Autonomous innervation in renal inflammatory disease-innocent bystander or active modulator?

Increasing evidence suggests a significant interrelation between the autonomic nervous system and the immune system. The kidney is innervated by efferent sympathetic nerves as well as by peptidergic sensory afferent nerve fibers. Inflammation in the kidney may be affected by both types of fibers. Peptidergic "sensory" neurons might play a particularly important role: These fibers can induce local neurogenic inflammation via paracrine effects of their transmitters and evoke increased efferent sympathetic nerve outflow via their projections to the central nervous system. Several reports support the notion that renal innervation does indeed contribute to inflammation and sclerosis in kidney diseases. Hence, receptor antagonists interfering with the interaction of innervation and the immune system may prove useful to mitigate inflammatory processes in the kidney.