The inflammatory reflex. The prototypical reflex circuit regulating immunity is comprised of afferent and efferent signals transmitted in the vagus nerve in response to the molecular products of infection and injury, including cytokines, eicosanoids, DAMPs, and PAMPs. The activation of adrenergic neurons in the spleen culminates in the release of norepinephrine in the vicinity of T cells that are capable of secreting acetylcholine. Acetylcholine crosses the marginal zone and enters the red pulp, where it interacts with α7 nAChR expressed on cytokine producing macrophages. α7 nAChR signal transduction suppresses the synthesis and release of TNF, IL-1, IL-18, HMGB1, and other cytokines.