The interface between cholinergic pathways and the immune system and its relevance to arthritis.

The interface between cholinergic pathways and the immune system and its relevance to arthritis.
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DOI:
10.1186/s13075-015-0597-2
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发表时间:
2015-03-31
影响因子:
4.9
通讯作者:
Hamilton JA
Hamilton JA
中科院分区:
医学2区
文献类型:
--
作者:
McAllen RM;Cook AD;Khiew HW;Martelli D;Hamilton JA

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神经和免疫系统可能在关节炎中相互作用,可能涉及神经和非神经胆碱能传递。中枢作用的毒蕈碱激动剂、迷走神经的电刺激和烟碱受体激动剂的治疗都可以全身性地起作用以减少炎症,尽管负责的途径还不完全清楚。虽然这种“胆碱能抗炎通路”被广泛认为是控制炎症的重要病理生理机制,但支持这一观点的证据被严格审查并被认为是不确定的;涉及通过交感神经的替代通路。本文还讨论了胆碱能途径,神经和非神经,可能会影响炎症,特别是关节炎。据报道,尼古丁激动剂可降低小鼠关节炎的发病率和严重程度,尽管我们无法证实这一观察结果,并且已提出和/或正在进行类风湿性关节炎的临床研究。虽然烟碱受体激动剂和迷走神经刺激的治疗潜力是明确的,我们认为,“胆碱能抗炎通路”不应该不加批判地接受作为一个重要因素,类风湿关节炎的发病机制。
The nervous and immune systems are likely to be interacting in arthritis, with the possible involvement of both neural and non-neural cholinergic transmission. Centrally acting muscarinic agonists, electrical stimulation of the vagus and treatment with nicotinic receptor agonists can all act systemically to reduce inflammation, although the responsible pathways are incompletely understood. While this ‘cholinergic anti-inflammatory pathway’ is widely viewed as a significant pathophysiological mechanism controlling inflammation, the evidence supporting this view is critically reviewed and considered inconclusive; an alternative pathway via sympathetic nerves is implicated. This review also discusses how cholinergic pathways, both neural and non-neural, may impact on inflammation and specifically arthritis. Nicotinic agonists have been reported to reduce the incidence and severity of murine arthritis, albeit an observation we could not confirm, and clinical studies in rheumatoid arthritis have been proposed and/or are underway. While the therapeutic potential of nicotinic agonists and vagal stimulation is clear, we suggest that the ‘cholinergic anti-inflammatory pathway’ should not be uncritically embraced as a significant factor in the pathogenesis of rheumatoid arthritis.
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