• C Cailotto, L M M Costes, J van der Vliet, S H W van Bree, J J van Heerikhuize, R M Buijs, and G E Boeckxstaens.
• Department of Gastroenterology, Tytgat Institute for Liver and Intestinal Research, Academic Medical Center (AMC), Amsterdam, The Netherlands.
• Neurogastroenterol. Motil. 2012 Feb 1; 24 (2): 191-200, e93.

BackgroundThe cholinergic anti-inflammatory pathway is proposed to be part of the so-called vago-vagal 'inflammatory reflex'. The aim of this study is to provide neuro-anatomical evidence to support the existence of a functional neuronal circuit and its activation in response to intestinal inflammation.MethodsThe expression of c-fos was evaluated at different levels of the neurocircuitry in the course of postoperative ileus (POI) in a mouse model. Specific activation of the motor neurons innervating the inflamed intestine and the spleen was monitored by retrograde tracing using cholera toxin-b. The role of the vagal afferent pathway nerve was evaluated by selective vagal denervation of the intestine.Key ResultsAbdominal surgery resulted in subtle inflammation of the manipulated intestine at 24 h (late phase), but not after 2 and 6 h (early) after surgery. This local inflammation was associated with activation of neurons in the nucleus of the solitary tract and in the dorsal nucleus of the vagus. The vagal output mainly targeted the inflamed zone: 42% of motor neurons innervating the intestine expressed c-fos IR in contrast to 7% of those innervating the spleen. Vagal denervation of the intestine abolished c-fos expression in the brain nuclei involved in the neuronal network activated by intestinal inflammation.Conclusions & InferencesOur data demonstrate that intestinal inflammation triggers a vagally mediated circuit leading mainly to activation of vagal motor neurons connected to the inflamed intestine. These findings for the first time provide neuro-anatomical evidence for the existence of the endogenous 'inflammatory reflex' and its activation during inflammation.© 2011 Blackwell Publishing Ltd.

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