Role of neuroimmunomodulation by vagus nerve stimulation in rheumatoid arthritis: Are we heading towards a drug-free era?

Progressive clinical research in the field of neuroimmunomodulation has formed a base for the development of a new therapeutic paradigm for various inflammatory diseases, including rheumatoid arthritis (RA). One of the most common mechanisms is electrical vagus nerve stimulation of inflammation. The...

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Main Authors: Prasan Deep Rath, Swetal Pandey, Rahul Bisaralli
Format: Article
Language:English
Published: SAGE Publishing 2020-01-01
Series:Indian Journal of Rheumatology
Subjects:
Online Access:http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2020;volume=15;issue=4;spage=323;epage=332;aulast=Rath
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author Prasan Deep Rath
Swetal Pandey
Rahul Bisaralli
author_facet Prasan Deep Rath
Swetal Pandey
Rahul Bisaralli
author_sort Prasan Deep Rath
collection DOAJ
description Progressive clinical research in the field of neuroimmunomodulation has formed a base for the development of a new therapeutic paradigm for various inflammatory diseases, including rheumatoid arthritis (RA). One of the most common mechanisms is electrical vagus nerve stimulation of inflammation. The role of the vagal nerves in activation of various immune responses through preclinical and clinical evidence has established its role in assisting the control of inflammation and improving survival in the infectious and inflammatory disorders through efferent as well as afferent vagal pathways that regulate the peripheral inflammation via the central nervous system. Another mechanism is the neural inflammatory reflex that regulates innate and adaptive immune responses and also inhibits the production of a vital inflammatory therapeutic target molecule, known as tumor necrosis factor, for RA. This review discusses the multifactorial and multidimensional interactions between neurons and immune cells, the mechanisms of the nervous system which are responsible for the regulation of inflammation, the impact of cholinergic pathways on inflammation, and the evidence supporting the role of various bioelectronic devices in vagus nerve stimulation.
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spelling doaj-art-9a8cf5a45ec6456995f8873d4e64eb432025-02-03T00:22:52ZengSAGE PublishingIndian Journal of Rheumatology0973-36980973-37012020-01-0115432333210.4103/injr.injr_92_20Role of neuroimmunomodulation by vagus nerve stimulation in rheumatoid arthritis: Are we heading towards a drug-free era?Prasan Deep RathSwetal PandeyRahul BisaralliProgressive clinical research in the field of neuroimmunomodulation has formed a base for the development of a new therapeutic paradigm for various inflammatory diseases, including rheumatoid arthritis (RA). One of the most common mechanisms is electrical vagus nerve stimulation of inflammation. The role of the vagal nerves in activation of various immune responses through preclinical and clinical evidence has established its role in assisting the control of inflammation and improving survival in the infectious and inflammatory disorders through efferent as well as afferent vagal pathways that regulate the peripheral inflammation via the central nervous system. Another mechanism is the neural inflammatory reflex that regulates innate and adaptive immune responses and also inhibits the production of a vital inflammatory therapeutic target molecule, known as tumor necrosis factor, for RA. This review discusses the multifactorial and multidimensional interactions between neurons and immune cells, the mechanisms of the nervous system which are responsible for the regulation of inflammation, the impact of cholinergic pathways on inflammation, and the evidence supporting the role of various bioelectronic devices in vagus nerve stimulation.http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2020;volume=15;issue=4;spage=323;epage=332;aulast=Rathinflammatory disordersneuroimmunomodulationrheumatoid arthritis
spellingShingle Prasan Deep Rath
Swetal Pandey
Rahul Bisaralli
Role of neuroimmunomodulation by vagus nerve stimulation in rheumatoid arthritis: Are we heading towards a drug-free era?
Indian Journal of Rheumatology
inflammatory disorders
neuroimmunomodulation
rheumatoid arthritis
title Role of neuroimmunomodulation by vagus nerve stimulation in rheumatoid arthritis: Are we heading towards a drug-free era?
title_full Role of neuroimmunomodulation by vagus nerve stimulation in rheumatoid arthritis: Are we heading towards a drug-free era?
title_fullStr Role of neuroimmunomodulation by vagus nerve stimulation in rheumatoid arthritis: Are we heading towards a drug-free era?
title_full_unstemmed Role of neuroimmunomodulation by vagus nerve stimulation in rheumatoid arthritis: Are we heading towards a drug-free era?
title_short Role of neuroimmunomodulation by vagus nerve stimulation in rheumatoid arthritis: Are we heading towards a drug-free era?
title_sort role of neuroimmunomodulation by vagus nerve stimulation in rheumatoid arthritis are we heading towards a drug free era
topic inflammatory disorders
neuroimmunomodulation
rheumatoid arthritis
url http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2020;volume=15;issue=4;spage=323;epage=332;aulast=Rath
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AT swetalpandey roleofneuroimmunomodulationbyvagusnervestimulationinrheumatoidarthritisareweheadingtowardsadrugfreeera
AT rahulbisaralli roleofneuroimmunomodulationbyvagusnervestimulationinrheumatoidarthritisareweheadingtowardsadrugfreeera