{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T02:32:54Z","timestamp":1792204374959,"version":"4.4.0"},"reference-count":214,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004479","name":"Natural Science Foundation of Jiangxi Province","doi-asserted-by":"publisher","award":["20242BAB26130 to EF, 20224ACB216006 to XL"],"award-info":[{"award-number":["20242BAB26130 to EF, 20224ACB216006 to XL"]}],"id":[{"id":"10.13039\/501100004479","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Acetylcholine (ACh) is an evolutionarily conserved neurotransmitter that is widely distributed in the central and peripheral nervous systems and plays essential roles in multiple physiological processes. This review summarizes the full biological cycle of ACh, including its synthesis, vesicular storage, release, degradation, and reuptake, and discusses the regulatory mechanisms underlying its functions in the nervous system and peripheral organs. Through nicotinic acetylcholine receptors (nAChRs) and muscarinic acetylcholine receptors (mAChRs), ACh is involved in central nervous system functions such as cognition, learning and memory, attention, arousal, reward, and decision-making, as well as peripheral processes including motor control, autonomic regulation, and immune modulation. In addition, ACh plays a pivotal role in the brain\u2013body axis. At the central level, the nervous system regulates peripheral organ function through autonomic and neuroendocrine pathways. At the peripheral level, cholinergic signals derived from the enteric nervous system and immune cells convey information about the body\u2019s internal state to the central nervous system through vagal and other afferent pathways, forming an important bottom-up regulatory network. Collectively, these findings indicate that ACh is not only a classical neurotransmitter but also a key molecular mediator of brain\u2013body communication. A more comprehensive understanding of cholinergic signaling may provide new insights into physiological regulation and the pathogenesis of neurological, psychiatric, cardiovascular, and inflammatory diseases.<\/jats:p>","DOI":"10.3390\/ijms27114686","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T16:06:08Z","timestamp":1779465968000},"page":"4686","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Acetylcholine in Brain\u2013Body Communication: Biological Mechanisms and Physiological Roles"],"prefix":"10.3390","volume":"27","author":[{"given":"Yuan","family":"Gao","sequence":"first","affiliation":[{"name":"HuanKui Academy, Jiangxi Medical College, Nanchang University, Nanchang 330031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5051-5182","authenticated-orcid":false,"given":"Tian","family":"Zhou","sequence":"additional","affiliation":[{"name":"HuanKui Academy, Jiangxi Medical College, Nanchang University, Nanchang 330031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6044-7811","authenticated-orcid":false,"given":"Xinsheng","family":"Lai","sequence":"additional","affiliation":[{"name":"School of Basic Medical Sciences, Jiangxi Medical College, Nanchang University, Nanchang 330031, China"},{"name":"Institute of Biomedical Innovation, Jiangxi Medical College, Nanchang University, Nanchang 330031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3581-9521","authenticated-orcid":false,"given":"Erkang","family":"Fei","sequence":"additional","affiliation":[{"name":"School of Basic Medical Sciences, Jiangxi Medical College, Nanchang University, Nanchang 330031, China"},{"name":"Institute of Biomedical Innovation, Jiangxi Medical College, Nanchang University, Nanchang 330031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"103678","DOI":"10.1016\/j.autrev.2024.103678","article-title":"Neuroimmune communication of the cholinergic system in gut inflammation and autoimmunity","volume":"23","author":"Halder","year":"2024","journal-title":"Autoimmun. 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