title: Neural Control of Inflammation: Implications for Perioperative and Critical Care.
abstract: Inflammation and immunity are regulated by neural reflexes. Recent basic science research has demonstrated that a neural reflex, termed the inflammatory reflex, modulates systemic and regional inflammation in a multiplicity of clinical conditions encountered in perioperative medicine and critical care. In this review, the authors describe the anatomic and physiologic basis of the inflammatory reflex and review the evidence implicating this pathway in the modulation of sepsis, ventilator-induced lung injury, postoperative cognitive dysfunction, myocardial ischemia-reperfusion injury, and traumatic hemorrhage. The authors conclude with a discussion of how these new insights might spawn novel therapeutic strategies for the treatment of inflammatory diseases in the context of perioperative and critical care medicine.
authors.affiliation: From the Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada (B.E.S.); Laboratory of Biomedical Science, The Feinstein Institute for Medical Research, Manhasset, New York (B.E.S., P.S.O.); Section for Anesthesiology and Intensive Care Medicine, Department of Physiology and Pharmacology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden (E.S., L.I.E.); Department of Anesthesiology, Duke University, Durham, North Carolina (N.T.); Department of Anesthesia, Surgical Services and Intensive Care, Karolinska University Hospital, Stockholm, Sweden (L.I.E.); and Department of Medicine, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden (E.S., P.S.O.).
authors.forename: Benjamin E
authors.initials: BE
authors.lastname: Steinberg
authors.forename: Eva
authors.initials: E
authors.lastname: Sundman
authors.forename: Niccolo
authors.initials: N
authors.lastname: Terrando
authors.forename: Lars I
authors.initials: LI
authors.lastname: Eriksson
authors.forename: Peder S
authors.initials: PS
authors.lastname: Olofsson
mesh_terms: D000818:Animals; D003422:Critical Care; D006801:Humans; D007249:Inflammation / Q000276:immunology / Q000503:physiopathology*; D009420:Nervous System / Q000276:immunology / Q000503:physiopathology*; D019990:Perioperative Care; D012018:Reflex