Neurotransmitters as regulators of autoimmunity: mechanisms and translational targeting

Autoimmune diseases arise from sustained breakdown of immune tolerance, chronic activation of innate and adaptive immune responses, and progressive tissue damage. Although cytokines, antigen receptor signaling, and genetic susceptibility have traditionally been considered the principal drivers, increasing evidence demonstrates that neurotransmitters have an underappreciated role in the pathogenesis of autoimmune diseases. The neuroimmune interactions link neural activity, psychological stress, and tissue innervation to autoimmune disease development, progression, and relapse. In this review, we integrate current mechanistic studies demonstrating how neurotransmitters regulate innate and adaptive immune responses and discuss their role in autoimmune diseases.