Pharmacological Modulation of Vagal Nerve Activity in Cardiovascular Diseases

Neurosci Bull. 2019 Feb;35(1):156-166. doi: 10.1007/s12264-018-0286-7. Epub 2018 Sep 14.

Abstract

Cardiovascular diseases are life-threatening illnesses with high morbidity and mortality. Suppressed vagal (parasympathetic) activity and increased sympathetic activity are involved in these diseases. Currently, pharmacological interventions primarily aim to inhibit over-excitation of sympathetic nerves, while vagal modulation has been largely neglected. Many studies have demonstrated that increased vagal activity reduces cardiovascular risk factors in both animal models and human patients. Therefore, the improvement of vagal activity may be an alternate approach for the treatment of cardiovascular diseases. However, drugs used for vagus nerve activation in cardiovascular diseases are limited in the clinic. In this review, we provide an overview of the potential drug targets for modulating vagal nerve activation, including muscarinic, and β-adrenergic receptors. In addition, vagomimetic drugs (such as choline, acetylcholine, and pyridostigmine) and the mechanism underlying their cardiovascular protective effects are also discussed.

Keywords: Cardiovascular disease; Cholinergic drugs; Muscarinic receptor; Vagomimetic drugs; Vagus nerve; α7-nACh receptor.

Publication types

  • Review

MeSH terms

  • Acetylcholine / pharmacology*
  • Animals
  • Cardiovascular Diseases / drug therapy*
  • Cholinergic Agents / therapeutic use*
  • Humans
  • Receptors, Muscarinic / drug effects
  • Sympathetic Nervous System / drug effects*
  • Sympathetic Nervous System / physiopathology
  • Vagus Nerve / drug effects*
  • Vagus Nerve / physiopathology

Substances

  • Cholinergic Agents
  • Receptors, Muscarinic
  • Acetylcholine