title: Acetylcholine and the alpha 7 nicotinic receptor: a potential therapeutic target for the treatment of periodontal disease?
abstract: OBJECTIVE
  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.
  
  
  BACKGROUND
  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 pro-inflammatory 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.
  
  
  CONCLUSIONS
  The evidence suggests a functional non-neuronal 'cholinergic anti-inflammatory pathway' may operate in the periodontium and that this may be targeted therapeutically to treat periodontal disease.
authors: Infection and Immunity Research Group, University of Glasgow Dental School, Level 9, 378 Sauchiehall Street, Glasgow, G2 3JZ, UK.
authors: Noha
authors: N
authors: Zoheir
authors: David F
authors: DF
authors: Lappin
authors: Christopher J
authors: CJ
authors: Nile
mesh_terms: D000109:Acetylcholine / Q000276:immunology / Q000378:metabolism*; D000818:Animals; D006801:Humans; D009538:Nicotine / Q000276:immunology / Q000378:metabolism; D010510:Periodontal Diseases / Q000276:immunology / Q000378:metabolism*; D010519:Periodontium / Q000276:immunology / Q000378:metabolism; D011978:Receptors, Nicotinic / Q000276:immunology / Q000378:metabolism*; D064569:alpha7 Nicotinic Acetylcholine Receptor
chemical_list: C579167:Chrna7 protein, human; D011978:Receptors, Nicotinic; D064569:alpha7 Nicotinic Acetylcholine Receptor; D009538:Nicotine; D000109:Acetylcholine