Wu Zhiyang, Zhang Xin, Cai Tiantian, Li Yankun, Guo Xi, Zhao Xiangyang, Wu Dawei, Li Zhi, Zhang Luyao
Department of Critical Care Medicine, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, Shandong, 266035, PR China.
Department of Pathology, School of Medicine and Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, PR China.
Brain Stimul. 2023 Mar-Apr;16(2):507-514. doi: 10.1016/j.brs.2023.02.008. Epub 2023 Feb 16.
Studies have shown that vagus nerve-mediated inflammatory reflex could inhibit cytokine production and inflammation in sepsis animals.
This study aimed to explore the efficacy of transcutaneous auricular vagus nerve stimulation (taVNS) on inflammation and disease severity of sepsis patients.
A randomized, double-blind, sham-controlled pilot study was performed. Twenty sepsis patients were randomly assigned to receive taVNS or sham stimulation for five consecutive days. Stimulation effect was assessed with serum cytokine levels, Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ score, and Sequential Organ Failure Assessment (SOFA) score at baseline and on Day 3, Day 5, and Day 7.
TaVNS was well tolerated in the study population. Patients receiving taVNS experienced significant reductions in serum TNF-α and IL-1β levels and increases in IL-4 and IL-10 levels. SOFA scores decreased on Day 5 and Day 7 compared with baseline in the taVNS group. However, no changes were found in sham stimulation group. The changes of cytokine from Day 7 to Day 1 were greater with taVNS than sham stimulation. No differences in the APACHE Ⅱ score and SOFA score were observed between the two groups.
TaVNS resulted in significantly lower serum pro-inflammatory cytokines and higher serum anti-inflammatory cytokines in sepsis patients.
研究表明,迷走神经介导的炎症反射可抑制脓毒症动物体内细胞因子的产生和炎症反应。
本研究旨在探讨经皮耳迷走神经刺激(taVNS)对脓毒症患者炎症及疾病严重程度的疗效。
进行一项随机、双盲、假刺激对照的前瞻性研究。20例脓毒症患者被随机分配,连续5天接受taVNS或假刺激。在基线、第3天、第5天和第7天,通过血清细胞因子水平、急性生理与慢性健康状况评分系统(APACHE)Ⅱ评分及序贯器官衰竭评估(SOFA)评分评估刺激效果。
研究人群对taVNS耐受性良好。接受taVNS的患者血清肿瘤坏死因子-α(TNF-α)和白细胞介素-1β(IL-1β)水平显著降低,白细胞介素-4(IL-4)和白细胞介素-10(IL-10)水平升高。与基线相比,taVNS组第5天和第7天的SOFA评分降低。然而,假刺激组未发现变化。taVNS组第7天至第1天细胞因子的变化大于假刺激组。两组之间的APACHEⅡ评分和SOFA评分没有差异。
taVNS可使脓毒症患者血清促炎细胞因子显著降低,抗炎细胞因子升高。