Cholinergic control of inflammation in cardiovascular diseases.

A neuroimmunological reflexive signaling pathway with potent anti-inflammatory capacity has been discovered recently. Within this so called cholinergic anti-inflammatory pathway the vagus nerve plays a central role in both signal integration and signal output, by measuring and influencing levels of circulating pro-inflammatory cytokines. Our group has recently shown that parasympathomimetic stimulation of the vagus nerve has the potential to inhibit inflammatory processes in experimental autoimmune myocarditis. Although vagus nerve stimulation has been shown to be protective in several inflammatory diseases, its potential as a therapeutic strategy has not been studied extensively in clinical settings. In this review we will discuss general molecular mechanisms of the cholinergic anti-inflammatory pathway with emphasis on autoimmune myocarditis. Furthermore, clinical and experimental studies that investigate the role of vagus nerve stimulation in cardiovascular diseases will be discussed.