Si-Tong Ming, Peng-Yue Guo, Fei Chen, Wei-Dong Zhang, Xia Liu
Noninfectious inflammatory diseases (NIDs), including neurological, cardiovascular, autoimmune and metabolic diseases, impose a heavy burden on the global medical system. Currently, the main drugs used in the treatment of NIDs are nonsteroidal anti-inflammatory drugs and glucocorticoids, which can alleviate the symptoms but are often accompanied by serious adverse effects. In contrast, active components of herbal medicine provide a new option for the treatment of NIDs because of their multi-targeting properties and low toxicity. With the complexity of inflammatory responses, the cholinergic anti-inflammatory pathway (CAP) can be a potential therapeutic pathway for NIDs. This review aims to elucidate the mechanisms by which the active components, extracts and formulas of Chinese herbal medicines modulate CAP for the treatment of NIDs. These therapeutic effects can be achieved by regulating key targets in the CAP, including the α7 nicotinic acetylcholine receptor, choline acetyltransferase, acetylcholinesterase and downstream signaling. These findings provide valuable hints for the development of new potential drugs targeting NIDs. Please cite this article as: Ming ST, Guo PY, Chen F, Zhang WD, Liu X. Chinese herbal medicines in the treatment of noninfectious inflammatory diseases: Cholinergic mechanisms and therapeutic potential. J Integr Med. 2026; Epub ahead of print.