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T and B cell lymphocytes express choline acetyltransferase (ChAT), high-affinity choline transporters (ChRM and ChRN), acetylcholine transferase, and can produce and release ACh ( In vitro studies show that ACh and other ChRM and ChRN agonists enhance T cell cytotoxicity, B and T cell intracellular Ca 2+ , c-fos expression, nitric oxide, and IL-2 production, cyclic guanosine monophosphate (cGMP), and inositol-1,4,5-triphosphate (IP 3 ) levels, and modulate DNA synthesis and cell proliferation ( + and CD8 + T cells in an IL-21-dependent manner ( Figure 3 )

Acetylcholine bidirectionally regulates learning and memory

Chen W-S, et al

What investigations may help guide further management in this case

Interleukin-6 as a central mediator of cardiovascular risk associated with chronic inflammation, smoking, diabetes, and visceral obesity: down-regulation with essential fatty acids, ethanol and pentoxifylline

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