Neuroimmunomodulation: A new frontier of treating cardiovascular diseases

Stavrakis, Stavros; Po, Sunny S.

doi:10.1016/j.tcm.2015.04.007

Cited by 3 publications

(3 citation statements)

References 21 publications

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“…Our hypotheses on the therapeutic effects of VNS-induced parasympathetic activity are supported by a wide range of state-of-the-art clinical and experimental data: decrease of pro-inflammatory cytokines and modulation of lung injuries by activation of the anti-inflammatory pathways, improvement of pulmonary and cardiac functions by adjusting the sympatho-vagal imbalance, etc. (Dos Santos et al, 2011 ; Krzyzaniak et al, 2011 ; Kessler et al, 2012 ; Kox et al, 2012 ; Levy et al, 2012 ; Reys et al, 2013 ; Tarras et al, 2013 ; Shinlapawittayatorn et al, 2014 ; Akella and Deshpande, 2015 ; Chen et al, 2016 ; Stavrakis and Po, 2016 ; Liu et al, 2017 ; Huang et al, 2019 ).…”

Section: Methodsmentioning

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: Methodsmentioning

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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“…Heart failure is another relevant condition for neuromodu-lation (Stavrakis and Po, 2015), characterized by a chronic autonomic imbalance with reduced VN activity and accelerated sympathetic activity (Olshansky et al, 2008; De Ferrari and Schwartz, 2011; Byku and Mann, 2016). In animals, VNS was proposed as a potential treatment of heart failure and angina pectoris (Bilgutay et al, 1968).…”

Section: Vagus Nerve Stimulation – From Biophysics To Animal and To Hmentioning

confidence: 99%

Current Directions in the Auricular Vagus Nerve Stimulation I – A Physiological Perspective

et al. 2019

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Electrical stimulation of the auricular vagus nerve (aVNS) is an emerging technology in the field of bioelectronic medicine with applications in therapy. Modulation of the afferent vagus nerve affects a large number of physiological processes and bodily states associated with information transfer between the brain and body. These include disease mitigating effects and sustainable therapeutic applications ranging from chronic pain diseases, neurodegenerative and metabolic ailments to inflammatory and cardiovascular diseases. Given the current evidence from experimental research in animal and clinical studies we discuss basic aVNS mechanisms and their potential clinical effects. Collectively, we provide a focused review on the physiological role of the vagus nerve and formulate a biology-driven rationale for aVNS. For the first time, two international workshops on aVNS have been held in Warsaw and Vienna in 2017 within the framework of EU COST Action “European network for innovative uses of EMFs in biomedical applications (BM1309).” Both workshops focused critically on the driving physiological mechanisms of aVNS, its experimental and clinical studies in animals and humans, in silico aVNS studies, technological advancements, and regulatory barriers. The results of the workshops are covered in two reviews, covering physiological and engineering aspects. The present review summarizes on physiological aspects – a discussion of engineering aspects is provided by our accompanying article ( Kaniusas et al., 2019 ). Both reviews build a reasonable bridge from the rationale of aVNS as a therapeutic tool to current research lines, all of them being highly relevant for the promising aVNS technology to reach the patient.

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“…For instance, the relevance of the proper timing of VNS was shown for the induced ischemia and the following reperfusion in a swine model, with favorable VNS effects when applied before the reperfusion but not afterward (Shinlapawittayatorn et al, 2014). In general, VNS should be applied early in the course of the disease event or process (Stavrakis and Po, 2015).…”

Section: Personalized Avnsmentioning

confidence: 99%

Current Directions in the Auricular Vagus Nerve Stimulation II – An Engineering Perspective

et al. 2019

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Electrical stimulation of the auricular vagus nerve (aVNS) is an emerging electroceutical technology in the field of bioelectronic medicine with applications in therapy. Artificial modulation of the afferent vagus nerve – a powerful entrance to the brain – affects a large number of physiological processes implicating interactions between the brain and body. Engineering aspects of aVNS determine its efficiency in application. The relevant safety and regulatory issues need to be appropriately addressed. In particular, in silico modeling acts as a tool for aVNS optimization. The evolution of personalized electroceuticals using novel architectures of the closed-loop aVNS paradigms with biofeedback can be expected to optimally meet therapy needs. For the first time, two international workshops on aVNS have been held in Warsaw and Vienna in 2017 within the scope of EU COST Action “European network for innovative uses of EMFs in biomedical applications (BM1309).” Both workshops focused critically on the driving physiological mechanisms of aVNS, its experimental and clinical studies in animals and humans, in silico aVNS studies, technological advancements, and regulatory barriers. The results of the workshops are covered in two reviews, covering physiological and engineering aspects. The present review summarizes on engineering aspects – a discussion of physiological aspects is provided by our accompanying article ( Kaniusas et al., 2019 ). Both reviews build a reasonable bridge from the rationale of aVNS as a therapeutic tool to current research lines, all of them being highly relevant for the promising aVNS technology to reach the patient.

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Neuroimmunomodulation: A new frontier of treating cardiovascular diseases

Cited by 3 publications

References 21 publications

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

Current Directions in the Auricular Vagus Nerve Stimulation I – A Physiological Perspective

Current Directions in the Auricular Vagus Nerve Stimulation II – An Engineering Perspective

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