The cholinergic anti-inflammatory pathway: A critical review

Abstract

From a critical review of the evidence on the cholinergic anti-inflammatory pathway and its mode of action, the following conclusions were reached.(1) Both local and systemic inflammation may be suppressed by electrical stimulation of the peripheral cut end of either vagus.(2) The spleen mediates most of the systemic inflammatory response (measured by TNF-α production) to systemic endotoxin and is also the site where that response is suppressed by vagal stimulation.(3) The anti-inflammatory effect of vagal stimulation depends on the presence of noradrenaline-containing nerve terminals in the spleen.(4) There is no disynaptic connection from the vagus to the spleen via the splenic sympathetic..