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ISRN Gastroenterology
Volume 2013 (2013), Article ID 630159, 17 pages
Review Article

The Gut’s Little Brain in Control of Intestinal Immunity

Tytgat Institute for Gastrointestinal and Liver Research, Department of Gastroenterology, Academic Medical Centre, Meibergdreef 69, 1105 NH Amsterdam, The Netherlands

Received 24 December 2012; Accepted 12 January 2013

Academic Editors: M. Candelli, N. Figura, M. Kairaluoma, H. Kuwano, S. C. Shih, and H. Shimoda

Copyright © 2013 Wouter J. de Jonge. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The gut immune system shares many mediators and receptors with the autonomic nervous system. Good examples thereof are the parasympathetic (vagal) and sympathetic neurotransmitters, for which many immune cell types in a gut context express receptors or enzymes required for their synthesis. For some of these the relevance for immune regulation has been recently defined. Earlier and more recent studies in neuroscience and immunology have indicated the anatomical and cellular basis for bidirectional interactions between the nervous and immune systems. Sympathetic immune modulation is well described earlier, and in the last decade the parasympathetic vagal nerve has been put forward as an integral part of an immune regulation network via its release of Ach, a system coined “the cholinergic anti-inflammatory reflex.” A prototypical example is the inflammatory reflex, comprised of an afferent arm that senses inflammation and an efferent arm: the cholinergic anti-inflammatory pathway, that inhibits innate immune responses. In this paper, the current understanding of how innate mucosal immunity can be influenced by the neuronal system is summarized, and cell types and receptors involved in this interaction will be highlighted. Focus will be given on the direct neuronal regulatory mechanisms, as well as current advances regarding the role of microbes in modulating communication in the gut-brain axis.