Reflex control of immunity

Work in the past decade has revealed the role of neural circuits in modulating inflammatory conditions. Here, Kevin Tracey discusses the inflammatory reflex, and in particular the efferent arc of this reflex, which is known as the cholinergic anti-inflammatory pathway. In this pathway, acetylcholine activity suppresses the release of pro-inflammatory cytokines. 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.