Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
Clin Sci (Lond). 2012 Apr;122(7):323-8. doi: 10.1042/CS20110299.
Can different pathophysiological mechanisms and risk factors leading to various diseases be linked with altered transmission of signals by one common pathway? The present article provides evidence for the hypothesis that adequate vagal nerve activity reduces the risk of major diseases, via common basic mechanisms and interim risk factors. These diseases include cardiovascular disease, cancer, Alzheimer's disease and the metabolic syndrome. Three basic mechanisms contribute to such illnesses: local oxidative stress and DNA damage, inflammatory reactions and excessive sympathetic responses, all of which are inhibited by vagal nerve activity. Efferent vagal activity that can be non-invasively measured by HRV (heart rate variability), derived from an ECG, is inversely related to all three basic mechanisms, to various risk factors (e.g. diabetes and dyslipidaemia) and, more broadly, to the diseases as well. Finally, vagal activity is proposed to moderate the effects of risk factors on developing such illnesses. By proposing an integrative neurobiological model of major diseases, identifying people at risk for, and treating patients with, such diseases may be done more efficiently. People with low HRV may be identified and subsequently treated by vagus nerve activation to possibly prevent or treat such illnesses. This proposed disease paradigm may have important preventative and therapeutic implications, whose clinical effects need to be investigated.
不同的病理生理机制和导致各种疾病的风险因素是否可以通过一个共同的途径与信号传递的改变联系起来？本文提供了一个假设的证据，即适当的迷走神经活动通过共同的基本机制和中间风险因素降低了发生主要疾病的风险。这些疾病包括心血管疾病、癌症、阿尔茨海默病和代谢综合征。三个基本机制导致了这些疾病：局部氧化应激和 DNA 损伤、炎症反应和过度的交感神经反应，所有这些都被迷走神经活动所抑制。可以通过 HRV（心率变异性）从心电图中无创测量的传出迷走神经活动与所有三种基本机制、各种风险因素（如糖尿病和血脂异常）以及更广泛的疾病呈负相关。最后，迷走神经活动被提出可以调节风险因素对这些疾病的影响。通过提出一个主要疾病的综合神经生物学模型，可以更有效地识别有患病风险的人，并对这些疾病的患者进行治疗。可以通过迷走神经激活来识别和随后治疗 HRV 较低的人，以可能预防或治疗这些疾病。这个提出的疾病范式可能具有重要的预防和治疗意义，其临床效果需要进行研究。
