Neural aspects of immunomodulation: Focus on the vagus nerve

Inflammation and immunity have been implicated in a wide variety of diseases and disorders ranging from Alzheimer’s disease to cardiovascular disease to hemorrhagic shock. In this review, we will briefly consider the evidence for the neural concomitants of immunomodulation. First, we will briefly review the anatomy and physiology of neural-immune communication. Evidence for the somatotopic organization of the vagus nerve and for pain processes suggests that such an organization may be relevant for the investigation of the neural concomitants of immunity. Then we will provide an overview of what is known from both animal and human studies including neuroimaging and clinical studies. Finally, we will discuss some of the challenges and opportunities in this exciting area of investigation.

Research highlights
► Complex interactions exist among the central nervous system, the endocrine system and the autonomic nervous system.
► We review the evidence for the role of the vagus nerve in immunomodulation.
► Animal and human research suggests an important and clinically relevant role for both the afferent and efferent vagus in neural-immune communication.