REVIEW article
Front. Immunol.
Sec. Inflammation
This article is part of the Research TopicExploring Molecular Mechanisms and Therapeutic Strategies for Inflammatory DiseasesView all 3 articles
Cholinergic Reflex Control of Inflammation: Mechanistic and Translational Advances in Transcutaneous auricular vagus nerve stimulation across Rheumatic, Metabolic and Postoperative Disorders
Provisionally accepted
- First Affiliated Hospital of Gannan Medical University, Nanchang, China
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Transcutaneous auricular vagus nerve stimulation (taVNS) has recently emerged as a focal non-invasive neuromodulatory strategy in anti-inflammatory therapeutics. The vagus nerve serves as a critical neuro-immune interface that tonically suppresses pro-inflammatory cytokine release via the cholinergic anti-inflammatory pathway (CAP)[1, 2]. This mechanism confers substantial therapeutic potential across diverse inflammatory disorders and postoperative systemic inflammation. Clinical trials have demonstrated anti-inflammatory efficacy of taVNS, leading to its expanded use in rheumatoid arthritis, systemic lupus erythematosus, gout, inflammatory bowel disease (IBD ), and other immune-mediated disorders. Investigations into postoperative inflammation and metabolic syndrome are now emerging. Herein, we synthesize the anatomical substrate, mechanistic framework, and disease-specific applications of taVNS, emphasizing how stimulation parameters govern therapeutic outcomes. Finally, we outline current challenges and future directions to guide subsequent research.
Keywords: Cholinergic anti-inflammatory pathway, Cytokines, Inflammatory diseases, Neuromodulation, stimulation parameters, taVNS, Vagus Nerve
Received: 09 Sep 2025; Accepted: 12 Dec 2025.
Copyright: © 2025 韩, Song, Liu, Zhuo and Zhong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mao-ling Zhong
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