The autonomic nervous system as a communication channel between the brain and the immune system.

Much evidence from various fields has revealed multiple channels of communication between the brain and the immune system. Among the routes of signal transmission, this review focuses on the roles and mechanisms of neural communication between the two systems. As for the centrifugal neural pathway by which the brain modulates immunity, there are various requirements for the noradrenergic sympathetic innervation of the primary and secondary lymphoid organs. In addition to the presence of beta- and alpha-adrenergic receptors on different types of immunocompetent cells, histological studies have demonstrated direct contact between tyrosine-hydroxylase-positive nerve terminals and lymphocytes in the spleen and thymus. The exposure of lymphocytes and macrophages to adrenergic agonists in vitro modulates their functions. A surgical or chemical sympathectomy is known to alter the immune responses in rodents. Recent data from the rat show that stress-induced immunosuppression is only slightly affected, if at all, by hypophysectomy or adrenalectomy, whereas it is largely dependent on sympathetic innervation. The splenic sympathetic nerve alters the firing rate by an ablation or stimulation of the hypothalamus, the administration of cytokines or neuropeptides, and an exposure to stress. Furthermore, such procedures provoke the increase in the release of noradrenaline in the rat spleen as assessed by in vivo microdialysis. The altered activities of the splenic sympathetic nerves mentioned above have been found to be causally related to the alteration in immunological responses including natural killer cytotoxicity. The splenic sympathetic nerve may thus constitute a communication channel that mediates central modulation of peripheral cellular immunity. Although the roles and mechanisms of parasympathetic control of lymphoid organs still remain obscure, recent data suggest that the thymic vagal efferent nerve may be involved in central modulation of immunity. Finally, electrophysiological studies have shown that hepatic vagal afferents may be one of the pathways through which blood-borne cytokines signal the brain.