Vagus Nerve Stimulation: A Personalized Therapeutic Approach for Crohn's and Other Inflammatory Bowel Diseases

Cells. 2022 Dec 17;11(24):4103. doi: 10.3390/cells11244103.

Abstract

Inflammatory bowel diseases, including Crohn's disease and ulcerative colitis, are incurable autoimmune diseases characterized by chronic inflammation of the gastrointestinal tract. There is increasing evidence that inappropriate interaction between the enteric nervous system and central nervous system and/or low activity of the vagus nerve, which connects the enteric and central nervous systems, could play a crucial role in their pathogenesis. Therefore, it has been suggested that appropriate neuroprosthetic stimulation of the vagus nerve could lead to the modulation of the inflammation of the gastrointestinal tract and consequent long-term control of these autoimmune diseases. In the present paper, we provide a comprehensive overview of (1) the cellular and molecular bases of the immune system, (2) the way central and enteric nervous systems interact and contribute to the immune responses, (3) the pathogenesis of the inflammatory bowel disease, and (4) the therapeutic use of vagus nerve stimulation, and in particular, the transcutaneous stimulation of the auricular branch of the vagus nerve. Then, we expose the working hypotheses for the modulation of the molecular processes that are responsible for intestinal inflammation in autoimmune diseases and the way we could develop personalized neuroprosthetic therapeutic devices and procedures in favor of the patients.

Keywords: Crohn’s disease; auricular vagus nerve; inflammatory bowel disease; neuroprostheses; transcutaneous auricular vagus nerve stimulation; vagus nerve; vagus nerve stimulation.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Colitis, Ulcerative*
  • Crohn Disease* / therapy
  • Humans
  • Inflammation
  • Inflammatory Bowel Diseases* / therapy
  • Vagus Nerve Stimulation* / methods

Grants and funding

This work was supported by grants from Regione Campania (L.R. N.5 Bando 2003 to MP), the Italian Minister of Research and University (PRIN 2007 to MP; PRIN 2017-2017XJ38A4_003 to GC and MP), UNIMIB (Progetto ID 2019-ATESP-0001 and Progetto ID 2018-CONV-0056 to AV).