Transcutaneous vagal nerve stimulation protects against stress‐induced intestinal barrier dysfunction in healthy adults

Mogilevski, Tamara; Rosella, Sam; Aziz, Qasim

doi:10.1111/nmo.14382

Cited by 20 publications

(26 citation statements)

References 38 publications

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Section: Effect Of Vagus Nerve Stimulation On Intestinal Permeabilitymentioning

confidence: 93%

“…To the best of our knowledge, there are presently no published data regarding the effect of VNS on intestinal permeability in IBS, IBD, and celiac disease. Consequently, the work of Mogilevski et al1 as well as the data presented above on the effects of VNS on intestinal barrier function in other models of intestinal injury pave the way for future clinical trials in such gastro-intestinal disorders.AUTH O R CO NTR I B UTI O N SBruno Bonaz contributed to the conception, drafting, and editing of the manuscript.FU N D I N G I N FO R M ATI O NNo funding declaredCO N FLI C T O F I NTE R E S TBruno Bonaz is a consultant to Abbvie, Biogen, Janssen, Livanova, Mayoly Spindler, MSD, Norgine, Schär, Schwa Medico, Takeda.…”

mentioning

confidence: 92%

“…In an original manuscript published in the present issue of neurogastroenterology and motility, Mogilevski et al 1 aimed to determine the effect of transcutaneous auricular vagal nerve stimulation (VNS) on intestinal permeability in adults receiving a bolus dose of intravenous corticotropin releasing hormone (CRH) known to increase small intestinal permeability in healthy human subjects. They report that a brief non‐invasive transcutaneous auricular VNS consistently reduces paracellular permeability of the small intestine after CRH administration but does not mitigate the release of intestinal fatty‐acid binding protein (I‐FABP), an intracellular protein released from the epithelium at times of epithelial injury without cellular disruption.…”

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confidence: 99%

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Anti‐inflammatory effects of vagal nerve stimulation with a special attention to intestinal barrier dysfunction

Bonaz

2022

Neurogastroenterology Motil

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The vagus nerve (VN), the longest nerve of the organism innervating the gastrointestinal tract, is a mixed nerve with anti-inflammatory properties through its afferents, activating the hypothalamic-pituitary adrenal axis, and its efferents through the cholinergic anti-inflammatory pathway inhibiting the release of pro-inflammatory cytokines (e.g., TNFα) by splenic and gut macrophages. In addition, the VN is also able to modulate the permeability of the intestinal barrier although the VN does not innervate directly the intestinal epithelium. Targeting the VN through VN stimulation (VNS) has been developed in experimental model of intestinal inflammation and in inflammatory bowel disease (IBD) and might be of interest to decrease intestinal permeability in gastrointestinal disorders with intestinal barrier defect such as IBD, irritable bowel syndrome (IBS), and celiac disease. In this issue of neurogastroenterology and motility, Mogilevski et al. report that a brief non-invasive transcutaneous auricular VNS in healthy volunteers consistently reduces the permeability of the small intestine induced by intravenous administration of the stress peptide corticotropin releasing hormone, known to increase intestinal permeability and to inhibit the VN. In this review, we outline the mechanistic underpinning the effect of stress, of the VN and VNS on intestinal permeability. In particular, the VN can act on intestinal permeability through enteric nerves, and/or cells such as enteric glial cells. We also review the existing evidence of the effects VNS on intestinal permeability in models such as burn intestinal injury and traumatic brain injury, which pave the way for future clinical trials in IBD, IBS, and celiac disease.

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Section: Effect Of Vagus Nerve Stimulation On Intestinal Permeabilitymentioning

confidence: 93%

mentioning

confidence: 92%

mentioning

confidence: 99%

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Anti‐inflammatory effects of vagal nerve stimulation with a special attention to intestinal barrier dysfunction

Bonaz

2022

Neurogastroenterology Motil

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“…Moreover, increased expression of CRH in eosinophils correlated with symptom severity and life stress in patients with IBS-D 146. Mast cells carry CRH receptors and exogenous CRH has been shown to increase intestinal permeability in healthy individuals which was blocked by mast cell stabilisation and vagal nerve stimulation 142 147 148. Additionally, reduced expression of the antiinflammatory, antinociceptive and barrier-stabilising CRH receptor 2 (CRHR2) in duodenal biopsies of patients with FD was recently reported and may also contribute to stress-related mast cell activation in FD 149 150.…”

Section: Immune Activationmentioning

confidence: 99%

Understanding neuroimmune interactions in disorders of gut–brain interaction: from functional to immune-mediated disorders

Vanuytsel

Berčík

Boeckxstaens

2023

Gut

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Functional gastrointestinal disorders—recently renamed into disorders of gut–brain interaction—such as irritable bowel syndrome and functional dyspepsia are highly prevalent conditions with bothersome abdominal symptoms in the absence of structural abnormalities. While traditionally considered as motility disorders or even psychosomatic conditions, our understanding of the pathophysiology has evolved significantly over the last two decades. Initial observations of subtle mucosal infiltration with immune cells, especially mast cells and eosinophils, are since recently being backed up by mechanistic evidence demonstrating increased release of nociceptive mediators by immune cells and the intestinal epithelium. These mediators can activate sensitised neurons leading to visceral hypersensitivity with bothersome symptoms. The interaction between immune activation and an impaired barrier function of the gut is most likely a bidirectional one with alterations in the microbiota, psychological stress and food components as upstream players in the pathophysiology. Only few immune-targeting treatments are currently available, but an improved understanding through a multidisciplinary scientific approach will hopefully identify novel, more precise treatment targets with ultimately better outcomes.

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“…In addition, a plethora of recent research has focused on the use of VN stimulation (VNS) in the rehabilitation of stroke and TBI patients. 148,149,[244][245][246][247][248][249][250] These studies have shown promising evidence that VNS may rescue decreased gut mucosal integrity by upregulation of enteric glial cells, reduce systemic proinflammatory cytokines and promote recovery.…”

Section: Vn Stimulationmentioning

confidence: 99%

Gut microbiome and neurosurgery: Implications for treatment

Willman

Reddy

et al. 2022

Clinical and Translational Dis

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Introduction: The aim of this review is to summarize the current understanding of the gut-brain axis (GBA), its impact on neurosurgery, and its implications for future treatment. Background: An abundance of research has established the existence of a collection of pathways between the gut microbiome and the central nervous system (CNS), commonly known as the GBA. Complicating this relationship, the gut microbiome bacterial diversity appears to change with age, antibiotic exposure and a number of external and internal factors. Methods: In this paper, we present the current understanding of the key protective and deleterious roles the gut microbiome plays in the pathogenesis of several common neurosurgical concerns. Results: Specifically, we examine how spinal cord injury, traumatic brain injury and stroke may cause gut microbial dysbiosis. Furthermore, this link appears to be bidirectional as gut dysbiosis contributes to secondary CNS injury in each of these ailment settings. This toxic cycle may be broken, and the future secondary damage rescued by timely, therapeutic, gut microbiome modification. In addition, a robust gut microbiome appears to improve outcomes in brain tumour treatment. There are several primary routes by which microbiome dysbiosis may be ameliorated, including faecal microbiota transplant, oral probiotics, bacteriophages, genetic modification of gut microbiota and vagus nerve stimulation. Conclusion: The GBA represents an important component of patient care in the field of neurosurgery. Future research may illuminate ideal methods of therapeutic microbiome modulation in distinct pathogenic settings.

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Transcutaneous vagal nerve stimulation protects against stress‐induced intestinal barrier dysfunction in healthy adults

Cited by 20 publications

References 38 publications

Anti‐inflammatory effects of vagal nerve stimulation with a special attention to intestinal barrier dysfunction

Anti‐inflammatory effects of vagal nerve stimulation with a special attention to intestinal barrier dysfunction

Understanding neuroimmune interactions in disorders of gut–brain interaction: from functional to immune-mediated disorders

Gut microbiome and neurosurgery: Implications for treatment

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