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This mechanism provides substantial therapeutic potential across a spectrum of inflammatory disorders, including postoperative systemic inflammation. Clinical trials have demonstrated the anti-inflammatory efficacy of taVNS, supporting its expanded use in rheumatoid arthritis, systemic lupus erythematosus, gout, inflammatory bowel disease (IBD), and other immune-mediated disorders. Investigations into postoperative inflammation and metabolic syndrome are now emerging. In this review, we synthesize the anatomical substrate, mechanistic framework, and disease-specific applications of taVNS, with a particular emphasis on how stimulation parameters influence therapeutic outcomes. Finally, we outline current challenges and propose future directions to advance research and clinical translation.<\/jats:p>","DOI":"10.3389\/fimmu.2025.1702185","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T09:56:44Z","timestamp":1768989404000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":14,"title":["Cholinergic reflex control of inflammation: mechanistic and translational advances in transcutaneous auricular vagus nerve stimulation across rheumatic, metabolic, and postoperative disorders"],"prefix":"10.3389","volume":"16","author":[{"given":"Rui","family":"Han","sequence":"first","affiliation":[{"name":"The First Clinical Medical College, Gannan Medical University","place":["Ganzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zongbo","family":"Peng","sequence":"additional","affiliation":[{"name":"The First Clinical Medical College, Gannan Medical 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