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Neuromodulation of this signaling using artificial neural activation and\/or suppression is a potential treatment for diseases and disorders. We here review neural signaling regulating the immune system, with a special focus on the gateway reflex. The gateway reflex is a novel neuro-immune crosstalk mechanism that regulates tissue-specific inflammatory diseases. We have discovered six gateway reflexes so far; all are induced by environmental or artificial stimulations including gravity, electrical stimulation, pain sensation, stress, light, and inflammation in joints. In the presence of increased autoreactive T cells in the blood, such stimulation activates specific neural signaling to release noradrenaline (NA) from the nerve endings at specific blood vessels in the central nervous system. NA activates the interleukin-6 (IL-6) amplifier, which leads to the hyper-activation of nuclear factor-kappa B (NF-\u03baB) in non-immune cells, resulting in the formation of a gateway. This gateway allows autoreactive T cells and other immune cells to accumulate in the target tissue to induce inflammatory diseases. In gateway reflexes induced by stress or remote inflammation, adenosine triphosphate (ATP) secreted from inflammation sites activates specific neural pathways, resulting in organ dysfunction and inflammation in other tissues, suggesting that the gateway reflex regulates tissue-specific inflammatory diseases by bidirectional crosstalk between the neural and immune systems. We also discuss other cases of neural signaling including the inflammatory reflex.<\/jats:p>","DOI":"10.1093\/intimm\/dxaf009","type":"journal-article","created":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T19:38:20Z","timestamp":1743363500000},"page":"369-377","source":"Crossref","is-referenced-by-count":1,"title":["Neural signaling in immunology: the gateway reflex"],"prefix":"10.1093","volume":"37","author":[{"given":"Rie","family":"Hasebe","sequence":"first","affiliation":[{"name":"Division of Molecular Neuroimmunology, National Institute for Physiological Sciences , Okazaki 444-0855 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Division of Molecular Psychoimmunology, Institute for Genetic Medicine, and Graduate School of Medicine, Hokkaido University , Sapporo 060-0815 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