Fig. 4
From: The gateway reflex regulates tissue-specific autoimmune diseases
Stages of the remote inflammation gateway reflex. (1) ATP is highly secreted from nonimmune cells with activation of the IL-6 amplifier in an ankle joint. (2) ATP stimulates Nav1.8 + sensory neurons in the L5 DRG. (3) L5 sensory neurons signaling to proenkephalin-positive interneurons in the spinal cord between L5 and T10. (4) Sensory neurons in the contralateral L4-6 DRG are activated. (5) The activated sensory neurons secrete ATP antidromically in the contralateral ankle joint, leading to activation of the IL-6 amplifier, which is critical for the development of remote inflammation