Combined Treatment with Anisodamine and Neostigmine Inhibits Joint Inflammation in Collagen‐Induced Arthritis Mice

Rheumatoid arthritis (RA) is a complicated and treatment refractory autoimmune disease that is characterized by a chronic inflammatory infiltration of immune cells 1. The central nervous system plays an important role in limiting inflammatory responses via an inflammatory reflex of the vagus nerve termed as “the cholinergic antiinflammatory pathway” 2. Acetylcholine, the principal neurotransmitter of the vagus nerve, interacts with α7 nicotinic acetylcholine receptor (α7nAChR) expressed on macrophages and other cells and could inhibit the production of proinflammatory cytokines such as TNFα, interleukin (IL)-1β, and IL-6. Decreased level of vagus nerve activity is correlated with increased serum concentration of late-phase inflammation cytokine high-mobility group box chromosomal protein 1 in patients with RA. Stimulation of nicotinic acetylcholine receptors attenuates collagen-induced arthritis (CIA) in mice. Lack of α7nAChR aggravates the development of CIA 3.