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探索电神经调节作为炎症性肠病的一种替代治疗方法。

Exploring Electrical Neuromodulation as an Alternative Therapeutic Approach in Inflammatory Bowel Diseases.

机构信息

Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.

Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH 44109, USA.

出版信息

Medicina (Kaunas). 2024 Apr 27;60(5):729. doi: 10.3390/medicina60050729.


DOI:10.3390/medicina60050729
PMID:38792911
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11123282/
Abstract

: This review systematically evaluates the potential of electrical neuromodulation techniques-vagus nerve stimulation (VNS), sacral nerve stimulation (SNS), and tibial nerve stimulation (TNS)-as alternative treatments for inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's Disease (CD). It aims to synthesize current evidence on the efficacy and safety of these modalities, addressing the significant burden of IBD on patient quality of life and the limitations of existing pharmacological therapies. : We conducted a comprehensive analysis of studies from PubMed, focusing on research published between 1978 and 2024. The review included animal models and clinical trials investigating the mechanisms, effectiveness, and safety of VNS, SNS, and TNS in IBD management. Special attention was given to the modulation of inflammatory responses and its impact on gastrointestinal motility and functional gastrointestinal disorders associated with IBD. : Preliminary findings suggest that VNS, SNS, and TNS can significantly reduce inflammatory markers and improve symptoms in IBD patients. These techniques also show potential in treating related gastrointestinal disorders during IBD remission phases. However, the specific mechanisms underlying these benefits remain to be fully elucidated, and there is considerable variability in treatment parameters. : Electrical neuromodulation holds promise as a novel therapeutic avenue for IBD, offering an alternative to patients who do not respond to traditional treatments or experience adverse effects. The review highlights the need for further rigorous studies to optimize stimulation parameters, understand long-term outcomes, and integrate neuromodulation effectively into IBD treatment protocols.

摘要

这篇综述系统评估了电神经调节技术——迷走神经刺激(VNS)、骶神经刺激(SNS)和胫神经刺激(TNS)——作为炎症性肠病(IBD),包括溃疡性结肠炎(UC)和克罗恩病(CD)的替代治疗方法的潜力。它旨在综合这些方法的疗效和安全性的现有证据,解决 IBD 给患者生活质量带来的巨大负担和现有药物治疗的局限性。

我们对来自 PubMed 的研究进行了全面分析,重点关注 1978 年至 2024 年期间发表的研究。该综述包括研究迷走神经、骶神经和胫神经刺激在 IBD 管理中的机制、有效性和安全性的动物模型和临床试验。特别关注炎症反应的调节及其对胃肠道动力和与 IBD 相关的功能性胃肠疾病的影响。

初步研究结果表明,VNS、SNS 和 TNS 可显著降低 IBD 患者的炎症标志物并改善症状。这些技术在治疗 IBD 缓解期相关的胃肠道疾病方面也显示出潜力。然而,这些益处的具体机制仍有待充分阐明,并且治疗参数存在相当大的差异。

电神经调节作为 IBD 的一种新的治疗途径具有前景,为对传统治疗方法无反应或出现不良反应的患者提供了一种选择。该综述强调需要进一步进行严格的研究,以优化刺激参数、了解长期结果并将神经调节有效地整合到 IBD 治疗方案中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82f0/11123282/009bb392f3af/medicina-60-00729-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82f0/11123282/009bb392f3af/medicina-60-00729-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82f0/11123282/009bb392f3af/medicina-60-00729-g001.jpg

相似文献

[1]
Exploring Electrical Neuromodulation as an Alternative Therapeutic Approach in Inflammatory Bowel Diseases.

Medicina (Kaunas). 2024-4-27

[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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Cochrane Database Syst Rev. 2021-4-19

[8]
Sacral nerve stimulation for faecal incontinence and constipation in adults.

Cochrane Database Syst Rev. 2015-8-24

[9]
Faecal calprotectin testing for differentiating amongst inflammatory and non-inflammatory bowel diseases: systematic review and economic evaluation.

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[10]
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Cochrane Database Syst Rev. 2022-7-14

本文引用的文献

[1]
Chronic Sacral Nerve Stimulation Inhibits Visceral Hypersensitivity in Diarrhea-Predominant Irritable Bowel Syndrome Rats Model.

Neuromodulation. 2024-2

[2]
Transcutaneous auricular vagus nerve stimulation attenuates inflammatory bowel disease in children: a proof-of-concept clinical trial.

Bioelectron Med. 2023-10-18

[3]
Neuroimmune Modulation Through Vagus Nerve Stimulation Reduces Inflammatory Activity in Crohn's Disease Patients: A Prospective Open-label Study.

J Crohns Colitis. 2023-12-30

[4]
The enteric nervous system relays psychological stress to intestinal inflammation.

Cell. 2023-6-22

[5]
The Gut-Immune-Brain Axis: An Important Route for Neuropsychiatric Morbidity in Inflammatory Bowel Disease.

Int J Mol Sci. 2022-9-21

[6]
Anti-inflammatory effects of vagal nerve stimulation with a special attention to intestinal barrier dysfunction.

Neurogastroenterol Motil. 2022-10

[7]
Global Hospitalization Trends for Crohn's Disease and Ulcerative Colitis in the 21st Century: A Systematic Review With Temporal Analyses.

Clin Gastroenterol Hepatol. 2023-8

[8]
Chronic Experimental Model of TNBS-Induced Colitis to Study Inflammatory Bowel Disease.

Int J Mol Sci. 2022-4-25

[9]
The Lesson from the First Italian Lockdown: Impacts on Anxiety and Depressive Symptoms and Sleep Quality in Patients with Remission of Inflammatory Bowel Disease.

Rev Recent Clin Trials. 2022

[10]
The Interplay between Autonomic Nervous System and Inflammation across Systemic Autoimmune Diseases.

Int J Mol Sci. 2022-2-23

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