Vagal Nerve Stimulation-Modulation of the Anti-Inflammatory Response and Clinical Outcome in Psoriatic Arthritis or Ankylosing Spondylitis
Objectives. The vagal nerve exerts an essential pathway in controlling the cholinergic anti-inflammatory reflex. Thus, the study is aimed at investigating the acute effect of a noninvasive transcutaneous vagus nerve stimulation on clinical disease activity and systemic levels of inflammation in pati...
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| Format: | Article |
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Wiley
2021-01-01
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| Series: | Mediators of Inflammation |
| Online Access: | http://dx.doi.org/10.1155/2021/9933532 |
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| author | C. Brock S. E. Rasmussen A. M. Drewes H. J. Møller B. Brock B. Deleuran A. D. Farmer M. Pfeiffer-Jensen |
| author_facet | C. Brock S. E. Rasmussen A. M. Drewes H. J. Møller B. Brock B. Deleuran A. D. Farmer M. Pfeiffer-Jensen |
| author_sort | C. Brock |
| collection | DOAJ |
| description | Objectives. The vagal nerve exerts an essential pathway in controlling the cholinergic anti-inflammatory reflex. Thus, the study is aimed at investigating the acute effect of a noninvasive transcutaneous vagus nerve stimulation on clinical disease activity and systemic levels of inflammation in patients with psoriatic arthritis or ankylosing spondylitis. Methods. Twenty patients with psoriatic arthritis (PsA) and 20 patients with ankylosing spondylitis (AS) were included and stimulated bilaterally with a handheld vagal nerve stimulator for 120 seconds 3 times a day for 5 consecutive days. All patients were in remission. Cardiac vagal tone, clinical scores, CRP, and cytokine levels were assessed. Results. In PsA and AS, decreased heart rate was observed, confirming compliance. Furthermore, in PsA, a clear reduction of clinical disease activity associated with a 20% reduction in CRP was shown. In AS, a reduction in interferon-γ, interleukin- (IL-) 8, and 10 was shown. No side effects were described. Conclusion. This open-label study provides support for an anti-inflammatory effect of transcutaneous vagus nerve stimulation in patients with psoriatic arthritis and ankylosing spondylitis. The modulated immune response and reduced disease activity and CRP-levels raise the fascinating possibility of using neuromodulation as an add-on to existing pharmacological treatments. |
| format | Article |
| id | doaj-art-b88ad13692c54750a25d33cab71fa2d1 |
| institution | OA Journals |
| issn | 0962-9351 1466-1861 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Mediators of Inflammation |
| spelling | doaj-art-b88ad13692c54750a25d33cab71fa2d12025-08-20T02:19:11ZengWileyMediators of Inflammation0962-93511466-18612021-01-01202110.1155/2021/99335329933532Vagal Nerve Stimulation-Modulation of the Anti-Inflammatory Response and Clinical Outcome in Psoriatic Arthritis or Ankylosing SpondylitisC. Brock0S. E. Rasmussen1A. M. Drewes2H. J. Møller3B. Brock4B. Deleuran5A. D. Farmer6M. Pfeiffer-Jensen7Mech-Sense, Department of Gastroenterology and Hepatology, Clinical Institute, Aalborg University Hospital, Aalborg, DenmarkDepartment of Rheumatology, Aarhus University Hospital, Aarhus, DenmarkDepartment of Rheumatology, Aarhus University Hospital, Aarhus, DenmarkDepartment of Clinical Biochemistry, Aarhus University Hospital, DenmarkSteno Diabetes Center Copenhagen, Region Hovedstaden, Gentofte, DenmarkDepartment of Rheumatology, Aarhus University Hospital, Aarhus, DenmarkCentre for Trauma and Neuroscience, Blizard Institute, Wingate Institute of Neurogastroenterology, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UKDepartment of Rheumatology, Aarhus University Hospital, Aarhus, DenmarkObjectives. The vagal nerve exerts an essential pathway in controlling the cholinergic anti-inflammatory reflex. Thus, the study is aimed at investigating the acute effect of a noninvasive transcutaneous vagus nerve stimulation on clinical disease activity and systemic levels of inflammation in patients with psoriatic arthritis or ankylosing spondylitis. Methods. Twenty patients with psoriatic arthritis (PsA) and 20 patients with ankylosing spondylitis (AS) were included and stimulated bilaterally with a handheld vagal nerve stimulator for 120 seconds 3 times a day for 5 consecutive days. All patients were in remission. Cardiac vagal tone, clinical scores, CRP, and cytokine levels were assessed. Results. In PsA and AS, decreased heart rate was observed, confirming compliance. Furthermore, in PsA, a clear reduction of clinical disease activity associated with a 20% reduction in CRP was shown. In AS, a reduction in interferon-γ, interleukin- (IL-) 8, and 10 was shown. No side effects were described. Conclusion. This open-label study provides support for an anti-inflammatory effect of transcutaneous vagus nerve stimulation in patients with psoriatic arthritis and ankylosing spondylitis. The modulated immune response and reduced disease activity and CRP-levels raise the fascinating possibility of using neuromodulation as an add-on to existing pharmacological treatments.http://dx.doi.org/10.1155/2021/9933532 |
| spellingShingle | C. Brock S. E. Rasmussen A. M. Drewes H. J. Møller B. Brock B. Deleuran A. D. Farmer M. Pfeiffer-Jensen Vagal Nerve Stimulation-Modulation of the Anti-Inflammatory Response and Clinical Outcome in Psoriatic Arthritis or Ankylosing Spondylitis Mediators of Inflammation |
| title | Vagal Nerve Stimulation-Modulation of the Anti-Inflammatory Response and Clinical Outcome in Psoriatic Arthritis or Ankylosing Spondylitis |
| title_full | Vagal Nerve Stimulation-Modulation of the Anti-Inflammatory Response and Clinical Outcome in Psoriatic Arthritis or Ankylosing Spondylitis |
| title_fullStr | Vagal Nerve Stimulation-Modulation of the Anti-Inflammatory Response and Clinical Outcome in Psoriatic Arthritis or Ankylosing Spondylitis |
| title_full_unstemmed | Vagal Nerve Stimulation-Modulation of the Anti-Inflammatory Response and Clinical Outcome in Psoriatic Arthritis or Ankylosing Spondylitis |
| title_short | Vagal Nerve Stimulation-Modulation of the Anti-Inflammatory Response and Clinical Outcome in Psoriatic Arthritis or Ankylosing Spondylitis |
| title_sort | vagal nerve stimulation modulation of the anti inflammatory response and clinical outcome in psoriatic arthritis or ankylosing spondylitis |
| url | http://dx.doi.org/10.1155/2021/9933532 |
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