Neurogenic regulation of dendritic cells in the intestine

Vasoactive intestinal peptide (VIP), norepinephrine (NE), and acetylcholine (ACh) released by the enteric nervous system can tolerize dendritic cells in the gut. Antigen presenting cells like dendritic cells (DC) are responsible for the initiation of adaptive immune responses via the T helper cells they activate. The type of T cell responses DC induce is dependant on the local immunological environment where antigen has been taken up. In the gut, resident DC are phenotypically and functionally shaped by epithelial and stromal cell derived signals, the cytokine microenvironment, and neuronal products. These factors can control the activation state of DC thereby inducing tolerance for food and commensal organisms or immunity against pathogenic microbes. The enteric nervous system (ENS) is increasingly recognized as an important regulatory factor in intestinal immune cell control. Neurotransmitters and neuropeptides like acetylcholine (ACh), norepinephrine (NE) and vasoactive intestinal peptide (VIP) are released by neurons of the ENS and can affect the function of DC and subsequent immune responses. The critical balance between tolerance and protective immunity is disrupted in inflammatory bowel disease, which results in an exaggerated immune response against commensal bacteria. In this review we discuss the effects of ACh, VIP, and NE on DC function. DC express various receptors for these neuron derived products and can alter DC co-stimulatory molecule expression, cytokine release and subsequent T cell activation in an anti-inflammatory fashion. Knowledge about these interactions will help find new drug targets and may facilitate the development of specific therapies for diseases like inflammatory bowel disease (IBD).