The role of the cholinergic anti-inflammatory pathway in autoimmune rheumatic diseases

Scand J Immunol. 2021 Oct;94(4):e13092. doi: 10.1111/sji.13092. Epub 2021 Aug 1.

Abstract

The cholinergic anti-inflammatory pathway (CAP) is a classic neuroimmune pathway, consisting of the vagus nerve, acetylcholine (ACh)-the pivotal neurotransmitter of the vagus nerve-and its receptors. This pathway can activate and regulate the activities of immune cells, inhibit cell proliferation and differentiation, as well as suppress cytokine release, thereby playing an anti-inflammatory role, and widely involved in the occurrence and development of various diseases; recent studies have demonstrated that the CAP may be a new target for the treatment of autoimmune rheumatic diseases. In this review, we will summarize the latest progress with the view of figuring out the role of the cholinergic pathway and how it interacts with inflammatory reactions in several autoimmune rheumatic diseases, and many advances are results from a wide range of experiments performed in vitro and in vivo.

Keywords: acetylcholine; autoimmune rheumatic diseases; nicotinic acetylcholine receptor alpha7 subunit; the cholinergic anti‐inflammatory pathway.

Publication types

  • Review

MeSH terms

  • Acetylcholine / immunology
  • Animals
  • Arthritis, Rheumatoid / etiology
  • Arthritis, Rheumatoid / immunology
  • Autoimmune Diseases / etiology*
  • Autoimmune Diseases / immunology
  • Humans
  • Inflammation / immunology
  • Lupus Erythematosus, Systemic / etiology
  • Lupus Erythematosus, Systemic / immunology
  • Neuroimmunomodulation
  • Osteoarthritis / etiology
  • Osteoarthritis / immunology
  • Receptors, Cholinergic / immunology
  • Rheumatic Diseases / etiology*
  • Rheumatic Diseases / immunology
  • Scleroderma, Systemic / etiology
  • Scleroderma, Systemic / immunology
  • Sjogren's Syndrome / etiology
  • Sjogren's Syndrome / immunology
  • Spondylarthropathies / etiology
  • Spondylarthropathies / immunology
  • Vagus Nerve / immunology

Substances

  • Receptors, Cholinergic
  • Acetylcholine