B-005vagus Nerve Stimulation Attenuates the Acute Postsurgical Inflammatory Response After Lung Lobectomy

Salama, Mohamed; Akan, Ahmet; Mueller, Michael

doi:10.1093/icvts/ivx280.005

Cited by 2 publications

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“…aVNS effects are systemic: the auricular branch of the vagus nerve projects directly to the NST and through that it excites DMNV neurons that modulate the parasympathetic division of the autonomic nervous system ( Figure 1 ), an in particular the cardiovascular, respiratory and immunological processes. aVNS therapeutic effects (Kaniusas et al, 2019a , b ) in inflammation, respiratory dysfunction and cardiovascular diseases include reduction of pro-inflammatory cytokines (Tracey, 2007 ; Stavrakis et al, 2015 ), decrease of inflammation level in chronic inflammatory processes like rheumatoid arthritis, postoperative ileus, inflammatory bowel disease (Crohn's disease, ulcerative colitis), systemic inflammation and attenuation of the acute postsurgical inflammatory response after lung lobectomy (Barone et al, 2007 ; Bernateck et al, 2008 ; Chakravarthy et al, 2015 ; Kox et al, 2015 ; Marshall et al, 2015 ; Bonaz et al, 2016 ; Koopman et al, 2016 ; Kwan et al, 2016 ; French et al, 2017 ; Hoover, 2017 ; Salama et al, 2017 ). aVNS resulted in an increase of the middle cerebral and supratrochlear artery blood flow velocity in human subjects (Széles and Litscher, 2004 ) and a decrease of the velocity of the carotid-femoral flow (Hackl et al, 2017 ).…”

Section: Resultsmentioning

confidence: 99%

Non-invasive Auricular Vagus Nerve Stimulation as a Potential Treatment for Covid19-Originated Acute Respiratory Distress Syndrome

Kaniušas

Széles

Kampusch³

et al. 2020

Front. Physiol.

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Background: Covid-19 is an infectious disease caused by an invasion of the alveolar epithelial cells by coronavirus 19. The most severe outcome of the disease is the Acute Respiratory Distress Syndrome (ARDS) combined with hypoxemia and cardiovascular damage. ARDS and co-morbidities are associated with inflammatory cytokine storms, sympathetic hyperactivity, and respiratory dysfunction. Hypothesis: In the present paper, we present and justify a novel potential treatment for Covid19-originated ARDS and associated co-morbidities, based on the non-invasive stimulation of the auricular branch of the vagus nerve. Methods: Auricular vagus nerve stimulation activates the parasympathetic system including anti-inflammatory pathways (the cholinergic anti-inflammatory pathway and the hypothalamic pituitary adrenal axis) while regulating the abnormal sympatho-vagal balance and improving respiratory control. Results: Along the paper (1) we expose the role of the parasympathetic system and the vagus nerve in the control of inflammatory processes (2) we formulate our physiological and methodological hypotheses (3) we provide a large body of clinical and preclinical data that support the favorable effects of auricular vagus nerve stimulation in inflammation, sympatho-vagal balance as well as in respiratory and cardiac ailments, and (4) we list the (few) possible collateral effects of the treatment. Finally, we discuss auricular vagus nerve stimulation protective potential, especially in the elderly and co-morbid population with already reduced parasympathetic response. Conclusions: Auricular vagus nerve stimulation is a safe clinical procedure and it could be either an effective treatment for ARDS originated by Covid-19 and similar viruses or a supplementary treatment to actual ARDS therapeutic approaches.

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Section: Resultsmentioning

confidence: 99%

Non-invasive Auricular Vagus Nerve Stimulation as a Potential Treatment for Covid19-Originated Acute Respiratory Distress Syndrome

Kaniušas

Széles

Kampusch³

et al. 2020

Front. Physiol.

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“…aVNS reduced pro-inflammatory cytokines and suppressed lipopolysaccharide-induced inflammatory responses in endotoxemic rats ( Zhao et al, 2012 ). In humans, anti-inflammatory effects were shown in rheumatoid arthritis ( Bernateck et al, 2008 ; Koopman et al, 2016 ), inflammatory bowel disease (Crohn’s disease, ulcerative colitis), and postoperative ileus ( Tracey, 2007 ; Marshall et al, 2015 ; Bonaz, Sinniger and Pellissier, 2016 ), and lobectomy ( Salama, Akan and Mueller, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Auricular Vagus Nerve Stimulation Reduces Inflammation in Critical Covid-19 Patients

Seitz

Széles²,

Kitzberger³

et al. 2022

Front. Physiol.

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Covid-19 is an infectious disease associated with cytokine storms and derailed sympatho-vagal balance leading to respiratory distress, hypoxemia and cardiovascular damage. We applied the auricular vagus nerve stimulation to modulate the parasympathetic nervous system, activate the associated anti-inflammatory pathways, and reestablish the abnormal sympatho-vagal balance. aVNS is performed percutaneously using miniature needle electrodes in ear regions innervated by the auricular vagus nerve. In terms of a randomized prospective study, chronic aVNS is started in critical, but not yet ventilated Covid-19 patients during their stay at the intensive care unit. The results show decreased pro-inflammatory parameters, e.g. a reduction of CRP levels by 32% after 1 day of aVNS and 80% over 7 days (from the mean 151.9 mg/dl to 31.5 mg/dl) or similarly a reduction of TNFalpha levels by 58.1% over 7 days (from a mean 19.3 pg/ml to 8.1 pg/ml) and coagulation parameters, e.g. reduction of DDIMER levels by 66% over 7 days (from a mean 4.5 μg/ml to 1.5 μg/ml) and increased anti-inflammatory parameters, e.g. an increase of IL-10 levels by 66% over 7 days (from the mean 2.7 pg/ml to 7 pg/ml) over the aVNS duration without collateral effects. aVNS proved to be a safe clinical procedure and could effectively supplement treatment of critical Covid-19 patients while preventing devastating over-inflammation.

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B-005vagus Nerve Stimulation Attenuates the Acute Postsurgical Inflammatory Response After Lung Lobectomy

Cited by 2 publications

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Non-invasive Auricular Vagus Nerve Stimulation as a Potential Treatment for Covid19-Originated Acute Respiratory Distress Syndrome

Non-invasive Auricular Vagus Nerve Stimulation as a Potential Treatment for Covid19-Originated Acute Respiratory Distress Syndrome

Percutaneous Auricular Vagus Nerve Stimulation Reduces Inflammation in Critical Covid-19 Patients

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