Neuroimmune system-mediated renal protection mechanisms

Abstract

The autonomic nervous system plays an important role in maintaining homeostasis in organisms. Recent studies have shown that it also controls inflammation by directly altering the function of the immune system. The cholinergic anti-inflammatory pathway (CAP) is one of the neural circuits operating through the vagus nerve. Acetylcholine released from the terminal of the vagus nerve, which is a parasympathetic nerve, acts on the α7 nicotinic acetylcholine receptor of macrophages and reduces inflammation in the body. Previous animal studies demonstrated that vagus nerve stimulation reduced renal ischemia–reperfusion injury. Furthermore, restraint stress and pulsed ultrasound had similar protective effects against kidney injury, which were mainly thought to be mediated by the CAP. Using optogenetics, which can stimulate specific nerves, it was also revealed that activation of the CAP by restraint stress was mediated by C1 neurons in the medulla oblongata. Nevertheless, there still remain many unclear points regarding the role of the nervous and immune systems in controlling renal diseases, and further research is needed.

Ropivacaine with intraspinal administration alleviates preeclampsia-induced kidney injury via glycocalyx /alpha 7 nicotinic acetylcholine receptor pathway

“…Moreover, the ischemia-reperfusion (I/R) injury induced upregulated expression of α7nAChR in the endothelium of cortical peritubular capillaries of kidney, which could be suppressed by nicotine to improve the outcome after renal I/R injury [ 30 ]. It was reported in another study that α7nAChR in macrophages was activated by acetylcholine released from the vagus nerve subjected to stimulation, while vagus nerve stimulation reduced renal I/R injury [ 31 ]. α7nAChR could be activated by Dexmedetomidine to effectively alleviate Lipopolysaccharide-induced kidney injury in mice [ 32 ].…”

Application of Electrolyzed Hydrogen Water for Management of Chronic Kidney Disease and Dialysis Treatment—Perspective View

“…On the other hand, inhalation of H 2 has been reported to ameliorate hypertension, implying involvement of changes in the balance of the sympathetic and parasympathetic nervous systems [87]. Considering the reported ability of parasympathetic nerve stimulation to suppress acute renal injury [88], it may be possible to hypothesize an influence of H 2 on the autonomic nervous system balance in the mechanism of inhibiting renal injury in CKD rats.…”

Targeting immunometabolism during cardiorenal injury: roles of conventional and alternative macrophage metabolic fuels

“…Recent evidence suggests that the CNS may also play an important role in modulating macrophage activation. The autonomic nervous system regulates immune responses via sympathetic and parasympathetic inputs to the spleen and bone marrow, ( Baez-Pagan et al, 2015 ; Rocha-Resende et al, 2021 ), as well as inflammatory responses during cardiac and renal injury ( Inoue, 2021 ; Rocha-Resende et al, 2021 ). In general, sympathetic activation leading to release of norepinephrine modulates macrophage phenotypes via activation of alpha-adrenergic receptors, which promotes M1 phenotypes, while activation of beta-adrenergic receptors promotes M2 phenotyptes, although there are some exceptions ( Freire et al, 2022 ).…”

“…However, the direct involvement of α7nAChR in macrophages in cardiac protection is still unclear. Stimulation of the vagus nerve also attenuates renal dysfunction and injury after acute kidney injury induced by bilateral ischemia/reperfusion ( Inoue et al, 2016 ; Inoue, 2021 ). During CKD, chronic sympathetic activation overrides the cholinergic anti-inflammatory system, leading to chronic inflammation which may worsen renal injury ( Hilderman and Bruchfeld, 2020 ).…”