Acetylcholine

Definition

A neurotransmitter used by the vagus nerve and other neural pathways to transmit signals between nerve cells and target tissues. In the context of inflammation, it is the key signaling molecule of the cholinergic anti-inflammatory pathway.

How acetylcholine works in the nervous system

Acetylcholine (ACh) functions across both the central and peripheral nervous systems. In the peripheral nervous system, it mediates signaling at neuromuscular junctions and between nerves and organ cells. Within the autonomic nervous system, it is the primary transmitter of the parasympathetic nervous system — including the vagus nerve.

Two major receptor families respond to acetylcholine: muscarinic receptors (found in smooth muscle and glands) and nicotinic receptors (found in skeletal muscle and certain immune cells). In the context of the inflammatory reflex, it is the nicotinic subtype — specifically α7 nAChR on macrophages and additional cells — that mediates the anti-inflammatory effect.

The Discovery of the Inflammatory Reflex

Reviewed by

Ulf Andersson

Professor of Pediatric Rheumatology, Karolinska Institutet

Worked at Karolinska for five decades as a clinician and a basic scientist focusing on inflammation. Co-discoverer of HMGB1 as the prototype alarmin molecule. Honorary doctor at Hofstra University in New York. Highly Cited Clarivate Researcher Web of Science awards.

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