Zouali Moncef
Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404, Taiwan.
Pharmaceuticals (Basel). 2023 Jul 31;16(8):1089. doi: 10.3390/ph16081089.
Continuous dialogue between the immune system and the brain plays a key homeostatic role in various immune responses to environmental cues. Several functions are under the control of the vagus nerve-based inflammatory reflex, a physiological mechanism through which nerve signals regulate immune functions. In the cholinergic anti-inflammatory pathway, the vagus nerve, its pivotal neurotransmitter acetylcholine, together with the corresponding receptors play a key role in modulating the immune response of mammals. Through communications of peripheral nerves with immune cells, it modulates proliferation and differentiation activities of various immune cell subsets. As a result, this pathway represents a potential target for treating autoimmune diseases characterized by overt inflammation and a decrease in vagal tone. Consistently, converging observations made in both animal models and clinical trials revealed that targeting the cholinergic anti-inflammatory pathway using pharmacologic approaches can provide beneficial effects. In parallel, bioelectronic medicine has recently emerged as an alternative approach to managing systemic inflammation. In several studies, nerve electrostimulation was reported to be clinically relevant in reducing chronic inflammation in autoimmune diseases, including rheumatoid arthritis and diabetes. In the future, these new approaches could represent a major therapeutic strategy for autoimmune and inflammatory diseases.
免疫系统与大脑之间的持续对话在各种针对环境线索的免疫反应中发挥着关键的稳态作用。几种功能受基于迷走神经的炎症反射控制，这是一种神经信号调节免疫功能的生理机制。在胆碱能抗炎途径中，迷走神经、其关键神经递质乙酰胆碱以及相应受体在调节哺乳动物免疫反应中起关键作用。通过外周神经与免疫细胞的通讯，它调节各种免疫细胞亚群的增殖和分化活动。因此，该途径代表了治疗以明显炎症和迷走神经张力降低为特征的自身免疫性疾病的潜在靶点。一致地，在动物模型和临床试验中得出的趋同观察结果表明，使用药理学方法靶向胆碱能抗炎途径可产生有益效果。同时，生物电子医学最近已成为管理全身炎症的一种替代方法。在几项研究中，据报道神经电刺激在减少包括类风湿性关节炎和糖尿病在内的自身免疫性疾病的慢性炎症方面具有临床相关性。未来，这些新方法可能代表自身免疫性和炎性疾病的主要治疗策略。
