Center for Biomedical Science and Center for Bioelectronic Medicine, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York 11030, USA; email:
Annu Rev Immunol. 2018 Apr 26;36:783-812. doi: 10.1146/annurev-immunol-042617-053158.
The nervous system regulates immunity and inflammation. The molecular detection of pathogen fragments, cytokines, and other immune molecules by sensory neurons generates immunoregulatory responses through efferent autonomic neuron signaling. The functional organization of this neural control is based on principles of reflex regulation. Reflexes involving the vagus nerve and other nerves have been therapeutically explored in models of inflammatory and autoimmune conditions, and recently in clinical settings. The brain integrates neuro-immune communication, and brain function is altered in diseases characterized by peripheral immune dysregulation and inflammation. Here we review the anatomical and molecular basis of the neural interface with immunity, focusing on peripheral neural control of immune functions and the role of the brain in the model of the immunological homunculus. Clinical advances stemming from this knowledge within the framework of bioelectronic medicine are also briefly outlined.
神经系统调节免疫和炎症。感觉神经元通过感应病原体片段、细胞因子和其他免疫分子,并通过传出自主神经元信号来产生免疫调节反应。这种神经控制的功能组织基于反射调节的原则。涉及迷走神经和其他神经的反射已在炎症和自身免疫性疾病的模型中进行了治疗探索,最近也在临床环境中进行了探索。大脑整合了神经免疫通讯,并且在以外周免疫失调和炎症为特征的疾病中,大脑功能发生改变。在这里,我们回顾了与免疫的神经接口的解剖学和分子基础,重点介绍了外周神经对免疫功能的控制以及大脑在免疫同形模型中的作用。我们还简要概述了生物电子医学框架内该知识所带来的临床进展。