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Vagus nerve
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=== Immune system === Because it is a bidirectional nerve, both the [[afferent]] (sensory) and [[efferent]] (motor) branches have important functions: afferent pathways mediate anti-inflammatory responses via the [[HPA axis]] and the release of [[corticosteroid]]s from the [[adrenal gland]]s. Efferents pathways mediate anti-inflammatory processes via direct effects on [[immune system|immune cells]] or through the splenic sympathetic nerve. This system is called the [[cholinergic]] anti-inflammatory pathway (CAP). For example, when the vagus nerve detects pro-[[inflammatory]] [[cytokine]]s such as [[tumor necrosis factor]]-alpha or [[interleukin 1]]-beta, chemoreceptors in the afferent vagus nerve send a signal into the [[brainstem]] that triggers both [[glial cell]] activation within the [[central nervous system]] as well as the general [[innate immune system|innate immune response]], sometimes called the [[sickness response]]. The efferent vagus nerve is responsible for an anti-inflammatory pathway.<ref name="Pavlov2003" /> The vagus nerve speaks directly to the [[immune system]] via the [[neurotransmitter]] [[acetylcholine]].<ref>{{Cite news | url=https://www.sciencedaily.com/releases/2007/10/071024083630.htm | title = Direct Route From The Brain To The Immune System Discovered | last = | first = | date = Oct 24, 2007|work=ScienceDaily|access-date=2018-08-10|archive-url=|archive-date=|language=en}}</ref><ref name="Gallagher2015">{{Cite news | url=http://www3.imperial.ac.uk/newsandeventspggrp/imperialcollege/newssummary/news_24-2-2015-14-16-10 | title = Scientists uncover new role for neurotransmitter that helps fight infection {{!}} Imperial News {{!}} Imperial College London | last =Gallagher | first = Laura | date = Feb 24, 2015 |work=Imperial News|access-date=2018-08-10|archive-url=|archive-date=|language=en-GB}}</ref><ref name="Darby2015">{{Cite journal | last =Darby | first = Matthew | last2 = Schnoeller | first2=Corinna | last3 = Vira | first3 = Alykhan | last4 = Culley | first4 = Fiona | last5 = Bobat | first5 = Saeeda | last6 = Logan | first6 = Erin | last7 = Kirstein | first7 = Frank | last8 = Wess | first8 = JΓΌrgen | last9 = Cunningham | first9 = Adam F | date = 2015-01-28 | title = The M3 Muscarinic Receptor Is Required for Optimal Adaptive Immunity to Helminth and Bacterial Infection|url=http://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1004636|journal=PLOS Pathogens|language=en|volume=11|issue=1| pages = e1004636|doi=10.1371/journal.ppat.1004636|issn=1553-7374|pmc=4309615|pmid=25629518}}</ref> Vagus is thus important for maintaining [[homeostasis]] and preventing an overreactive immune response that can cause major injury or death.<ref name="Pavlov2003">{{Cite journal | last =Pavlov | first = Valentin A | last2 = Wang | first2 = Hong | last3 = Czura | first3 = Christopher J | last4 = Friedman | first4=Steven G | last5 = Tracey | first5 = Kevin J | date = 2003 | title=The Cholinergic Anti-inflammatory Pathway: A Missing Link in Neuroimmunomodulation|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1430829/|journal=Molecular Medicine|volume=9|issue=5-8|pages=125β134|issn=1076-1551|pmid=14571320|via=}}</ref> For example, [[vagus nerve stimulation]] (VNS) is being used experimentally as an adjunct treatment for sepsis,<ref name="Wang2016">{{Cite journal | last =Wang | first = Da-Wei | last2 = Yin | first2=Yi-Mei | last3 = Yao | first3 = Yong-Ming | date = 2016-09-02 | title = Vagal Modulation of the Inflammatory Response in Sepsis|url=https://pubmed.ncbi.nlm.nih.gov/27128144/|journal=International Reviews of Immunology|volume=35|issue=5|pages=415β433|doi=10.3109/08830185.2015.1127369|issn=1563-5244|pmid=27128144}}</ref> which can cause death via a massive [[cytokine storm]].<ref name="Karbian2020">{{Cite journal | last = Karbian | first = Netanel | last2 = Abutbul | first2 = Avraham | last3 = el-Amore | first3 = Raja | last4 = Eliaz | first4 = Ran | last5 = Beeri | first5 = Ronen | last6 = Reicher | first6 = Barak | last7 = Mevorach | first7 = Dror | date = 2020-07-15 | title = Apoptotic cell therapy for cytokine storm associated with acute severe sepsis|url=https://www.nature.com/articles/s41419-020-02748-8|journal=Cell Death & Disease|language=en|volume=11|issue=7|pages=1β14|doi=10.1038/s41419-020-02748-8|issn=2041-4889}}</ref>
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