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.
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.