Neural regulation of inflammation: Pharmacological mechanisms and therapeutic perspectives

During the past three decades, our knowledge about the close relationship and functional integration between the immune system and the nervous system hugely increased, and the relevance of the neuroimmune network in health and disease is now established, providing novel and unanticipated opportunities for the modulation of the immune response by means of conventional neural targets. Primary and secondary lymphoyd organs are extensively innervated by the autonomic nervous system, and cells of adaptive as well as innate immunity express receptors for neurotransmitters and neurohormones, including noradrenaline, adrenaline, acetylcholine and many others, which control critical immune functions. In addition, immune cells themselves may produce and utilize classical neurotransmitters, providing additional complexity to the network but also additional opportunities to develop novel immunomodulating strategies. Neuroimmune pharmacology is a young but rapidly growing discipline, encompassing interdisciplinary research in pharmacology, immunology and neuroscience, offering original therapeutic approaches to investigate the neuroimmune network. The present chapter provides an overview of the main neurotransmitter- operated pathways affecting the immune system, as well as of their clinical and translational potential with regard to major diseases such as multiple sclerosis, cancer and rheumatoid arthritis.