Neuroimmunomodulation of tissue injury and disease: an expanding view of the inflammatory reflex pathway.


Author: Tanaka S1, Hammond B2, Rosin DL3, Okusa MD1

Affiliation: <sup>1</sup>1Division of Nephrology and Center for Immunity, Inflammation and Regenerative Medicine, University of Virginia, Charlottesville, Virginia USA.

<sup>2</sup>Byram Hills High School, Armonk, New York, USA.

<sup>3</sup>3Department of Pharmacology, University of Virginia, Charlottesville, Virginia USA.
Conference/Journal: Bioelectron Med.
Date published: 2019 Aug 13
Other:
 Volume ID: 5   ,  Pages: 13   ,  Special Notes: doi: 10.1186/s42234-019-0029-8. eCollection  2019.   ,  Word Count: 189  
    Neuroimmunomodulation through peripheral nerve activation is an important therapeutic approach to various disorders. Central to this approach is the inflammatory reflex pathway in which the cholinergic anti-inflammatory pathway represents the efferent limb. Recent studies provide a framework for understanding this control pathway, however our understanding remains incomplete. Genetically modified mice, using optogenetics and pharmacogenomics, have been invaluable resources that will allow investigators to disentangle neural pathways that provide a unifying mechanism by which vagal nerve stimulation (and other means of stimulating the pathway) leads to an anti-inflammatory and tissue protective effect. In this review we describe disease models that contribute to our understanding of how vagal nerve stimulation attenuates inflammation and organ injury: acute kidney injury, rheumatoid arthritis, and inflammatory gastrointestinal disease. The gut microbiota contributes to health and disease and the potential role of the vagus nerve in affecting the relationship between gut microbiota and the immune system and modifying diseases remains an intriguing opportunity to attenuate local and systemic inflammation that undergird disease processes.



© The Author(s) 2019.



KEYWORDS: Acute kidney injury; Cholinergic anti-inflammatory pathway; Colitis; Gut microbiota; Rheumatoid arthritis



PMID: 32232102 PMCID: PMC7098254 DOI: 10.1186/s42234-019-0029-8