Department of Bioregulatory Science, Nippon Medical School Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo, Tokyo, 113-8602, Japan.
Neurochem Int. 2021 Feb;143:104934. doi: 10.1016/j.neuint.2020.104934. Epub 2020 Dec 8.
The vagus nerve (VN) belongs to the parasympathetic nervous system, which is well known to be involved in the regulation of the functions of organs in the body. The neurotransmitter acetylcholine, released from the cholinergic system including VN, has been known to play an anti-inflammatory role through the efferent pathways in regulating peripheral inflammatory responses profoundly involved in the pathogenesis of diseases. In contrast, anatomically, it connects the central nervous system (CNS) and peripheral organs, including the heart and gastrointestinal (GI) tract. Therefore, it has been recently reported that the VN also plays an important role in the pathogenesis of psychological disorders since it confers varied signals from the GI tract to the CNS, and alteration of microbiota residing in GI definitely influences the condition of neuropsychiatric disorders. Furthermore, the CNS includes microglia, a neuroinflammatory effector in the brain, which is also influenced by the VN to modulate its inflammatory status. Based on significant findings of the VN, the VN stimulation (VNS) has recently drawn attention from many scientific fields. VNS was initially applied to patients with refractory epilepsy, followed by patients with refractory depression. Subsequently, VNS was also attempted to be introduced to other diseases. However, against whichever disease, central or peripheral, detailed underlying mechanisms of VNS involved in neuropsychiatric disorders as well as VNS target molecules in the GI tract and the CNS remains to be studied. In this review, we discuss the mechanisms and predicted responsible factors of VNS in terms of neuropsychiatric disorders.
迷走神经（VN）属于副交感神经系统，众所周知，它参与调节体内器官的功能。包括 VN 在内的胆碱能系统释放的神经递质乙酰胆碱，通过传出途径在调节外周炎症反应中发挥抗炎作用，而外周炎症反应与疾病的发病机制密切相关。相比之下，在解剖学上，它连接中枢神经系统（CNS）和外周器官，包括心脏和胃肠道（GI）道。因此，最近有报道称，VN 还在心理障碍的发病机制中发挥重要作用，因为它将来自 GI 道的各种信号传递到 CNS，而 GI 道中居住的微生物群的改变肯定会影响神经精神疾病的状况。此外，CNS 包括小胶质细胞，这是大脑中的一种神经炎症效应物，也受 VN 调节其炎症状态。基于 VN 的重要发现，VN 刺激（VNS）最近引起了许多科学领域的关注。VNS 最初应用于难治性癫痫患者，随后应用于难治性抑郁症患者。随后，VNS 也被尝试应用于其他疾病。然而，无论是针对哪种疾病，中枢还是外周，VNS 在神经精神障碍中的潜在机制以及 VNS 在 GI 道和 CNS 中的靶分子仍有待研究。在这篇综述中，我们讨论了 VNS 在神经精神障碍方面的机制和预测的负责因素。
