Cholinergic anti-inflammatory pathway (CAP)

The cholinergic anti-inflammatory pathway (CAP) is a neural circuit linking the central nervous system with peripheral immune regulation. It is the efferent (motor) arm of the inflammatory reflex, relying on the vagus nerve to signal immune cells through the release of acetylcholine. This neurotransmitter then acts on α7 nicotinic acetylcholine receptors on macrophages and other immune cells to inhibit the release of pro-inflammatory cytokines such as TNF and IL-1. CAP serves to regulate the magnitude and duration of the inflammatory response, protecting tissues from the detrimental effects of excessive or systemic inflammation. Components of the pathway, such as α7nAChR, have emerged as potential therapeutic targets, with approaches including pharmacological agonists and vagus nerve stimulation devices under investigation to treat a variety of inflammatory and autoimmune diseases[1][2][3][4][7][8].

Other names

Cholinergic anti-inflammatory reflexCAPInflammatory reflex efferent arm

Activation of the vagus nerve increases acetylcholine release, which binds to α7 nicotinic acetylcholine receptors on macrophages and other immune cells, inhibiting pro-inflammatory cytokine release (e.g., TNF, IL-1). Suppression of systemic inflammation via modulation of neural circuits.