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Acetylcholine and the alpha 7 nicotinic receptor: A potential therapeutic target for the treatment of periodontal disease?

Lookup NU author(s): Dr Christopher NileORCiD


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Objectives: The aim of this review is to examine the evidence for a functional cholinergic system operating within the periodontium and determine the evidence for its role in periodontal immunity. Introduction: Acetylcholine can influence the immune system via the 'cholinergic anti-inflammatory pathway'. This pathway is mediated by the vagus nerve which releases acetylcholine to interact with the α7 subunit of the nicotinic acetylcholine receptor (α7nAChR) on proximate immuno-regulatory cells. Activation of the α7nAChR on these cells leads to down-regulated expression of proinflammatory mediators and thus regulates localised inflammatory responses. The role of the vagus nerve in periodontal pathophysiology is currently unknown. However, non-neuronal cells can also release acetylcholine and express the α7nAChR; these include keratinocytes, fibroblasts, T cells, B cells and macrophages. Therefore, by both autocrine and paracrine methods non-neuronal acetylcholine can also be hypothesised to modulate the localised immune response. Methods: A Pubmed database search was performed for studies providing evidence for a functional cholinergic system operating in the periodontium. In addition, literature on the role of the 'cholinergic anti-inflammatory pathway' in modulating the immune response was extrapolated to hypothesise that similar mechanisms of immune regulation occur within the periodontium. Conclusion: The evidence suggests a functional nonneuronal 'cholinergic anti-inflammatory pathway' may operate in the periodontium and that this may be targeted therapeutically to treat periodontal disease. © Springer Basel AG 2012.

Publication metadata

Author(s): Zoheir N, Lappin DF, Nile CJ

Publication type: Review

Publication status: Published

Journal: Inflammation Research

Year: 2012

Volume: 61

Issue: 9

Pages: 915-926

Online publication date: 10/07/2012

ISSN (print): 1023-3830

ISSN (electronic): 1420-908X


DOI: 10.1007/s00011-012-0513-z

PubMed id: 22777144