concentration). In the second part we focus on autoimmune arthritis as a well investigated example for sympathetically controlled inflammation to show that the SNS and catecholamines play a differential role depending on the time point of ongoing disease. A model will be developed to explain the proinflammatory effects of the SNS in the early phase and the anti-inflammatory effects of catecholamines in the later phase of autoimmune arthritis. In the final part, a conceptual framework is discussed that shows that a major purpose of increased SNS activity is nourishment of a continuously activated immune system at a systemic level using energy-rich fuels (glucose, amino acids, lipids), while uncoupling from central nervous regulation occurs at sites of inflammation by repulsion of sympathetic fibers and local adrenoceptor regulation. This creates zones of ‘permitted local inflammation’. However, if this ‘inflammatory configuration’ persists and is strong, as in autoimmunity, the effects are detrimental because of the resultant chronic catabolic state, leading to cachexia, high blood pressure, insulin resistance, and increased cardiovascular mortality, and so on. Today, the challenge is to translate this conceptual knowledge into clinical benefit.
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Adrenergic signalling can have both anti-inflammatory and pro-inflammatory effects, depending on adrenergic receptor subtype, level of activation of specific cell types, and stage of disease progression.
“Both anti-inflammatory and pro-inflammatory effects of adrenergic signalling have been demonstrated, depending upon the subtype of adrenergic receptors expressed167, the level of activation of specific cell types and the stage of disease progression168.”
From The gut microbiota and the brain–gut–kidney axis in hypertension and chronic kidney disease (2018) · cites this paper as [167]
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The gut microbiota and the brain–gut–kidney axis in hypertension and chronic kidney disease
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- Authors
- Pongratz, G., & Straub, R. H.
- Affiliations
- University Hospital Regensburg (DE)
- Corresponding author
- Pongratz, Georg
- Venue
- Arthritis Research & Therapy
- Published
- 2014-12-12
- Volume
- 16
- Issue
- 6
- Pages
- 504-504
- ISSN
- 1478-6354 (ISSN-L)
- PMC
- PMC4396833
- OpenAlex
- W2128414222
- Cited by
- 427
- References
- 104
- Citations by year
- 2026: 36 · 2025: 57 · 2024: 41 · 2023: 50 · 2022: 50 · 2021: 52 · 2020: 31 · 2019: 35 · 2018: 35 · 2017: 14 · 2016: 21 · 2015: 4 · 2013: 1
- FWCI
- 1.05
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Arthritis Research & Therapy (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Keywords
- sympathetic nervous system, inflammation, autoimmune arthritis, catecholamines, neuroimmune interactions, adrenergic receptors, cachexia, insulin resistance, cardiovascular mortality
- MeSH terms
- Animals, Arthritis, Humans, Inflammation, Sympathetic Nervous System, Autoimmunity, Inflammation Mediators
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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