Medicinal nicotine in COVID-19 acute respiratory distress syndrome, the new corticosteroid

Figure 3 Efferent limb of the inflammatory reflex. Signal from the dorsal nuclei of vagus is transmitted via cholinergic fibers of the vagus nerve to the celiac ganglion. Noradrenergic neurons from the celiac ganglion via the splenic nerve innervate the spleen. Choline-acetyltransferase positive T cells that reside in the spleen express β-2 adrenergic receptors. Activation of this receptor causes the release of Acetylcholine which binds to the α-7 nicotinic acetylcholinergic receptor on splenic macrophages causing the inhibition of NF-kappa β pathway and upregulation of STAT3, ultimately suppressing inflammation[16,23].