MK II Rheumatologie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Germany.
Z Rheumatol. 2024 Feb;83(Suppl 1):1-7. doi: 10.1007/s00393-023-01398-3. Epub 2023 Aug 19.
Modulation of the parasympathetic tone leads to extensive physiological reactions at several levels, including the decreased production of proinflammatory cytokines. Many studies have demonstrated that chronic inflammatory diseases are associated with reduced parasympathetic and increased sympathetic activities. Moreover, it was demonstrated that a low parasympathetic and a high sympathetic activity in patients with rheumatoid arthritis (RA) predicts a poor therapeutic response to anti-tumor necrosis factor (TNF) treatment compared to RA patients with a more balanced autonomic nervous system. The autonomic equilibrium could be restored by electrical stimulation of the vagus nerve. Considering the patients who do not sufficiently respond to the available drugs, patients for whom the effectiveness of the drugs wanes over time, or have drug-related adverse events, a nonpharmacological approach such as bioelectronics might be a useful supplement as an instrument in the successful extension of the therapeutic armamentarium for rheumatic diseases; however, there is a great need for further studies and the development of novel therapeutic strategies in the field of neuroimmunology.
副交感神经活动的调节会导致多个层面的广泛生理反应，包括促炎细胞因子生成减少。许多研究表明，慢性炎症性疾病与副交感神经活性降低和交感神经活性增加有关。此外，研究还表明，类风湿关节炎 (RA) 患者的副交感神经活性低、交感神经活性高，预示着他们对抗肿瘤坏死因子 (TNF) 治疗的反应较差，而自主神经系统更为平衡的 RA 患者则反应较好。迷走神经电刺激可以恢复自主神经平衡。对于那些对现有药物反应不足、药物随时间推移效果减弱或有药物相关不良反应的患者，生物电子学等非药物方法可能是一种有用的补充，作为成功扩展风湿性疾病治疗手段的工具；然而，神经免疫学领域还需要进一步研究和开发新的治疗策略。
