The pathophysiology of inflammatory bowel disease (IBD) involves immunological, genetic and environmental factors. Through its ability to sense environmental stimuli, the autonomic nervous system plays a key role in the development and persistence of IBD. The vagus nerve (VN), which contains sensory and motor neurons, travels throughout the body to innervate the gut and other visceral organs in the thoracic and abdominopelvic cavities. Recent studies show that the VN has anti-inflammatory effects via the release of acetylcholine, in what is known as the cholinergic anti-inflammatory pathway (CAIP). In the gut immune system, the CAIP is proposed to be activated directly by signals from the gut and indirectly by signals from the liver, which receives gut-derived bioactive substances via the portal vein and senses the status of the gut. The gut–brain axis and liver–brain–gut reflex arc regulate a wide variety of peripheral immune cells to maintain homeostasis in the gut. Therefore, targeting the neural reflex by methods such as VN stimulation is now under investigation for suppressing intestinal inflammation associated with IBD. In this review, we describe the role of the VN in the regulation of intestinal immunity, and we discuss novel therapeutic approaches for IBD that target neuroimmune interactions.

中文翻译：

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迷走神经介导的肠道免疫调节：炎症性肠病的治疗意义

炎症性肠病 (IBD) 的病理生理学涉及免疫学、遗传和环境因素。通过其感知环境刺激的能力，自主神经系统在 IBD 的发展和持续中起关键作用。迷走神经 (VN) 包含感觉神经元和运动神经元，它遍布全身，支配胸腔和腹腔内的肠道和其他内脏器官。最近的研究表明，VN 通过释放乙酰胆碱具有抗炎作用，即所谓的胆碱能抗炎途径 (CAIP)。在肠道免疫系统中，CAIP 被提议直接由来自肠道的信号激活，并由来自肝脏的信号间接激活，肝脏通过门静脉接收来自肠道的生物活性物质并感知肠道的状态。肠-脑轴和肝-脑-肠反射弧调节多种外周免疫细胞以维持肠道内的稳态。因此，目前正在研究通过 VN 刺激等方法靶向神经反射，以抑制与 IBD 相关的肠道炎症。在这篇综述中，我们描述了 VN 在调节肠道免疫中的作用，并讨论了针对神经免疫相互作用的 IBD 新治疗方法。