Targeting the anti-inflammatory properties of the vagus nerve through vagus nerve stimulation: Therapeutic implications for inflammatory bowel diseases and other inflammatory conditions
DOI:
https://doi.org/10.33910/2687-1270-2020-1-4-277-284Keywords:
vagus nerve, vagus nerve stimulation, cholinergic anti-inflammatory pathway, hypothalamic-pituitary adrenal axis, inflammatory bowel diseases, rheumatoid arthritisAbstract
The vagus nerve (VN) is the longest nerve of the organism that innervates major organs such as the heart, lungs and gastro-intestinal tract and is a major component of the autonomic nervous system at the interface of the central nervous system and the body. The VN has anti-inflammatory properties both through its afferent fibers, activating the hypothalamic-pituitary adrenal axis, and its efferent fibers activating the cholinergic anti-inflammatory pathway. Targeting these anti-inflammatory pathways is of interest for various inflammatory conditions. Bioelectronic medicine through VN stimulation (VNS) appears as an interesting tool to release inflammatory conditions. VNS is approved for the treatment of drug-resistant epilepsy and has potential therapeutic applications in chronic inflammatory disorders such as inflammatory bowel diseases and others. Preclinical data and pilot clinical studies argue for such an effect. However, larger randomized double-blinded control study and a long-lasting follow-up of the patients to confirm these promising results are awaiting. In addition, the optimal neurostimulation parameters to better treat common conditions and diseases that involve immune regulation need to be determined.
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