Spikeotherapeutics: the Cholinergic Anti-inflammatory Pathway, the Vagus Nerve and Dysautonomia: is Nicotine an answer?
Main Article Content
Abstract
Severe COVID-19 is characterised by immune dysregulation and a highly inflammatory cytokine storm with symptoms of dysautonomia. It has been proposed that this is at least partially a result of dysregulation of the cholinergic anti-inflammatory pathway and that nicotine may be a useful therapeutic intervention. Post Acute COVID Syndrome (also known as ‘Long COVID’) and Post COVID Vaccination Syndrome are being increasingly recognised and are also characterised by prominent inflammatory markers and dysautonomia. A narrative review of the literature found the actions of the cholinergic system are profoundly anti-inflammatory and act via the α7nACh receptors. The spike protein has been demonstrated to contain an amino acid sequence near the Receptor Binding Domain that has homology with a-1 neurotoxins and is demonstrated in silico to interact with α7nACh, impairing the cholinergic anti-inflammatory system. Nicotine has been proposed as having a possible therapeutic role in mitigating this effect. However, its place is limited due to widespread nicotine actions and significant adverse effects in chronic dosing. Other potential therapeutic interventions addressing background chronic sympathetic nervous system activation and dysautonomia are therefore considered for modulation of the cholinergic system in the management of Post Acute COVID Syndrome/ Post Acute COVID Vaccination Syndrome in the stead of nicotine.
Keywords:
Cholinergic Anti-inflammatory Pathway, nicotine, sympathetic activation, dysautonomia, spike protein, a-1 neurotoxin, spikeopathy, anticholinesterases, vagal nerve stimulation
Article Details
How to Cite
COSFORD, Robyn.
Spikeotherapeutics: the Cholinergic Anti-inflammatory Pathway, the Vagus Nerve and Dysautonomia: is Nicotine an answer?.
Medical Research Archives, [S.l.], v. 13, n. 6, june 2025.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/6530>. Date accessed: 17 july 2025.
doi: https://doi.org/10.18103/mra.v13i6.6530.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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